CP Diagnosis with normal MRIs???

Does anyone out there have a child who was diagnosed with CP, yet have had normal brain and spine MRIs? My son has had both a brain and spinal MRI with no damage shown on either one. However, he clinically presents some symtoms of spastic diplegia, so we were given a preliminary diagnosis of spastic diplegia. Does this mean that if there is no damage evident on the MRI that it is most likely "mild"? Any info is appreciated.. THanks so much.

Report post

15 replies. Join the discussion

hello jakersmom, my daughter's story is similar.she is 3 1/2 yrs with mild ataxia.her MRI is normal but she is diagnosed with ataxic cerebral palsy.it so happens tht in many cases there could be very very minute problem and the mri is normal.there is another scan they do these days its called SPECT scan.i am told in tht u can see the damage but not sure as we hvnt done it.dnt really worry abt the scan as i knw as mothers we do feel probably there is hope just keep doing the phsiotherapy needed for the kid.

Report post

My son's MRI from when he was about 10 mo showed "no evidence of damage or stroke." But he certainly has CP-like symptoms. We are going to a neurologist in July and hope to learn more. He does have an underlying genetic issue (mitochondrial disorder) and I'm told that may be the reason for some of his symptoms, but then again, he may just have more than one clear issue. One of the discussions on this site (I can't remember which one) mentioned something about MRI's with obvious damage where kids have no symptoms and MRI's with pinpoint sized damage and multiple symptoms. The brain is very mysterious...

Report post

Thanks for your replies....I am always looking to see if there is anything out there that I may have missed since he has a normal brain scan. I will have to inquire about the SPECT scan...I haven't heard of that before now. I definately will keep doing his PT...and you are right, momjax, the brain is very mysterious.

Report post

I would definitely recommend asking the neurologist about any genetics consult if the cause for the symptoms is not apparent. It's good to check with more than one specialist since there are so many things that can affect a child's condition.

Report post

Thanks Melady...We did go for a genetics consult and there were no "red flags" that would call for any genetic testing at this point....In fact, the doctor said that she wouldn't even know where to begin since there wasn't anything calling out to her. At this point, we have been to a geneticist, a hematologist, the neuro, and also had an ECHO done....so far everything (tests, X rays, etc) have all come back normal. Which is great, but puzzling at the same time. Thanks for your response and suggestion.

Report post

The good thing by having those assesments is looking for something that can provide additional intervention, such as a mitochondrial issue or a neuromuscular transmission issue, or to identify something that demonstrates a degenerative process. If the end result is your kid has cp, at least it is not going to get worse and whatever the cause, your kid can respond to therapy and hopefully continue imporvement. My little girl has probably some genetic componenet, so we can't say we know the cause, but at least it is not expected to get worse.

Report post

Hi! I want to introduce myself. My name is Sarah and I am the mother of a sweet two year old boy who was diagnosed with mild spastic diplegia in october 2009. My son was born at 30 weeks gestation with minimal complications in NICU. He had no brain bleeds, no major infections, and was only on a resperator for less then 24 hours. He was on nasal canula for five days. His lungs were and still are healthy. I started noticing symtoms of CP when he was 6 months of age. His ankels were tight. By 12 months he wasn't sitting up unsupported or crawling. He started physical therapy and learned how to pull to a stand, cruise, crawl, and get into a sitting position. By August 2009 he was still very spastic in his hips, ankels, and a very mild touch in his arms. He had an MRI done which came back "normal". At his appointment in October the nuerologist told us that it is probably mild spastic diplegia cerebral palsy. He also mentioned a possibility of muscular dystrophy but said that it was highly unlikely. We took our son to a geneticist who ruled out our fears and offered a very high definition chromesone test so we could close the possibility of MD. We got the results and the test came back normal..(which was no suprise to the doctor) but it gave us peace of mind. My son isn't mild by all definitions but he is begining to take steps without any assitance. He uses a walker to get around but I just don't think he will need it for too long.

Report post

My sweet 2 mos old son is still being tested (genetically now), but they are guessing a mild cp also. MRI normal also. I just don't understand the diagnosis...is it something that is given after all other disgnosis don't fit. My sons walks, but on his tippy toes, and he has overall delay especially with speech. He got his AFO's and he started bringing his foot down. I guess dignosis is given when the symptoms are there, yet the actual reasons can't be explained??? I'm confused...

Report post

Yes, qtodie....it is confusing. From what we were told by our doctors, a child does not have to have damage evident on a scan or a MRI to be diagnosed with CP because CP is by definition any type of movement disorder. Still doesn't make sense though.....I would think that the smaller the damage (or none for that matter) the smaller (or milder) the case....although my son is not yet walking! I would think that if it is affecting him that much that I would be able to see something on his MRI. I just hope and pray that he will continue to progress, moving one day toward independent ambulation! Best of luck to you and your little one!

Report post

Our neruo told me that sometimes babies can have such slight damage that it will not show up and he said that he has seen babies that have about the size of a pin head of damage be so severe they need breathing machines. Ofcourse, this was after our grade VI grade bleed on the left side so he was trying to tell me that babies who have damage all over the brain can be "normal" and not to be our faith in a MRI

Report post

Hi my son is spastic diplegic with no MRI damage visible. Our neurologist says about half CP kids he sees have normal MRIs. And my son is definately not mild.?

Report post

My mom has told this story so many times I know it by heart. She first started noticing signs in me at 6 months. My left hand was clenched. The orginally told her I wasn't getting enough "floor time." I was finally diagnosed at 10-11 months of age. The Dr that diagnosed me used such big words my mom didn't understand or wait for my dad to come in from parking the car either. My mom was literally in tears when dad got there. She finally asked the PT what I had in plain terms-that someone like her could understand. He told her I may never walk or talk.

They figured that my CP happened before birth. I have Spastic Tripelgia CP. The Orthopedist that did my leg braces over corrected my right leg w/o CP and under corrected my left leg with CP. My left arm is also affected.

I have had MRIs, CAT Scans and EEGs. The MRIs are all normal.

Report post

Hi,

My 19-month old daughter had normal MRI's, EEG, EKG, and most blood work came back normal as well. Our neurologist told us she didn't have CP, but after a lengthy process we switched to a Physical Medicine and Rehab doctor who diagnosed her with Spastic Diplegia one month ago. My daughter had genetic testing done and she does have 2 deletions and a premutation for Fragile X syndrome. We are at a loss with her, in some senses, in that she has failure to thrive with no real answers as to why she is not gaining weight. She is a twin and her twin weighs 5-6 lbs more than her. We are also noticing sensory issues, as well as speech delays.

The Physical Medicine and Rehab doctor just did spine and hip x-rays on my daughter. He was hoping to get more answers from those.

My daughter does not crawl in a four point and she cannot walk. She just started pulling to stand 2 weeks ago and she is able to take 3-4 steps along furniture. She is getting solid AFO's next week.

-Rebecca

Report post

@ jakersmom, the symptoms you describe sound like classic CP to me. Unfortunatley, many people never find out what caused their child's CP. there are also many kids who have genetic/chromosome problems, and their symptoms are so like CP that that is the only diagnosis they end up with. I suspect that with us understanding so little about the brain, that, just like autism, there are causes for Cp that we just cannot see. All you need for CP is something to disrupt the part of the brain that controls motor function. I guess if that happens when you're a baby, all your brain is motor function, as you have not learned much else. TBI in babies and adults seem so different, as you hear many more stories of adults (who's brains have had the chance to develop normally) suffering a brain injury of some type, and either being left with some little quirk, or recovering fully. I guess this is because the brain has developed so much more,so many more connections have been made, that, just like a road block in New York City, there are plenty of other ways to get the message across. Whereas in a baby, that network does not yet exist to that extent, so damage, even minute, causes so many more problems. If you think about it, we all know that the more enriched a baby's and toddler's lives are, the better their brains will be. They will learn faster, and cope with more situations etc. I guess the exact opposite applies when part of the brain is damaged. That small part of the brain being damaged blocks these babies from doing so much which would normally have been the foundation blocks to all that they would learn. For example, a child not being able to eat will lead to disfunctions in speech, and potentially then developmental delay. An inability to grasp an object and see and taste it as a baby will mean their vision does not develop as normal, they will not understand the world around them and objects as well if they have not mouthed them. Hmmm, a few potentially interesting studies there!

Report post

Just to add, from an MD:
the MRI is a look at the structure of the brain; CP is a problem with the complex and coordinated FUNCTION of the brain. If the functional disruption is caused by a structural problem, the MRI will likely show it, but no one should be surprised that many (probably most) CP kids have normal MRI's. And no one should assume that a normal MRI means it must be mild motor impairment. They do not correlate.

Report post

This discussion is closed to replies. We close all discussions after 90 days.

If there's something you'd like to discuss, click below to start a new discussion.

Things you can do

Discussion topics

Community leaders