What Other Diagnoses Are Similar to Cerebral Palsy?

Because of the many origins of cerebral palsy it can be confused with other distinct diagnoses. It is
especially important to consider other potentially treatable causes. Distinguishing features of these “other”
diagnoses often includes the history there is an absence of difficulties at or around the time of birth that can
account for the developmental motor and associated abnormalities. Additionally, the progressive impairment
is not simply a change over time in the existing motor problems e.g. due to contracture formation. It is
instead a distinctive deterioration in the patient with changes in one or more of the following: movement
disorder, intellectual ability, and increase in tone.
One of the diagnoses that should be take into account is a progressive movement disorder called Dopa
responsive dystonia (DYT5). This rare genetic disorder that occurs due to a metabolic problem with the
enzyme that converts normal products into an important neurochemical called DOPA. This results in a
progressive increase in tone and physical limitations that resemble cerebral palsy. These patients are
classically of normal intelligence in spite of progressive and severe spasticity or dystonia. A large number of
these individuals also have variation in their tone during the day. Important is the responsiveness to
therapy. These children and adults often respond to very low dose DOPA supplement and have significant
improvement in their symptoms.
Another genetic disorder that is confused early in the course of the disorder is Glutaric aciduria type 1. The
distinguishing feature is the progression of the movement disorder where the child demonstrates significant
chorea (rapid random movements). Also imaging of the brain reveals a distinctive pattern of abnormalities
in the temporal area. While reversal of the symptoms is not anticipated the people do need to have specific
interventions to attempt to stop the progression.
Instability of the spinal column is also an important consideration. This possibility should be strongly
considered if an individual has progressive spasticity, deterioration of motor function, sensory changes, and
progressive bowel and bladder abnormalities. The spinal cord can be injured directly by the increased movement of the boney vertebra. This may be as high as the cervical area or at any point along the spine.
Intervention to stabilize the spine is critical to stop the progression. Reversal of the new neurological finding
is frequently not possible but again the intervention may stop the deterioration.