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Saturday, May 18, 2013
Hello,My daughter is 2yrs 9 months old.She has been diagnosed with mild spastic diplegia.She walks with her heels slightly above the ground,but stands with her heels on ground.she is not very stable and seems to walk in a hurry.Her other developments are normal, she talks,can even narrate stories,learns anything easily, knows colors,shapes,alphabets. She is on physical therapy and braces for walking, though it is tough to keep her in braces all the time but atleast 6 hrs during the day we do keep her in braces. My query is that what shud we expect in future,will she be fine once her height development is over, can she climb stairs,and will her improvement be very slow.Can she go to a normal school, will her stability improve? I request you to please reply to my queries, I am really desperate for the answers.I will really be very thankful.
If she has spasticity present and has not lost any developmental milestones once gained, most likely she has a mild version of cerebral palsy. Some physicians are reluctant to "label" children with a diagnosis of cerebral palsy and use descriptive term like spastic diplegia or static encephalopathy instead. Irrespective of her diagnosis, she may need other intervention to address her tight heel cords in future (Pediatric Rehabilitation and Orthopedics, and possibly Neurology there is a need to further pursue a diagnosis). If she was premature and had any kind of intracranial hemorrhage on ultrasound that would probably clinch the CP diagnosis. In addition, an MRI could be done looking for paraventricular leukomalacia which would be the finding left from the initial hemorrhage, however, if very mild case could look normal. She might be at risk for some mild cognitive deficits as well, which we usually address with Neuropsychiatric testing around the age of 5. It sounds like she is doing well, but we would typically recommend being followed by Pediatric Rehabilitation or Pediatric Neurology (possibly Developmental Pediatrics if there is no access to Rehabilitation or Neurology) to help family with future planning and monitor her progress.
Answered with: Douglas G. Kinnett, MD, Associate Professor of Clinical Physical Medicine, Rehabilitation and Clinical Pediatrics
Michael Spigarelli, MD, PhD
Formerly, Associate Professor of Pediatrics and Internal Medicine
College of Medicine
University of Cincinnati