Interest of neuromotor assessment in early screening of children at high risk for cerebral palsy within a specialized network

Objective To identify clinical and laboratory signs of early screening of cerebral palsy in order to propose an early management of children. Methods Prospective study including 100 newborns with risk factors for CP (relying on gestational age, birth weight, perinatal and neonatal brain injuries). The screening was conducted during a medical consultation by a specialist and was based on clinical setting (neurological examination and neuromotor assessment) and radiological examination (cranial ultrasound, magnetic resonance imaging). The clinical assessment was performed at the 1st, 4th, 9th, 12th, 18th, 24th months and at 5 years after selection of patients. Results The different clinical factors were weak predictors of becoming during the first month of life. At 4 months, the factors correlated with the evolution to cerebral palsy were: the decrease of lower limbs’ spontaneous movements and the lower limb fixed in extension at suspension maneuvers ( P P P P P P P P  = 0.004) and the Babinski sign ( P P Discussion Neurological examination focusing on reflexes and muscle tone is poorly predictive in the first months of life. Neuromotor assessment with the study of spontaneous movements may reflect functional limitations in the first months of life and have been shown to predict later CP. However, the distinction between CP and TMA remains difficult and requires a long follow-up.