Monitoring
Long-term monitoring depends on the severity of CP.
Patients with a gross motor function classification system (GMFCS) level of I or II need less monitoring, those with level III should be monitored at least every other year during active growth, and those with level IV or V need assessment at least every year during active growth (and possibly into adulthood if they have communication difficulties, learning disabilities, or multiple comorbidities).[106]
Patients are monitored in multidisciplinary clinics to allow assessment of the hips and spine; to check for general health issues, psychosocial functioning, and need for anti-spasticity medications; and to detect any changes in the underlying neurological condition.
All children should have serial height, weight, and head circumference measured on age- and sex-specific growth charts. Starting at age 3 years and depending on the physical findings, serial x-rays are required (e.g., hip x-rays to monitor for subluxation of hips and spinal x-rays to confirm progression in patients present with scoliosis, kyphosis, or lordosis).
Attention is paid to the need for mobility aids and wheelchair modifications and repairs, and augmentative and alternative communication systems. Medication adjustments, considerations for orthopaedic surgery, baclofen pumps, rhizotomies, and advanced neurosurgical procedures are discussed, as necessary. Patients should also be assessed for associated problems such as pain, discomfort, distress, sleep disturbance, and emotional and behavioural difficulties at every review.[20][56]
Use of this content is subject to our disclaimer