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3 Years Old Having Developmental Delay And Cerebral Palsy. Which Specialist Should I Consult?

Posted on Mon, 10 Dec 2012

Question: I have a 3 year old son born of full term normal delivery, he is developmentally delayed.We started physio and speech therapy from 2 and his muscle tone and strength has improved, though he is still little unsteady.iam showing him to Dr. XXXXXXX Aroor in Bangalore,during his last checkup he stopped all medications (he was taking some calcium supplements) asked us to do only home physio as he has improved a lot.he is still non verbal, says only 2/3 words but is social and comprehension is good. his doc said he didnt suspect CP (he has a clean MRI), his speech therapist and audiologist at the centre said he has flacid cerebral palsy for sure.What should i do now? where to consult what to do? we r based in bangalore.His hearing and vision are normal.

Answered by Dr. Rajiv K Khandelwal (8 hours later)

Hi,

Thank you for your query.

I can understand your concern. Development delay and cerebral palsy (CP) are clinical diagnosis and cannot be confirmed by MRI. It is good that the hearing and vision are normal. As your son has been worked up and is undergoing physiotherapy and speech therapy, you are providing the appropriate management for him. Medicines have not been shown to improve the development delay and CP.

Regarding your doubt about CP and your wish to have another opinion I suggest you can consult at National Institute of Mental Health and Neuroscience (NIMHANS) in Bangalore. It is a premier institute and you shall get the best opinion.

I hope I have answered your query to your satisfaction. Please feel free to revert back for any clarifications or if you would like to share any other fact regarding the case.

Wishing you and your son all the best.

Regards,

RKK

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rajiv K Khandelwal (1 hour later)

I am willing to show him in Nimhans , but does he need to undergo any tests further?I have asked the padeatric neuro about a diagnosis and he has ruled out CP.he doesnt show any symptoms of Severe CP, But mild CP as it is difficult to daignose maybe,does patients with mild CP lead a normal life?CP indicates brain damage y doesnt that show up in structural mri?

Answered by Dr. Rajiv K Khandelwal (49 minutes later)

Hi,

Thank you for the query.

CP has to do with neurological function and does not necessarily corroborate with structural anomalies. Every investigation has its limitiations and we should not forget that clinical examination will remain the mainstay of diagnosis of CP.

You mentioned that that at the audiology centre they were suspecting flaccid paralysis. According to you physiotherapy has improved the tone and strength in the muscles.

Your son does not require any specific investigations but a thorough follow-up to see the development progress.

Regarding your query about leading a normal life, I can only state that positive, stimulating intervention will go a long way in helping your son to integrate in social, academic life. As development is an ongoing process no one can predict the final outcome.

I hope I have provided satisfying answers to your queries.

Regards,

RKK

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar