Abstract
Objective Argument for complete diagnosis and separating by aetiology.
Cerebral Palsy (CP) has been an umbrella term capturing persons with motor development problems traceable to prenatal and perinatal insults to neurodevelopment. Apt arguments are made for ‘splitting’ and ‘lumping’ diagnostic labels in CP.
A 46 y/o female with Congenital Rubella Syndrome (CRS) presented, post head-strike, with imaging that revealed a prenatal right parietal infarct, and colpocephaly. She exhibited a smaller, spastic, right upper limb, bilateral congenital deafness, different partial colour to the right iris. She had intellectual impairment.
She fulfilled the criteria for monoplegic CP.
As new details of neurodevelopmental processes emerge, the original concept of CP (1843, Little; Osler; Freud), with minor modifications since that time, warrants close reflection. Arguments by ‘lumpers’ seek to continue current practices for surety of surveillance, rehabilitative, prognostic and financial equipoise purposes: this merits review. Modern-day diagnoses by genetics aid reproductive plans; rehabilitation via virtual therapies relying on vision and hearing; artificial limbs, robotics and the application of nanotechnology for monitoring and mobility purposes – have altered the landscape in which modern CP is contextualized.
Conclusion CP is multi-dimensional: so many trajectories can now be clearly specified, quantified and ameliorated. There are cogent arguments for specifying causes as far as possible (‘splitting’), with specific interventions for each aetiology (including financial), naturally flowing.
