The classification of cerebral palsy (CP) remains a challenge; hence the presence of so many classifications and a lack of consensus. Each classification used alone is incomplete. Therefore, a multiaxial classification gives a more comprehensive description of a child with CP. The recent WHO International Classification of Functioning, Disability and Health (ICF) emphasizes the importance of focusing on the functional consequences of various states of health and has stimulated the development of newer functional scales in CP. It is widely accepted that the functional classification is the best classification for the patient because it guides management. The objectives of this chapter are to review the various classifications of CP, to highlight the clinical features used in the various classifications, to outline the recent functional classifications of CP and to highlight how these recent classifications guide current management. It is expected that at the end of this chapter, the reader should be able to understand the difficulties in classifying CP, enumerate and discuss the various classifications of CP, understand the merits and shortcomings of each classification scheme, clinically evaluate and classify a child with CP multiaxially and understand how functional scales predict current and future needs of children with CP.
Part of the book: Cerebral Palsy
The accurate identification of the actual causes (aetiology) of cerebral palsy (CP) and understanding the causal pathways and the neuropathological correlations are critical to the development of both prevention strategies and a holistic classification of CP. The aetiology of CP is multifactorial with diverse and complex causal mechanisms. It has remained a challenge to identify all the non-progressive disturbances and causal pathways in CP despite pivotal contributions from recent advances in neuroimaging. The objectives of this chapter are to discuss the risk factors for CP, elucidate the causal pathways based on current perspectives and explain the pathophysiology of the clinical manifestations of an abnormally developing or damaged motor system. It is expected that at the end of this chapter, the reader should be able to comprehend the challenge in accurately identifying the actual causes of CP and understanding the complex causal pathways and explain the protean clinical features of CP.
Part of the book: Cerebral Palsy - Updates