An Early Motor Pattern Profile (EMPP), consisting of 15 tests of muscle tone, reflexes, and movement, organized in a standardized format, was used to identify children with cerebral palsy (CP) in the first year of life at the University of Illinois at Chicago, College of Medicine at Peoria. The items evaluated included head lag, hip abduction, tonic neck reflex, fisting, scissoring, and toe-walking, and a three-point scoring system was applied to each item. In 1247 high-risk infants from a neonatal intensive care unit followed for 36 months, the EMPP identified children at risk for CP by 6 to 12 months of age. The optimal cutoff score of points at 6 months was 10, and at 12 months it was 4. The predictive value was approximately 90%. [1]

COMMENT. The authors emphasize that the EMPP is not a method of diagnosis, but only a step toward more formal evaluation by a pediatric neurologist. False positive and negative results are always a problem with screening procedures of this type, and their sensitivity is dependent on the skill and expertise of the examiner.

Progressive deterioration of dyskinetic cerebral palsy in adult life is reported in the majority of 20 patients examined between 20 and 40 years of age at the Institute of Neurology, London [2]. Genetic heterogeneity with autosomal recessive and dominant variants was suggested by familial cases, casting doubt on the perinatal hypoxic-ischemic etiology of this form of CP.