Differential Diagnosis for Cerebral Palsy with Unilateral Limb Involvement
Single Most Likely Diagnosis
- Hemiplegic Cerebral Palsy: This is the most common form of cerebral palsy that affects one side of the body, resulting in weakness or paralysis of the arm and leg on the same side. It often leads to gait abnormalities due to the asymmetrical involvement of the limbs.
Other Likely Diagnoses
- Stroke or Perinatal Arterial Ischemic Stroke: Although less common, a stroke in the perinatal period can cause unilateral cerebral damage, leading to hemiparesis (weakness on one side of the body) and gait disturbances similar to those seen in cerebral palsy.
- Brain Malformations (e.g., Hemimegalencephaly): Conditions where one half of the brain is malformed or larger than the other can lead to significant motor impairments on the contralateral side of the body, affecting gait.
Do Not Miss Diagnoses
- Tumors (e.g., Brainstem or Cerebral Hemispheric Tumors): Although rare, tumors can cause focal neurological deficits, including hemiparesis and gait disturbances. Early detection is crucial for treatment and prognosis.
- Infectious or Inflammatory Conditions (e.g., Encephalitis, Meningitis): Certain infections can cause localized brain damage leading to unilateral motor deficits. Prompt diagnosis and treatment are essential to prevent long-term sequelae.
- Vascular Malformations (e.g., Arteriovenous Malformations): These can cause focal neurological deficits, including hemiparesis, due to hemorrhage or mass effect. They require urgent medical attention.
Rare Diagnoses
- Rasmussen's Encephalitis: A rare inflammatory neurological disease, characterized by frequent and severe seizures, loss of motor skills, and eventual hemiparesis. It typically affects one half of the brain.
- Sturge-Weber Syndrome: A disorder that affects the development of certain blood vessels, leading to abnormalities in the brain, skin, and eyes. It can cause hemiparesis and other neurological symptoms due to the leptomeningeal angioma.
- Linear Scleroderma "en coup de sabre": A rare form of scleroderma that can cause hemifacial atrophy and, in some cases, neurological symptoms including hemiparesis due to the involvement of the underlying brain tissue.