Genetic mimics of cerebral palsy

Mov Disord. 2019 May;34(5):625-636. doi: 10.1002/mds.27655. Epub 2019 Mar 26.

Abstract

The term "cerebral palsy mimic" is used to describe a number of neurogenetic disorders that may present with motor symptoms in early childhood, resulting in a misdiagnosis of cerebral palsy. Cerebral palsy describes a heterogeneous group of neurodevelopmental disorders characterized by onset in infancy or early childhood of motor symptoms (including hypotonia, spasticity, dystonia, and chorea), often accompanied by developmental delay. The primary etiology of a cerebral palsy syndrome should always be identified if possible. This is particularly important in the case of genetic or metabolic disorders that have specific disease-modifying treatment. In this article, we discuss clinical features that should alert the clinician to the possibility of a cerebral palsy mimic, provide a practical framework for selecting and interpreting neuroimaging, biochemical, and genetic investigations, and highlight selected conditions that may present with predominant spasticity, dystonia/chorea, and ataxia. Making a precise diagnosis of a genetic disorder has important implications for treatment, and for advising the family regarding prognosis and genetic counseling. © 2019 International Parkinson and Movement Disorder Society.

Keywords: ataxia; cerebral palsy; dystonia; inborn errors of metabolism; spasticity.

Publication types

  • Review

MeSH terms

  • Adenylyl Cyclases / genetics
  • Ataxia / physiopathology
  • Ataxia Telangiectasia / diagnosis
  • Ataxia Telangiectasia / genetics
  • Ataxia Telangiectasia / physiopathology
  • Ataxia Telangiectasia / therapy
  • Brain / diagnostic imaging
  • Brain Diseases, Metabolic, Inborn / diagnosis
  • Brain Diseases, Metabolic, Inborn / genetics
  • Brain Diseases, Metabolic, Inborn / physiopathology
  • Brain Diseases, Metabolic, Inborn / therapy
  • Carbohydrate Metabolism, Inborn Errors / diagnosis
  • Carbohydrate Metabolism, Inborn Errors / genetics
  • Carbohydrate Metabolism, Inborn Errors / physiopathology
  • Carbohydrate Metabolism, Inborn Errors / therapy
  • Cerebral Palsy / diagnosis*
  • Cerebral Palsy / physiopathology
  • Chorea / physiopathology
  • Creatine / deficiency
  • Creatine / genetics
  • Diagnosis, Differential*
  • Dyskinesias / diagnosis
  • Dyskinesias / genetics
  • Dyskinesias / physiopathology
  • Dyskinesias / therapy
  • Dystonia / physiopathology
  • Folic Acid Deficiency / diagnosis
  • Folic Acid Deficiency / genetics
  • Folic Acid Deficiency / physiopathology
  • Folic Acid Deficiency / therapy
  • GTP-Binding Protein alpha Subunits, Gi-Go / genetics
  • Humans
  • Hyperargininemia / diagnosis
  • Hyperargininemia / genetics
  • Hyperargininemia / physiopathology
  • Hyperargininemia / therapy
  • Lesch-Nyhan Syndrome / diagnosis
  • Lesch-Nyhan Syndrome / genetics
  • Lesch-Nyhan Syndrome / physiopathology
  • Lesch-Nyhan Syndrome / therapy
  • Magnetic Resonance Imaging
  • Mental Retardation, X-Linked / diagnosis
  • Mental Retardation, X-Linked / genetics
  • Mental Retardation, X-Linked / physiopathology
  • Mental Retardation, X-Linked / therapy
  • Monosaccharide Transport Proteins / deficiency
  • Monosaccharide Transport Proteins / genetics
  • Movement Disorders / diagnosis*
  • Movement Disorders / genetics
  • Movement Disorders / physiopathology
  • Movement Disorders / therapy
  • Multiple Carboxylase Deficiency / diagnosis
  • Multiple Carboxylase Deficiency / genetics
  • Multiple Carboxylase Deficiency / physiopathology
  • Multiple Carboxylase Deficiency / therapy
  • Muscle Spasticity / physiopathology
  • Pelizaeus-Merzbacher Disease / diagnosis
  • Pelizaeus-Merzbacher Disease / genetics
  • Pelizaeus-Merzbacher Disease / physiopathology
  • Pelizaeus-Merzbacher Disease / therapy
  • Plasma Membrane Neurotransmitter Transport Proteins / deficiency
  • Plasma Membrane Neurotransmitter Transport Proteins / genetics
  • Spastic Paraplegia, Hereditary / diagnosis
  • Spastic Paraplegia, Hereditary / genetics
  • Spastic Paraplegia, Hereditary / physiopathology
  • Spastic Paraplegia, Hereditary / therapy
  • Thyroid Nuclear Factor 1 / genetics

Substances

  • GNAO1 protein, human
  • Monosaccharide Transport Proteins
  • NKX2-1 protein, human
  • Plasma Membrane Neurotransmitter Transport Proteins
  • Thyroid Nuclear Factor 1
  • GTP-Binding Protein alpha Subunits, Gi-Go
  • Adenylyl Cyclases
  • adenylyl cyclase type V
  • Creatine

Supplementary concepts

  • Creatine deficiency, X-linked
  • Glut1 Deficiency Syndrome