Reconstructing cerebral palsy

Forty years ago, a consensual definition of the cerebral palsy concept was suggested, delineating it as a disorder of movement and posture secondary to non-progressive pathological processes that affect the immature brain. Because this concept is pragmatic and based on function, it has survived unaltered many changes in pathophysiolgical knowledge, diagnostic technology and general nosology. However, its basis has appeared to be flawed. Its main justification remains management, for which the need to meticulously select patients, define adapted objectives, design appropriate management programs and evaluate results has been increasingly recognized. Fine movement analysis using recent technologies can provide a wealth of information about neurological functioning in cerebral palsy that can serve these purposes. Specific patterns of motor organization reveal different modes of motor control in individuals with developmental motor problems. The different motor patterns reflect individual adaptation to the impairment of the central nervous system. Taken phenomenologically these patterns can contribute to the clinical approach to cerebral palsy and redefine patients groups within this framework. © 2004, IOS Press. All rights reserved.