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Spastic diplegic cerebral palsy — MRCPCH FOP MCQ

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HardNeurology and neurodevelopmentSpastic diplegic cerebral palsyMRCPCH FOP

A 2-year-old boy born at 28 weeks walks on his toes with scissoring of the legs. He has brisk knee reflexes, normal head circumference and delayed gross motor milestones. What is the most likely diagnosis?

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Correct answer: D — Spastic diplegic cerebral palsy

Prematurity with symmetrical lower-limb spasticity, scissoring and brisk reflexes is typical of spastic diplegic cerebral palsy. Duchenne muscular dystrophy causes proximal weakness and reduced reflexes rather than spasticity. Guillain-Barré syndrome is acute with areflexia. The pearl is that cerebral palsy describes a motor phenotype, not a single cause.

Reference: NICE NG62 Cerebral palsy in under 25s