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Spastic diplegic cerebral palsy — RACP Paediatrics MCQ

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ModerateNeurology and neurodevelopmentSpastic diplegic cerebral palsyRACP Paediatrics

A 2-year-old born at 28 weeks has increased tone in both legs, brisk reflexes and scissoring when held upright. Upper limb function is relatively preserved and cranial ultrasound in infancy showed periventricular white matter injury. What is the most likely diagnosis?

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Correct answer: D — Spastic diplegic cerebral palsy

Prematurity with periventricular leukomalacia classically causes spastic diplegic cerebral palsy, with leg-predominant upper motor neurone signs. Duchenne causes proximal weakness rather than spasticity and brisk reflexes. The pearl is that early detection allows physiotherapy, hip surveillance and developmental support before contractures emerge.

Reference: RCH Clinical Practice Guidelines; Australian Cerebral Palsy Register resources