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OuR son is 12 now and when he was about 9 months old we took…

OuR son is 12 now...

OuR son is 12 now and when he was about 9 months old we took him to a pediatric neurologist about some issues about using both hands. The doctor asked about my pregnancy and I told him I went into prelabor at 32 weeks and they stopped my labor. I then delivered him at 40 weeks. When he was born he was blue and his body temp ws low. They gave him oxygen and got his temp up. Other than that everything was good. He said it sounded like he had a stroke. We tried doing an mri but couldn't sedate him so we never got it. The doctor said it wasn't anything g reoccurring so just start physical therapy and that was ot. We did that. At the age of 12 he is cognitively awesome but does have lack of usage of left hand and left leg is smaller in muscle tone. Walks fine but lwft foot angles in. I don't ever want to put him thru testing because he lives a basically normal life but I was wanting your thoughts. At this point in his life does he need testing really?

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Answered in 31 minutes by:
9/7/2015
Dr. Chip
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 35,162
Experience: Over 20 yrs of Family Practice
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Hi. At this point all the testing would do is show what may be the problem--the old stroke might show up but now there'd be nothing to do specifically for it other than physical therapy for his physical problems. So I personally see no reason for any further testing

Let me know if you need to discuss this further please

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Customer reply replied 2 years ago

We r wondering do you have to have a major test like that to say if a child has cp? We r trying to get a 504 for him at school. He hasn't been to the doctor in a couple of years because when he gets sick it's usually when they aren't open so he goes to the urgent care. Can his doctor or pa do a physical examination and determine that

OK. In that case a brain MRI along with nerve conduction studies and EMG's of his limbs can document the aftereffects of CP and that along with a physical exam can produce the documentation necessary for the 504

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Customer reply replied 2 years ago

I think I made that sound wrong. We have the 504. My question is can a doctor diagnose cp by a physical examination

Not specifically but with his history and physical exam it can be inferred

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Customer reply replied 2 years ago

Inferred? Not sure I understand. Can the doctor writ a letter saying he has cp or signs of a stroke or what

Well his physical disabilities along with the events during his delivery would make CP likely but without more formal documentation like the studies I mentioned, just the exam alone and the history wouldn't be enough to document CP.

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Customer reply replied 2 years ago

Would they be able to state a physical impairment at least or an orthopedic impairment

Before we go on can you clear up something for me please? It sounds like you need documentation of something here--can I ask specifically why?

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Customer reply replied 2 years ago

WWe r pretty sure we have the 504 and I don't want to put my son thru testing that isn't necessary. This is a print screen of the school system requirements. He had PT at ot at the schools as well as speech whem he was younger so they are confident they can use that. I was just curious from this of just saying he has an impairment was enough? The lack of use of left hand

OK. He's obviously physically impaired and that only takes a physician's exam to document that--he doesn't need any testing other than the exam

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Customer reply replied 2 years ago

Ok. Great! If you were the parent of this child would you get a mri or ct to know for sure if he had a stroke or whatever it was? The pediatrician neuro back then said it wasn't anything reoccurring just something we will or him have to work thru. What r your thoughts

At this point, no I wouldn't--that would only be a piece of paper with some information on it that wouldn't make any difference as goes his physical disabilities.

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Customer reply replied 2 years ago

In the future when he becomes an adult what if he began having chest pains or something crazy would it be necessary to know if he had a stroke in womb or whenever. I want to make sure we r not taking any roses by not making 100 percent sure

Customer reply replied 2 years ago

Here is the complete 504 MPS

There's absolutely no need for further testing other than a physicians physical exam then

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Customer reply replied 2 years ago

And nothing for any other future health issues? Someone mentioned if people have strokes they can't have certain meds and stuff. Only reason why u am asking about this part. Is your last response in relation o the document I sent? Just trying to make sure I'm on the same page with you

That document doesn't say any further testing is needed. As for in the future, yes there can be some problems with certain medications in a stroke victim but really just ask his doctor if the tests are really needed

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Customer reply replied 2 years ago

One last thought. When that document talked about major life activities it mentions lifting. He is obviously right handed but since he can't lift, write or have any actual usage of his left hand does that count for a limit on a major life activity (since he had a normal right hand) hope that makes sense

Yes--that is a limit. The examining doctor can give an impairment rating--the percent less that 100% that he's limited in physical activities as compared to a normal person with no disabilities

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Customer reply replied 2 years ago

So to sum it up no major expensive tests are necessary and when I take him for a check up the pa can diagnose him with a physical impairment with the symptoms of cp?

Exactly--you got it right on

Dr. Chip
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 35,162
Experience: Over 20 yrs of Family Practice
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Customer reply replied 2 years ago

Do you think at this point a mri of cervical spine is necessary either?

No, I don't

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Customer reply replied 2 years ago

If there were tumors or something wouldn't we have more complications or something by now at the age of 12

Exactly

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Customer reply replied 2 years ago

Would that show a pinched nerve or what

If the problem were a disk in his neck the MRI would show that but I think his disability if from the brain injury and not a disk problem

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Customer reply replied 2 years ago

9 month check uo evaluation. Got a a copy from pediatric neurologist when he had it. Any thoughts? Some of the lingo I'm not sure. Is he debating between pinched nerve or stroke? Is that what he is saying

Sorry--my thoughts?

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Customer reply replied 2 years ago

Is that what this report is saying the possibilities are? Pinched nerves or stroke

Just saying stroke and that's the reason for the brain MRI. He's thinking of doing the cervical MRI to look for a disk pressing on a nerve root

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Customer reply replied 2 years ago

And with his age now and the lack of usage in left arm a D hand and the curve in on left foot and smaller muscle tone in leg and arm and that means towards stroke and cp right

Right

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Customer reply replied 2 years ago

Last question. What is contralateral cerebral infarct

The right hemisphere of the brain controls movement of the left side of the body. So it takes a stroke located in the right hemisphere to affect the left arm and left leg. Contralateral means right brain/left side of body

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Customer reply replied 2 years ago

What do you think a cay scan would show on my son

If you mean of his brain, it might not show anything abnormal but there might be some indication of a previous stroke with some scarring

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Customer reply replied 2 years ago

Can ypu tell from this type of scan how big of a stroke or anything like that?

If there's scarring then the exact location of the stroke can be seen and the amount of scarring can indicate the severity of the stroke

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Customer reply replied 2 years ago

Mg sister n law does cat scans and she said she could do one on my son next weekend and it makes me cry and worry what we will find

What worries you about that?

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Customer reply replied 2 years ago

Finding out exactly what happened. He is so smart and had no issues at all with his left side. Just his left hand and his left foot angles in

But you already know about his disabilities so what about the ct worries you?

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Customer reply replied 2 years ago

How severe the stroke was or if something else pops up

I'm still not sure exactly what you're worried about?

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Customer reply replied 2 years ago

What if it's worse than we think. People keep saying it had to been a mild stroke. Do you agree? What Do you think we will see

Not sure about the term mild stroke. I would consider his disabilities indicative of more than a mild stroke but strokes can be much worse as to the degree of disability. But the main point would be his stroke was years ago and it's over and done with--there'd be no reason to think things would ever get any worse

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Customer reply replied 2 years ago

So you think his stroke was pretty severe then and we will probably see lots of scarring then

Terms like mild, moderate, or severe are really not specific medical terms. But I still don't understand your concern since as I said nothing would ever get any worse

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Customer reply replied 2 years ago

Donyou think there is another medical possibility that caused his disability? I think the other scary part is seeing and hearing about the scarring on his brain

Sorry--other medical possibility?

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Customer reply replied 2 years ago

CCould is disability be caused by something other than a stroke

No, not in his case. There would be nothing else that would do that to just one side of his body

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Customer reply replied 2 years ago

SSo in his case do you think the cat scan will show a lot of scarring? Like that scares me. Ever since he was a baby I have felt like this is my fault. Somehow I was supposed to protect him. I always take care of myself no drugz no alcohol nothing amd then this happens. It feels crappy and now he is 12 and he wants to know

You're not at fault at all here. He should be made aware of that by his doctors

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Customer reply replied 2 years ago

When we went in last Tuesday his doctor said like you it is what it is. He has a permanent weakness on his left upper and lower extremity. But brain scarring really that sounds awful. You still haven't answered what your thoughts are on the severity of the stroke or scarring.

The severity of the stroke is basically what his disabilities are now. I wouldn't like to put an exact term to it but I'd call it mildly moderate. If there's scarring it probably is in a small area of his left hemisphere

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Customer reply replied 2 years ago

S you said if the scarring is there. Does that mean there may not be scarring at all or does every stroke cause scarring

No, sometimes there is no visible scarring with a stroke. But may I ask where we're going with this?

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Customer reply replied 2 years ago

Would he be considered a spastic hemipegia cerebral palsy? If so what are sign of scoliosis amd what are the symptoms look for

Yes it could be that and if so the ct may not show anything at all. But why do you ask about scoliosis?

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Customer reply replied 2 years ago

I have been told people with this type of cp are more prone to it that's all. If the ct doesn't show anything then does that mean it wasn't a stroke then? What can cause this type then. The article online talk about this tyoe of cp and it describes him to a T

Well CP is in a way a kind of stoke but not a thrombotic one that would normally show a scar, Scoliosis shouldn't be a problem with him though

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Customer reply replied 2 years ago

So wit that muscle spastic cp there isn't usually scarring then? Is that what you are saying then

Exactly

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Customer reply replied 2 years ago

So then we wouldn't really no if he had a stroke then or what really caused it?

Why are you so concerned with the term stroke when CP is in essence the same thing?

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Customer reply replied 2 years ago

We have always been told a stroke causes CP. I guess that's why. So the blue color after birth, low body temp after birth and all the symptoms now with weakness in left arm and left leg. Fisting left hand while doing something and lack of able to grab things, smaller muscle tone on left leg and arm all ALL sign of spastic muscle cp

Yes they could very well be but I'm still not sure at this point where we're headed with this?

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Customer reply replied 2 years ago

Last question then I will rerate. With all this info on him did you havr a different type of cp in mind

No, just the spastic type of CP

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Customer reply replied 2 years ago

And you really don't think scarring will show.

I honestly don't think there'll be any scarring seen

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Customer reply replied 2 years ago

So if scarring does show will it more than likely be a really small spot or like golf ball size? Just curious

If there's any scarring it would be small and in his right hemisphere--sorry--I think I said left hemisphere before

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Have to be off for now

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Customer reply replied 2 years ago

Like quarter size or nickel size

Likely no more than a dime size if at all

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Customer reply replied 2 years ago

Mybsister n law mentioned it would be a small dead spot on his brain on the right frontal lobe? Is that what u r thinking

For his left arm and leg to be affected it would have to be in his right hemisphere but not in the rear portion of his frontal lobe

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Customer reply replied 2 years ago

So those are 2 different areas then?

Not necessarily--they could be encompassed with just one small scar.

But seriously I have to log off for now

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Customer reply replied 2 years ago

U said not the rear part of the frontal lobe? So it could be the front part of the frontal lobe on the bright hemisphere?

Not at all sure what you're asking there?

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Customer reply replied 2 years ago

So is where my sister n law is expecting to see a dead spot not where you think it is then? Is that what scarring is a dead spot? That sounds horrible? Also can this type of cp cause a little stuttering in speech

No--both your sister-in-law and I agree that it would be in the right frontal lobe. Stuttering doesn't have to be a part of CP. Now--final time--I have to be off so if you need to continue the conversation please wait until tomorrow. And scarring is an area of brain tissue death

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Customer reply replied 2 years ago

We had him in speech for a few years in early grade school. Speech is good now but stutters some. Is this a symptom as well? He doesn't do it all the time or will something else show up somewhere else on the scan for that too

As I said before stuttering isn't a sign of CP nor of a stroke

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