Cerebral palsy or high risk of cerebral palsy can be diagnosed accurately and early using the clinical signs and symptoms of cerebral palsy,involves neuroimaging,standardized neurological and standardized motor assess-ments before 6 months' corrected age. When the clinical diagnosis is suspected but cannot be made with certainty,re-commend using the interim clinical diagnosis of high risk of cerebral palsy until a diagnosis is confirmed,because infant with cerebral palsy require and benefit from different early interventions. Before 5 months' corrected age,the most pre-dictive tools for detecting risk are term - age magnetic resonance imaging(MRI),the Prechtl Qualitative Assessment of General Movements(GMs),and the Hammersmith Infant Neurological Examination(HINE). After 5 months' corrected age,the most predictive tools for detecting risk are MRI,HINE and the Developmental Assessment of Young Children. Early diagnosis and early intervention can optimize infant motor and cognitive plasticity,prevent secondary complica-tions. Cerebral palsy - specific early intervention maximizes neuroplasticity and minimizes deleterious modifications to muscle and bone growth and development. Early interventions included Goals - Activity - Motor Enrichment,neurode-velopmental treatment(Bobath,Vojta),Conductive Education and Environmental enrichment. Infants with of cerebral palsy who receive early CIMT have better hand function,and infants with any type and topography of cerebral palsy who receive GAME have better motor and cognitive skills than those who receive usual care.%根据脑性瘫痪(脑瘫)及脑瘫高风险儿的早期临床表现、标准化运动及神经系统评估和头颅影像学结果,可在矫正6月龄前做出脑瘫或脑瘫高风险儿的早期精准诊断.对那些暂时达不到脑瘫早期精准诊断标准,但患脑瘫的风险远远大于普通婴幼儿的儿童,建议暂时诊断为脑瘫高风险儿,以便尽早得到特异性早期干预而改善预后.矫正5月龄以前最具预测脑瘫风险的标准化工具是头颅磁共振(MRI)、全身运动评估(GMs)和Hammersmith婴幼儿神经系统评估(HINE);矫正5月龄以后最具预测脑瘫风险的标准化工具是头颅MRI、HINE和儿童发育评估.早期特异性干预可优化婴儿运动和认知功能,改善脑瘫患儿的严重程度及减少并发症;特异性干预可阻止脑瘫高风险儿向脑瘫发展,帮助其发育为正常或接近正常婴幼儿.干预方法有目标-活动-运动强化疗法(GAME)、神经发育学疗法[限制诱导疗法(CIMT)、Bobath法、Vojta法等]、引导式教育和环境强化等.循证医学依据证明CIMT对偏瘫有很好的疗效,GAME疗法对各种脑瘫类型患儿的运动和认知功能均较其他疗法效果显著.
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