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April 1996

Heterogeneity of Cerebral Palsy

Author Affiliations

Division of Medical Genetics Department of Pediatrics University of Texas Health Science Center–Houston 6431 Fannin, MSB 3.144 Houston, TX 77030

Arch Pediatr Adolesc Med. 1996;150(4):443. doi:10.1001/archpedi.1996.02170290109021

I read with interest the article by Dr Stevenson1 about anthropomorphic measurements in children with cerebral palsy. Measuring appropriateness and symmetry of growth in patients with encephalopathy is certainly important, and it is encouraging to have demonstrations of a way in which this can be achieved. I am concerned, however, that the broadness of definition of the patients will lead to inaccuracies in determining normal values. Cerebral palsy is better thought of as a symptom than as a diagnosis, and it is possible that some of the patients included in the author's definition of the normal growth pattern, in fact, have underlying conditions that effect their growth independent of their neuromuscular problem. The article identifies the patients as having been recruited from a rehabilitation center, but it does not elaborate on the degree of diagnostic workup that the patients received to eliminate the possibility of chromosomal, metabolic, skeletal, or