Per the international consensus definition, CP "is not an etiologic diagnosis, but a clinical descriptive term" (Rosenbaum et al., 2007). A separate international consensus statement notes "genetic or other causation should not change the clinical diagnosis of CP" (MacLennan et al. 2019). However, it is unclear how these statements are applied in clinical practice.

We surveyed practitioners who commonly diagnose CP (Â鶹´«Ã½Ó³»­ Child Neurology Section via Synapse;  American Academy of Cerebral Palsy and Developmental Medicine via e-mail, n=1867). The survey supplied the consensus definition of CP and then asked respondents (n=216) to state whether they would diagnose CP in four hypothetical scenarios:

1: A 5 year old boy born at 30 weeks gestation with periventricular T2 hyperintensities on MRI, motor delays, and non-progressive spastic diplegia

2: Same as scenario 1 but with progressive spastic diplegia

3: Same as scenario 1 but with pathogenic mutations in ADD3 likely explaining his phenotype

4: A 5 year old boy born at 40 weeks gestation with a normal MRI, global delays, non-progressive generalized hypotonia, and a chromosome 1q deletion explaining his phenotype

There is dramatic practice variability in CP diagnosis despite explicit access to the CP consensus definition. Clarification of the consensus definition may help ensure uniformity of practice.