Neurology: cerebral palsy: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Neurology: cerebral palsy

Sample item

A 2-year-old born at 28 weeks has stiff legs that cross in a scissoring pattern when held upright, with relatively normal arm function and normal intelligence. What is the likely pattern and its cause?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Spastic diplegia from periventricular leukomalacia

Periventricular leukomalacia, white matter injury near the lateral ventricles in preterm infants, damages corticospinal fibres to the legs, which lie closest to the ventricles, causing spastic diplegia with scissoring. Intelligence is often relatively spared. Kernicterus causes athetoid or dyskinetic palsy with deafness, and perinatal stroke causes hemiplegia.

Option by option

  • A. Spastic diplegia from periventricular leukomalacia (correct)

    Correct. Preterm white matter injury causes spastic diplegia with spared arms.

  • B. Athetoid cerebral palsy from kernicterus

    Kernicterus causes dyskinesia, hearing loss and gaze abnormalities.

  • C. Hemiplegic cerebral palsy from a middle cerebral artery infarct

    Hemiplegia involves one side of the body, not predominantly the legs.

  • D. Hypotonic cerebral palsy from a cerebellar lesion

    Cerebellar lesions cause ataxia rather than spasticity.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is A, Spastic diplegia from periventricular leukomalacia. Periventricular leukomalacia, white matter injury near the lateral ventricles in preterm infants, damages corticospinal fibres to the legs, which lie closest to the ventricles, causing spastic diplegia with scissoring.

Why is "Athetoid cerebral palsy from kernicterus" not the answer?

Kernicterus causes dyskinesia, hearing loss and gaze abnormalities.

Why is "Hemiplegic cerebral palsy from a middle cerebral artery infarct" not the answer?

Hemiplegia involves one side of the body, not predominantly the legs.

Why is "Hypotonic cerebral palsy from a cerebellar lesion" not the answer?

Cerebellar lesions cause ataxia rather than spasticity.

What concept does this question test?

It tests Neurology: cerebral palsy in Pediatrics. Intelligence is often relatively spared. Kernicterus causes athetoid or dyskinetic palsy with deafness, and perinatal stroke causes hemiplegia.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neurology: cerebral palsy?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.