When to Consider Hypopituitarism in a Child with Cerebral Palsy (CP)

Patient selection: cerebral palsy

When to consider the possibility of hypopituitarism in a patient with cerebral palsy:

(1) short stature not explained by malnutrition or other cause

(2) delayed puberty

(3) an abnormal pituitary gland on MRI of the brain

(4) clinical evidence of hypothyroidism or adrenal insufficiency

(5) low serum concentrations of TSH, ACTH, GH, LH and/or FSH

(6) low hormone concentrations in the blood

If the diagnosis is correct then appropriate therapy should result in some degree of clinical improvement. For conditions like short stature which may be multifactorial, further evaluation may be appropriate if a less than expected response is observed.