Distance Learning in Paediatric Neurology

Unit 4: Central Motor Deficits

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This Unit should familiarise you with the commonest motor disorders of childhood and will take you through neural tube disorders, cerebral palsy and acquired motor dysfunction. For each disorder you will be taken through the case of a child, or several children, and you should try to identify similar cases in your own practice with which you have had personal involvement. In addition, one section from the ‘Metabolic, Nutritional and Systemic Disease’unit is provided. This covers the movement disorders determined by primary metabolic disorders, and concentrates on the more common presentations of these, their biochemical and central nervous system substrate basis, a rational approach to investigation and how best to inform the families involved of their nature. With this addition, Unit 4 becomes a comprehensive resource for learning about the spectrum of paediatric movement disorders.


This Unit contains 63 hours of study, divided into the following sections:

  Study hours

1. Anatomy and physiology of central motor pathways, basal ganglia and cerebellum
Aim:  In this section you will revise the anatomy of the central motor pathways and how they relate to the basal ganglia and cerebellum in executing motor control.

3 hours

2. Normal development of motor skills
Aim: To add to what you should already know about motor milestones by equipping you to recognise the breadth of normal in the rate of acquisition of gross and fine motor milestones, and to appreciate when these are exceeded.

3 hours

3. Epidemiology, co-morbidity and natural history of the cerebral palsies
Aim: This section will give you a grasp of the incidence, classification, causes and phenotypic distribution of cerebral palsy together with the associated co-morbidities, natural history and motor prognosis.

9 hours

4. The assessment and management of disorders of walking and hypertonus in cerebral palsy: a physiological atlas
Aim: This section will look at the assessment and management of disorders of walking and hypertonus in cerebral palsy: it aims to provide a physiological atlas and to focus on different physiological problems and their potential solutions.

12 hours

5. Dystonia and dystonic cerebral palsy
Aim:  In this section you will look at a case scenario to study the presentation and potential underlying disease processes in a young child with dystonia. You should gain an understanding of how the history and examination can guide your investigations and treatment. You will explore some of the issues relating acute perinatal hypoxic-ischaemic injury and dystonic cerebral palsy, and you will look at the classification and presentation of the genetic dystonia of childhood.  During this section try to relate this information to patients you have personally managed.

Section 10 of this unit covers some broad principles of movement disorders, including dystonia. Neurotransmitter disorders which present with dystonia are also discussed in more detail in this section.

 6 hours

6.Total body involvement cerebral palsy: Feeding
Aim:  To recognise and be able to manage the feeding and communication difficulties of the child with total body cerebral palsy. The case of a child with total body cerebral palsy will be followed, in the first section his feeding problems will be addressed and in the second section his communication difficulties.

3 hours

7. Total body involvement cerebral palsy: Assessment of communication difficulties
Aim:  To recognise and be able to manage the communication difficulties of the child with total body cerebral palsy. The case of the child with total body cerebral palsy described in section 6 will be followed, and his communication difficulties explored.

3 hours

8. Neural tube disorders
Aim:  To review the epidemiology, causes, prevention and management of neural tube disorders including anencephaly, spina bifida, and caudal regression syndromes.

6 hours

9. Congenital and acquired spinal disorders
Aim:  To be able to recognise, investigate, diagnose and manage acute spinal injury and its chronic sequelae.

3 hours

10. Movement disorders
Aim: In this section you will learn about movement disorders in childhood.  You will concentrate on the more common presentations, their biochemical and central nervous system substrate basis, a rational approach to investigation, and how best to inform the families involved of their nature. 


15.5 hours
Total study hours = 63.5 hours


You can begin studying this Unit at any time and work through it at your own pace. There are no time limits to finish the Unit. If you spend about 4 hours per week on this course, you will complete it in 4 months. When you complete the unit, please send it to us and we will check that all 3 star activities have been completed and will issue a CPD certificate for the number of hours shown above.

Who is this Unit for?

The Central Motor Deficits Unit is particularly suitable for:

  • Specialist Paediatric Neurology trainees
  • Consultant Community Paediatricians
  • Consultant Paediatric Neurologists to update themselves as part of their continuing professional development
  • Those who have completed the BPNA 2-day Movement Disorders course and wish to learn more


The course materials are delivered via a dedicated website. On receipt of your application we will register you and send your username and password to access your unit. All the activities and required papers are available for you to download from the course website. You will need access to the notes of a child with cerebellar lesion. You will also need access to a few textbooks, which should be available to borrow from your local paediatric neurology department or medical library.

What do students say are the best things about this unit?

  • “Well organized and touching multidisciplinary areas in the management of CP” (Saudia Arabia)
  • “Actually gets down to neurophysiology and neuroanatomy and how these relate to disease processes” (UK)


Fees must be paid at the time of registering. You can register online and pay your fee by credit/debit card or request an invoice be sent to your place of work (you will need a purchase order number from your hospital for this option). The cost of this Unit depends on the country in which you are working.  

  • High income countries = £390 (eg Western Europe, Australia, North America, Gulf States)
  • Rest of the world = £128

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