Cerebral Palsy

Overview

What is cerebral palsy?

Cerebral palsy (also called CP) is a term for a group of disabilities that affect children in the first few years of life. Children who have CP have trouble controlling their muscles and coordinating body movements. They may have stiff or weak muscles, which can cause them to make unusual muscle movements. Babies who have CP may take longer than usual to start rolling over, sitting up, crawling, smiling or walking.

CP can be mild or severe. A child who has mild CP may have awkward movements but they may require little or no assistance. A child who has severe CP may not be able to walk, may have trouble speaking and may require lifelong care and assistance.

What are different types of CP?

There are 3 types of CP:

Some children will show signs of more than one type of CP. This is referred to as a mixed form of CP.

  • Spastic CP is the most common form of CP. It causes the muscles to stiffen and makes movement difficult. Spastic CP can affect just one side of the body, both legs or both arms and both legs.
  • Athetotic CP is not as common as Spastic CP. Athetotic CP causes uncontrolled, slow body movements and affects the entire body.

Ataxic CP is the least common form of CP. Ataxic CP affects balance and coordination.

Symptoms

What are the symptoms of CP?

The symptoms of CP usually do not get worse over time. Symptoms may include:

Children who have CP sometimes have other health problems. These can include problems with vision, problems with hearing or developmental delays.

  • Stiff muscles or muscles that are too floppy
  • Uncontrolled movements
  • Lack of coordination
  • Difficulty walking (for example, one foot or leg may drag)
  • Difficulty with fine motor control (for example, difficulty with writing or buttoning a shirt)
  • Difficulty speaking, swallowing or eating
  • Excessive drooling
  • Seizures

Causes & Risk Factors

What causes CP?

The brain damage that causes CP can occur before the child is born, during birth or in the first few years of life. In most cases, CP is present at birth. Normally, the brain sends out messages telling the body exactly how to move and exactly when to move. Children who have CP have damage to the part of the brain that sends out these messages. This affects the way a child who has CP talks, walks and moves.

Certain infections, such as rubella or chickenpox, in the pregnant mother can increase the risk of brain damage in the developing baby and cause CP. Sometimes, a baby’s brain does not develop properly while in the womb, which can also lead to CP. Doctors don’t know for sure why this happens, but in some cases it can be associated with the mother’s exposure to certain toxic substances.

A difficult labor or delivery can cause CP. This can happen if there is a lack of oxygen in the baby’s brain during birth. Severe jaundice that is left untreated in newborns can also result in CP.

Children who have meningitis or viral encephalitis can also lead to CP. Meningitis causes inflammation of the membranes surrounding the brain and spinal cord. Viral encephalitis causes inflammation of the brain.

CP has also been associated with brain injuries during the first few months or years of life.

Risk factors for CP

  • Infection, such as rubella, in a pregnant mother
  • Problems with blood circulation in the brain before birth
  • Abnormal brain development
  • Premature birth or low birth weight
  • Babies in a feet-first (breech) position at the beginning of labor
  • Difficult labor and delivery or delivery of multiple babies
  • Exposure to toxic substances in a pregnant mother
  • Severe jaundice in newborns
  • Infections in the baby after birth, such as bacterial meningitis
  • Head injuries after birth

Diagnosis & Tests

How can my doctor tell if my child has CP?

Your doctor will look at your child’s muscles, posture and reflexes. He or she will also ask you about your child’s physical development. Your doctor may also order special tests, such as a CT scan or an MRI, to see if there is any damage to the brain.

Treatment

What are the treatment options?

There is no cure for CP. If your child has CP, your doctor will help you create a treatment plan that may include:

  • Physical therapy: Exercise and muscle training will help your child with balance, flexibility, coordination and strength. Physical therapy can also help your child learn to use crutches, braces, splints or a wheelchair if necessary.
  • Speech therapy: A speech therapist can help your child with speaking or sign language, swallowing and eating.
  • Occupational therapy: This type of therapy teaches your child how to help take care of themselves. It can help teach your child to perform daily activities at home or school. It also helps your child learn or improve fine motor skills, such as writing.
  • Medicines: Your doctor may prescribe muscle relaxants to ease muscle stiffness. If your child has seizures, your doctor may also suggest an anticonvulsant medicine.
  • Surgery: Your doctor may recommend surgery if your child’s muscles or tendons are very stiff and limit the range of motion in the arms and legs.

Questions to Ask Your Doctor

  • What can I do to help my child?
  • Where can I get help and support in my community?
  • Will my child be able to attend school?
  • What kind of special equipment do I need in my home?
  • Will my child learn how to speak?
  • Will my child ever be able to walk without help?
  • Will my child ever be able to live independently?