An Overview of Cerebral Palsy

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Cerebral palsy (CP) is the most common motor disability in childhood, affecting your brain (cerebral) and the way that you use your muscles (palsy). Children with cerebral palsy have problems with muscle tone, which affects their balance, posture, and their ability to walk and move. Unlike other medical conditions that can affect movement, with cerebral palsy, the problem isn't in your muscles or nerves—damage to the brain itself affects your ability to control your muscles. Many people with CP also have related conditions like seizures (epilepsy), intellectual disability, hearing, feeding, or speech problems, spine changes, and joint problems. CP affects about one in 323 children in the United States.

Types of Cerebral Palsy

There are four types of cerebral palsy, including:

  • Spastic: This is the most common type, affecting around 80 percent of people with CP. It involves stiff muscles due to increased muscle tone, creating awkward movements. There are three subtypes of spastic CP: spastic diplegia/diparesis (mainly affects the legs), spastic hemiplegia/hemiparesis (only affects one side of the body), and spastic quadriplegia/quadriparesis (affects the arms, legs, face, and trunk).
  • Dyskinetic: This type involves difficulty controlling movement, particularly in the arms, legs, feet, and hands because muscle tone changes frequently, from being too tight to being too loose. The face and tongue can be affected too, making talking, swallowing, and sucking difficult.
  • Ataxic: Balance and coordination are affected by this type of CP, making it potentially difficult to write, walk, or reach.
  • Mixed: Some people have symptoms of more than one type, most commonly spastic and dyskinetic.

Symptoms

People with cerebral palsy can sometimes have very mild symptoms, such as being a little clumsy when they run. Others can have more severe symptoms like not being able to walk at all, being unable to speak, or having a severe intellectual disability, and may need lifelong care. The symptoms may not be noticeable for many months. In fact, mild cerebral palsy symptoms may not be detected until your child is several years old.

Cerebral palsy symptoms that you may notice, and that you should look for if you are concerned that your baby may have cerebral palsy, include:

  • Stiff or tight muscles (hypertonia)
  • Exaggerated reflexes
  • Uncontrolled body movements
  • Low muscle tone (hypotonia)
  • Toe walking, which can be normal before 3 years of age, especially if a child doesn't walk on his or her toes all of the time
  • Limping or dragging a foot while walking
  • Walking with a scissored gait, turning in the legs while walking
  • Excessive drooling
  • Difficulty swallowing, sucking or speaking
  • Seizures (about 35 percent of people with cerebral palsy also have epilepsy)
  • Trouble with fine motor skills, such as fastening buttons or holding a pencil

Early signs of cerebral palsy in babies include:

  • Still having poor head control after 2 months old
  • Always reaching with just one hand after 6 months old, keeping the other in a fist (keep in mind that many infants don't show a hand preference in their first year)
  • Inability to crawl or stand with support by the first birthday

Causes

The brain injury that causes cerebral palsy sometimes occurs early in pregnancy, while a baby's brain is still developing. It can also occur much later in pregnancy, during delivery, or less commonly, early in a baby's life.

Some common causes of cerebral palsy include:

  • Genetic conditions
  • Metabolic disorders
  • Bacterial meningitis
  • Prenatal infections like toxoplasmosis, human parvovirus (fifth disease), rubella, cytomegalovirus, herpes, syphilis, etc.
  • Bleeding in the brain
  • Lack of oxygen in utero due to problems with the placenta
  • Kernicterus (severe jaundice)
  • Head injury
  • Stroke
  • Child abuse and shaken baby syndrome

While prematurity doesn't cause cerebral palsy, it's often associated with the condition since premature babies are typically at risk for many of the problems that do cause it. Most experts now believe that very few cases of cerebral palsy are actually caused by a lack of oxygen during labor and delivery.

Diagnosis

The diagnosis of cerebral palsy is usually made when a parent or pediatrician notices that a child isn't meeting his or her physical and/or behavioral developmental milestones. Your pediatrician may also notice during a physical exam that your child has problems with his or her muscle tone or reflexes.

In addition to a physical exam, tests that are sometimes helpful when evaluating a child for cerebral palsy include a computerized tomography (CT) scan and/or magnetic resonance imaging (MRI) scan of the child's brain. Other tests may also be done if a genetic, metabolic, or infectious cause of cerebral palsy is suspected.

Treatment

Although there is no cure for cerebral palsy, if you have it, it won't get worse and it can even get better with treatment. This may include:

  • Physical therapy
  • Occupational therapy
  • Speech therapy
  • Hearing aids
  • Glasses
  • Medications, which can sometimes help more severe symptoms, such as muscle spasticity, seizures, and even drooling
  • Surgery on stiff tendons or joints
  • Surgery to correct strabismus (crossed eye)

In addition to therapy, children with moderate or severe cerebral palsy might need assistive devices to get around, such as orthotics, a walker, or a wheelchair. Other types of assistive technology can also help kids with severe cerebral palsy communicate and perform daily tasks, such as high-tech communication devices.

Coping

If you're the parent of a child who has been diagnosed with cerebral palsy, it will take some time to adjust to the diagnosis. This is perfectly normal. Acceptance of the diagnosis, helping your child set goals, minimizing stress, keeping a positive attitude, educating yourself about cerebral palsy, and being an advocate for your child are all healthy ways of coping.

If you're an adult with cerebral palsy, there are many strategies to help you live life to the fullest. Technology has come a long way and it can increase your independence and social network. Ask for help from friends and family if you need it. Consider joining a support group if you need to talk to others who understand what you're going through. No matter the degree of your symptoms, good coping skills are essential to living well.

Caregiving

Caring for a child with cerebral palsy comes with its own set of challenges. Not only does your child have movement difficulties, but he or she may have other related conditions as well, such as epilepsy, attention-deficit/hyperactivity disorder (ADHD), or pain. All of these issues can contribute to behavioral problems and difficulty with peers. It's important to implement strategies to help your child succeed at school, at home, and in life, as well as to start planning for your child's future as an adult. Thankfully, there are bountiful resources to help you navigate each stage of life as it comes along.

A Word From Verywell

If you're concerned that your child has cerebral palsy, be sure to talk to your pediatrician. If your child is under the age of 3 years, you can also call the early childhood system in your state to request a free evaluation to see if he or she qualifies for services such as speech, physical, and/or occupational therapy. You don't need a diagnosis or your doctor's referral to do this. If your child is over the age of 3 years, you can call your local public elementary school to request the same thing. Early intervention is key to helping your child learn skills and work through challenges, and it can help increase his or her future success.

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