What Is Cerebral Palsy?

Cerebral palsy is a neurological condition that occurs when a child experiences physical limitations due to brain damage. The condition usually develops before birth or shortly after a baby’s birth.

The effects of cerebral palsy can range from very mild to severe, and the condition lasts throughout a person’s life. Symptoms can include learning delays, inability to walk, and speech impairment. This article describes the types, causes, diagnosis, treatment, and how to care for someone with cerebral palsy.

Types of Cerebral Palsy

There are a few different types of cerebral palsy. These types differ based on the physical effects and the areas of brain damage.

It can be difficult to recognize the type of cerebral palsy when observing someone casually, but a medical examination can determine which type of cerebral palsy a person has. Knowing the type of cerebral palsy can help anticipate outcomes and guide a treatment plan.

Spastic Cerebral Palsy

The most common type of cerebral palsy is called spastic cerebral palsy. It is characterized by diminished motor control. People with this type of cerebral palsy experience stiff, jerky movements when attempting to move affected areas of the body voluntarily.

Spastic cerebral palsy can range in severity. For some people, a limited body area is affected, such as one arm, one leg, or the neck. However, spastic cerebral palsy may cause substantial limitations in movement, such as the inability to walk, use the arms, or speak clearly, along with spasticity affecting the arms, legs, trunk, and head.

Dyskinetic Cerebral Palsy

Dyskinesia is a type of involuntary movement that can occur with movement or at rest. The movements are slow, smooth, and purposeless. People who have dyskinetic cerebral palsy are typically aware of the movements, but unable to stop them from happening.

Dyskinetic cerebral palsy may affect both sides of the body or may cause involuntary movement in one area, such as the fingers on one hand. 

Ataxic Cerebral Palsy

Ataxia is a lack of coordination. Ataxic cerebral palsy can cause physical imbalance of the whole body or may impair coordination of one side or one area of the body. It occurs due to damage to the cerebellum, which is the area of the brain that controls the coordination of physical movement. 

Mixed Cerebral Palsy

Many people who have cerebral palsy have a mixed type. The most common mixed pattern is spastic dyskinetic cerebral palsy. 

What Causes Cerebral Palsy?

Cerebral palsy occurs when a child has brain damage during prenatal development or within the first days of birth.

The damage can occur due to:

• Low oxygen to the brain
• Diminished blood flow to an area of the brain
• Traumatic brain injury
• Illness, infection, or bleeding during pregnancy
• Hereditary conditions

These issues can occur while the fetus is still developing in utero (during pregnancy), or they can occur during labor and delivery or shortly after a baby’s birth. Often the cause of cerebral palsy is not known.

Risk Factors for Cerebral Palsy

Some factors increase the likelihood of a child having cerebral palsy. However, a child can have cerebral palsy even without risk factors.

Health Problems of the Pregnant Person

Malnutrition, toxin exposure, severe trauma, illness, or infection in the pregnant person may cause the baby to have cerebral palsy.

Pregnancy and Childbirth

Problems during pregnancy and childbirth may increase the risk of brain damage due to oxygen and nutrient deprivation to the developing fetal and newborn brain. Additionally, severe bleeding during pregnancy or childbirth may have a harmful effect on the baby’s brain.

A condition called eclampsia may also increase the risk of cerebral palsy. This is when the pregnant person experiences sudden, severe high blood pressure and seizures at the late stages of pregnancy or during labor and delivery.

Infant Illness

Illness during the first days of a baby’s life may cause harm to the brain, especially when a baby is born prematurely. Infantile infections, malnutrition, head trauma, heart malformations, lung disease, and metabolic abnormalities increase the risk of cerebral palsy.

What Are the Signs and Symptoms of Cerebral Palsy?

Cerebral palsy is known to affect physical development of a child. Often cognitive development is impacted as well, and many children who have cerebral palsy also have learning challenges.

Signs of cerebral palsy and young babies:

• Movement is less purposeful than usual for age
• More frequent jerky movements than expected for age
• Trouble eating
• Less alert and attentive to surroundings than expected for age
• Abnormal eye movements

Children who have mild cerebral palsy might not develop symptoms until early childhood or later.

Early childhood symptoms of cerebral palsy include:

• Speech delay
• Impaired vision
• Muscle weakness
• Lack of coordination
• Low vocabulary for their age
• Trouble walking or using objects properly
• A lazy eye
• Seizures

Depending on the severity of cerebral palsy, some children may have all of the signs while others may only have one or two. The condition does not worsen as a child gets older. But with increasing expectations of learning and motor development, some of the impairments can become more obvious as a child is growing into the early toddler years.

Screening and Diagnosis

Cerebral palsy is usually identified after a child is born.

After birth, tests that may support a diagnosis of cerebral palsy include:

• Brain imaging, such as computed tomography (CT), magnetic resonance imaging (MRI), or ultrasound can sometimes identify areas of brain damage.
• Electroencephalogram (EEG) may identify patterns consistent with epilepsy.
• Blood tests may identify metabolic abnormalities.
• Genetic testing may detect a hereditary disorder that can cause signs similar to those of cerebral palsy, such as Tay-Sachs disease.

Treatment for Cerebral Palsy

Getting a diagnosis of cerebral palsy as early as possible is important. Treatment and management can help optimize a child’s learning and physical abilities.

The condition cannot be cured, and there is no known method of repairing areas of brain damage. However, with early therapy, a child may be able to strengthen and control unaffected muscles. Additionally, early interventions can help a child to learn at their own pace rather than struggling to keep up.

Interventions can be beneficial for children with cerebral palsy, but interventions have limitations for children with severe impairment.

Medication

Medication plays an important role in the care of some children and adults who have cerebral palsy. Medication is used for symptomatic treatment, and the necessary treatment will differ based on the effects of the condition.

Medications commonly used in cerebral palsy include:

• Antiepileptic drugs (AEDs): Some people who have cerebral palsy experience recurrent seizures due to brain damage. The appropriate AED will be determined based on the type and frequency of seizures.
• Muscle relaxers: Muscle spasticity can interfere with movement, and muscle relaxants may be beneficial to help diminish the effects of muscle tightness.
• Laxatives: Some people with cerebral palsy may have problems with constipation, and medication may help alleviate this problem. Treatment improves digestion and nutrition and increases comfort.

Assistive Devices and Braces

For many people with cerebral palsy, a brace or other type of device can hold areas of the body in a selected position. Braces and similar devices help prevent muscle contractures and muscle atrophy.

Additionally, many people who have cerebral palsy require a walker or, more commonly, a wheelchair, to get around. When a wheelchair is necessary, the home may need to be modified with ramps or wide doorways.

Transportation may rely on a vehicle that is equipped to accommodate a wheelchair. Outings will require advance planning to ensure that places are equipped with ramps so that a person can enter with their wheelchair.

Surgery

Some complications of cerebral palsy require surgical treatment. This can include severe muscle contractures, an abscess, or intestinal obstruction due to severe constipation. In some instances, epilepsy surgery may be required for treatment of epilepsy that is not improved with medication.

Occupational Therapy

Physical therapy and occupational therapy are both crucial for maintaining function and quality of life with cerebral palsy. Physical therapy is directed toward strengthening muscles and preventing contractures. Occupational therapy is aimed at learning how to take care of day-to-day tasks safely and effectively.

How Does Cerebral Palsy Affect Life Expectancy?

The life expectancy of a person with cerebral palsy depends on the severity of their condition and which aspects of their physical and cognitive abilities are impaired.

For example, people who have mild cerebral palsy might have a life expectancy equivalent to that of the general population. But a person who has difficulty swallowing due to cerebral palsy is at high risk of aspiration pneumonia and may have a risk of dying earlier due to this complication.

Common complications of cerebral palsy include:

• Falling and injuries
• Choking
• Aspiration pneumonia
• Severe abscesses or infections

Caring for Someone With Cerebral Palsy

Many people with cerebral palsy can function almost independently and may need help with only a few activities. This can include help with getting into and out of a car or putting on a brace or other supportive physical device. 

However, people with severe cerebral palsy may need help with almost all tasks. Taking care of someone with substantial limitations due to cerebral palsy can be time-consuming, physically demanding, and emotionally draining.

It is important to seek advice and support from the healthcare team, as well as social workers and others who are knowledgeable about the methods of caring for people with cerebral palsy.

Many organizations can provide help, direction, and support. These include advocacy organizations, community resources, support groups, and more.