Symptoms of Cerebral Palsy

Cerebral palsy is characterized by a collection of symptoms that range from mild to debilitating. If you have cerebral palsy, your symptoms can be similar—but more or less severe—than the symptoms experienced by someone else who also has cerebral palsy. 

Symptoms of cerebral palsy involve any combination of the following: lack of muscle control, diminished coordination, trouble speaking clearly, cognitive deficits, and problems with chewing and swallowing.

Frequent Symptoms

A key feature of cerebral palsy is that the lack of development of normal abilities, in contrast to many other childhood neurological conditions, which are characterized by a decline in abilities.

Physical Weakness

Cerebral palsy manifests most commonly as a lack of deliberate control of some muscles of the body. The earliest symptoms can begin in early infancy.

Some children are unable to support themselves while sitting due to a lack of strength and control of the hips, trunk, or chest muscles.

Decreased Ability or Inability to Walk 

Sometimes, children who have cerebral palsy do not crawl or walk as well as they should for their age. Some children are unable to walk or crawl at all, and some have a leg or a foot that drags. A child may also hold an unusual position when they walk.

Decreased Ability or Inability to Use Arms 

Cerebral palsy can affect the movement of the arms or hands on one or both sides, making it difficult for children to hold or carry objects or to learn how to do things that require fine motor coordination, such as writing.

Learning Disability 

Many but not all children who have cerebral palsy have learning delays, learning disabilities, or cognitive deficits. The specific problems can include slow learning, lower than average IQ or deficits in verbal, math, or spatial abilities.

Swallowing Problems

When cerebral palsy causes weakness of the face, mouth, or throat muscles, this can result in trouble chewing, swallowing, or speaking. Some children and adults with cerebral palsy may drool while eating or while at rest.

Slurred Speech or Spastic Speech

Speech patterns of people with cerebral palsy can be slurred or spastic, characterized by an irregular pattern of sporadically rapid, slow, quiet, or loud speech that may be difficult to understand. This occurs as a result of diminished muscle strength combined with diminished coordination that affects some children and adults with cerebral palsy.

Lack of Bladder or Bowel Control 

Bowel and bladder control problems can include retention (inability to go when you want to) or incontinence (loss of control when you do not want to) or a combination of both.

Seizures 

About 30% of people with cerebral palsy experience seizures, and generally, the more severe the cerebral palsy.

Rare Symptoms

Some people with cerebral palsy may experience less common symptoms.

Visual Deficits and Eye Problems

Decreased visual acuity in one or both eyes or a lazy eye may affect some people who have cerebral palsy.

Tremors and Tics

Some children with cerebral palsy may experience tremors of the face, arm, or other parts of the body while at rest or when attempting to move. If you or your child has cerebral palsy, you may experience episodes of involuntary (not on purpose) movements that fit the description of tics.

Sensory Deficits

Decreased sensation is not an uncommon complaint among people with cerebral palsy, but if you experience this symptom it may interfere with normal motor movement. It can also contribute to injuries if you do not feel painful sensations as you should.

Psychiatric Symptoms 

Sometimes symptoms of agitation, aggression, anxiety, or hallucinations can develop among people who have cerebral palsy.

Complications

Over time, there are several complications that can occur as a result of the longstanding symptoms of cerebral palsy.

Spasticity and Muscle Stiffness

When motor weakness is rooted in conditions that originate in a person’s brain, such as cerebral palsy, the affected muscles may eventually become stiff, spastic, rigid, or may develop contractures. This can result in further difficulty with muscle movement and coordination and may cause pain in the affected arms or legs. 

Atrophy 

Atrophy, or thinning of muscles, can also develop if you have cerebral palsy. The condition is generally accompanied by a decrease in muscle tone, which appears as the softening or thinning of the muscle.

Sometimes, despite thinning of the muscles, you might notice that people with cerebral palsy are overweight rather than underweight, due to their inability to exercise.

Choking 

Trouble swallowing food, drinks, and saliva can result in choking, coughing, or gagging while eating, drinking, or at rest.

Aspiration Pneumonia 

Choking on food may cause it to go down the trachea, which leads to the lungs, instead of down the esophagus, which leads to the stomach. When this happens, aspiration pneumonia, a lung infection, may occur.

Aspiration pneumonia is a serious infection that can advance and cause sepsis or even death if it is untreated.

Pressure Ulcers 

Prolonged sitting or lying down without being able to adjust your position or regularly move your body can produce pressure on some areas of the body, eventually causing skin abrasions that may become infected.

Bladder Infections 

Urinary retention can lead to bladder infections due to the build-up of bacteria in the bladder when it does not regularly empty.

Constipation 

Prolonged sitting or lying down, combined with a lack of control of the muscles that control bowel movements, may contribute to constipation, which can be painful and may eventually cause problems such as hemorrhoids.

When to See a Doctor

Cerebral palsy is generally present at birth, but it might not be obvious right away. This is because cerebral palsy can cause a deficit in a number of skills that are not expected of a newborn infant.

Some early signs of cerebral palsy that can be apparent in very young babies include choking while eating, not rolling over, and unequal movement of the left and right arms or legs. Another subtle symptom includes unusual posture of the body when your baby is lying at rest.

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Often symptoms become apparent when a child does not attain developmental milestones as expected in early childhood. These skills can include learning, independently eating solid food, speaking, walking, and learning to control movements of the hands and arms.

If you're noting these scenarios, try not to panic right away. It's easy to expect the worst. Instead, bring them to your pediatrician's attention and discuss them together to attain an appropriate diagnosis and, in turn, treatment.

Frequently Asked Questions

What is cerebral palsy?

Cerebral palsy is a group of permanent disorders that affect a person’s ability to move and maintain balance and posture. It is the most common motor disability in children, affecting as many as one in every 345 people in the United States to varying degrees.

What is the cause of cerebral palsy?

Cerebral palsy is primarily a congenital disorder. It is due to an abnormality in brain development most often seen in children with low birth weight or preterm birth as well as with twins or multiple births. A child's chances of developing cerebral palsy can increase if there is a history of maternal infection, birth complications, or kernicterus (a type of brain damage caused by neonatal jaundice).

What are the different types of cerebral palsy?

Most children have spastic cerebral palsy, characterized by jerky movements and joint stiffness. There is also ataxic cerebral palsy (characterized by clumsiness and instability), athetoid cerebral palsy (causing involuntary movement), and hypotonic CP (in which muscles are “floppy”), or mixed cerebral palsy.

What are the first signs of cerebral palsy?

The first signs are often noticed in infants whose heads fall back when picked up or whose bodies feel stiff or floppy. Babies who are unable to roll over, who crawl in a lopsided fashion, or can’t bring their hands to their mouths should also be suspected of having cerebral palsy.

Does cerebral palsy get worse with age?

Cerebral palsy is a non-progressive disorder, meaning that a child's symptoms won't get worse when they get older. Still, it can cause health concerns in later life, including post-impairment syndrome in which the combination of bone deformity, muscle abnormalities, and overuse injuries can lead to worsening pain, fatigue, and disability.

How long can a person with cerebral palsy live?

It largely depends on the extent and severity of the symptoms. Some with mild symptoms can live well into their 70s. Children with severe cerebral palsy (such as those who cannot lift their heads and require tube feeding) have a life expectancy of around 17 years.

Can a child outgrow cerebral palsy?

There have been suggestions that children with mild cerebral palsy can "outgrow" the disorder. It is a controversial contention that some scientists believe may be related to the initial misdiagnosis of the disease (given that many other conditions can cause mild palsy-like symptoms).