Cerebral palsy (CP) is a group of chronic disorders that affect the ability to control movement. It appears in the first few years of life. Generally, the nerve damage does not worsen over time, but the muscle, joint, and skeletal effects can get worse without treatment.
CP occurs due to damage to areas of the brain that direct movement. This damage interferes with the brain's ability to control movement and posture. Other areas of the brain controlling thinking, speech, vision, or hearing may also be involved. CP may develop before, during, or after birth.
Causes include: Stroke
or bleeding occurs in the baby's brain during development or after birth
Child sustains a head injury or brain infectionThere are abnormalities of the umbilical cord or placenta, or the placenta separates too early from the wall of the uterusChild does not get enough oxygen during or after birth
encephalitis, seizures, or head injuryChild has genetic/metabolic abnormalitiesBrain tissue that may not develop correctly during pregnancy—growing fetus may experience a lack of oxygen or nutrientsMother has rubella, toxoplasmosis, or cytomegalovirus while pregnantMother and child's blood types are not compatible causing severe jaundice
Factors that increase the risk of CP include: Premature birthLow birth weightComplicated or premature deliveryMultiple births, such as twins or tripletsBreech birthIn vitro fertilization (IVF)—in part due to multiple births associated with IVF
Infection or blood clotting problems during pregnancyVaginal bleeding during pregnancyFamily history of CP in parent or siblingSeizures or
in the expectant motherCord prolapseLow Apgar score—a rating of the child's condition just after birthVaginal or urinary tract infection during pregnancyHigh birth weightType 1 diabetes
in the expectant mother
Obesity in the expectant motherSmall headSeizures
Symptoms of CP vary widely. They may include difficulty with fine motor tasks like writing or using scissors, difficulty maintaining balance or walking, difficulty hearing or speaking, muscle tightness, and involuntary movements . The symptoms differ from person to person and may change over time.
CP first shows up in children aged 3 years or younger. Symptoms vary depending on what areas of the brain are affected. The problems can involve one side of the body (hemiplegia), the upper or lower body (diplegia), or both the upper and lower body on both sides (quadraplegia). Occasionally the face and neck are involved.
Disabilities can be mild to severe and vary from side to side and top to bottom. Although symptoms may change or progress slightly as the child grows older, the child's condition is unlikely to worsen significantly, especially with treatment.
Symptoms include: Late to turn over, sit up, smile, or walkTrouble writing, buttoning a button, or other fine motor activitiesDifficulty walking or standingTight, spastic musclesWeak musclesPoor balanceSpeech problemsTremorsUnintentional body movementsDifficulty swallowingDrooling
Some people with CP suffer from other medical disorders as well, including: SeizuresIntellectual disabilityLearning disabilities
hearing problemsFailure-to-thriveDecreased ability to feel pain or identify items by touchProblems with bowel and bladder controlBreathing problems if food or water has accidentally entered the lungsSkin breakdown
Low bone density and
Doctors diagnose CP by testing motor skills and reflexes, looking into medical history, and using a variety of specialized tests.
You may have your brain's electrical activity tested. This can be done with an
You may have pictures taken of structures inside your head. This can be done with:
CT scanMRI scan
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There is no treatment to cure CP. The brain damage cannot be corrected. Therapy aims to help the child reach his or her full potential. Children with CP grow to adulthood and may be able to work and live independently.
Drugs help control muscle spasms and seizures, and prevent bone loss.
Medications may help: Decrease droolingTreat osteoporosis
Different seizure medications can be used depending on the type of seizure
Certain operations may improve the ability to sit, stand, and walk. These may include tendon transfers or lengthening, joint loosening, bone straightening, and nerve surgery.
Braces and splints help reduce muscle contraction, keep limbs in correct alignment, and prevent deformities. Positioning devices enable better posture.
Walkers, special scooters, and
make it easier to move around.
Programs designed to meet the child's special needs may improve learning. Some children do well attending regular schools with special services. Vocational training can help prepare young adults for jobs.
Speech, physical, and occupational therapies may improve the ability to speak, move, walk, and perform activities of daily living. Physical therapy helps strengthen muscles and improve fitness. Children can learn different ways to complete difficult tasks.
Professional support helps a patient and family cope with CP.
help parents learn how to modify behaviors. Caring for a child with CP can be stressful. Some families find
Therapeutic electrical stimulation might help increase muscle strength and range of motion.
Several of the causes of CP that have been identified through research are preventable or treatable:
Before getting pregnant, receive a
Seek early prenatal care.Receive testing for blood-type problems when pregnant. Get treatment if tests reveal incompatible blood types.
alcohol, or use drugs while pregnant.
Put the baby in a child safety seat when in the car.Insist that the child wear a helmet when riding a bicycle.Seek help if you have, or want to, hurt the child.Keep poisons away from your child.Closely supervise bathing.
Get your child
at the recommended time.
If your baby becomes sick, call the doctor right away.For infants with brain injury at birth, hypothermia to lower body temperature can reduce the risk of tissue injury and of long-term problems.
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Cerebral palsy (CP).
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Comparison of the efficacies of botulinum toxin A and Johnstone pressure splints against hip adductor spasticity among patients with cerebral palsy: a randomized trial.
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http://www.dynamed.com/topics/dmp~AN~T114012/Cerebral-palsy-CP: Mergler S, Evenhuis HM, Boot AM, et al. Epidemiology of low bone mineral density and fractures in children with severe cerebral palsy: a systematic review.
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Published July 28, 2010. Accessed September 15, 2015.
Last reviewed September 2016 by Kari Kassir, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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