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Cerebral Palsy (CP)

Many different conditions can cause motor disabilities and muscle tone problems in childhood. Among these, cerebral palsy is the most common.

 

What is cerebral palsy?

Cerebral palsy (CP) is a motor disability that can affect a person’s movement, balance, coordination, and posture. Cerebral palsy is caused by damage to the motor center of the brain, often due to injury or infection before or during birth.

Symptoms of cerebral palsy appear during infancy or preschool years.

Symptoms of cerebral palsy

Because there are multiple forms of cerebral palsy, symptoms vary. However, in most cases, the symptoms of cerebral palsy are associated with movement and coordination. Children and adults with cerebral palsy typically have challenges related to movement or posture. It may also impact speech or learning processes.

Below are some common symptoms of cerebral palsy. Not every child with cerebral palsy may have all of these symptoms.

  • muscle tone variation (overly stiff in some areas, floppy in others)
  • rigid or floppy muscles
  • abnormal reflexes (such as excessive or underdeveloped reflexes)
  • abnormal posture
  • difficulty maintaining balance
  • eyes unable to focus on the same object
  • reduced range of motion
  • delays in motor skill development
  • impaired gross motor function
  • difficulty with fine motor control
  • difficulty swallowing or excessive drooling
  • delays in speech development or difficulty speaking
  • tremors or involuntary movements
  • seizures
 

In babies, there can also be specific early signs that a child has CP.

What causes cerebral palsy?

While the specific cause of cerebral palsy is unknown, most is related to damage or injury to the motor center of the brain. Most often, this damage or injury happens before or after birth and is called congenital cerebral palsy. However, a small percentage of cerebral palsy is caused by infection or injury more than 28 days after birth. Examples of these infections or injuries before or after birth include:

  • lead poisoning
  • bacterial meningitis
  • insufficient blood flow or oxygen to the brain
  • being shaken as an infant (shaken baby syndrome)
  • car accidents or other physical trauma
  • maternal infection during pregnancy
  • fetal stroke
  • severe, untreated jaundice (kernicterus)
  • gene mutations
 

How common is cerebral palsy?

Cerebral palsy affects about 1 in 323 children, according to estimates from Centers for Disease Control.

Who is most at risk for cerebral palsy?

Most cerebral palsy is related to damage to the brain that occurs before or during birth (congenital cerebral palsy). Some risk factors that may increase the risk for congenital cerebral palsy include:

  • being born too small (low birthweight)
  • being born too early (premature birth)
  • being part of a multiple birth (such as twins or triplets)
  • being conceived via in vitro fertilization or other assisted reproductive treatments
  • being born to a mother who had an infection during pregnancy

How is cerebral palsy diagnosed?

Cerebral palsy is usually diagnosed during the first or second year after birth. However, if the symptoms are mild, the diagnosis may occur later in life.

Diagnosis for cerebral palsy usually begins when the parent or doctor recognizes early signs of developmental delays. Often, a child with cerebral palsy will not reach typical developmental milestones – such as holding up their heads, rolling over, crawling or walking – or will exhibit unusual behavior when doing so.

Early signs of cerebral palsy

In a baby 3 to 6 months of age:

  • head falls back when picked up from lying on back
  • feels stiff or floppy
  • overextends back or neck when being held
  • legs stiffen and cross or scissor when picked up

In a baby 6 to 10 months of age:

  • doesn’t roll over
  • cannot bring hands together
  • has difficulty bringing hands to mouth
  • reaches with only one hand

In a baby over 10 months of age:

  • drags one hand and/or leg when crawling
  • scoots on buttocks, hops on knees, or otherwise does not crawl on all fours

If early signs of cerebral palsy are present, the child’s doctor will run diagnostic tests to identify areas of brain injury. This usually includes brain imaging such as:

  • MRI (magnetic resonance imaging)
  • CT Exam (computed tomography or CT Scan)
  • EEG (electroencephalogram)
  • ultrasound

How is cerebral palsy treated?

While there is currently no cure for cerebral palsy, orthopedists offer care to optimize their function and prevent deformities. Some of this care may include:

  • bracing
  • spasticity treatments (such as Botox injections)
  • nerve surgery (rhizotomy)
  • medication
  • orthopedic surgery

Additional treatments may include:

  • physical therapy
  • occupational therapy
  • speech therapy
  • pain management
  • dietary management

Treatment for cerebral palsy depends on several factors including the patient’s age, the type of symptoms the child is experiencing, and the severity of symptoms.

What is the prognosis for people with cerebral palsy?

Cerebral palsy does not typically get worse over time. With the right services and support, many individuals with cerebral palsy can live healthy, active lives.

Children with mild forms of cerebral palsy have a normal life expectancy. Some factors that may affect life span include:

  • number of and severity of impairments
  • level of restricted mobility
  • severity of feeding difficulties
  • seizures
  • vision problems
  • intellectual capabilities
  • respiratory functions

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