Cerebral Palsy
What is it?
Cerebral palsy the name for a group of movement
disorders caused by an injury to the brain either
during pregnancy, during birth, shortly after
birth, or before age 5. Children with cerebral
palsy have difficulty coordinating muscle movement
because nerve cells in the motor control centers
of the brain are damaged and can’t signal the
appropriate muscles. Cerebral palsy is not a
disease and symptoms do not steadily worsen as the
child gets older. For this reason, it is also
called static encephalopathy. Static means it
stays the same; encephalopathy refers to a
disorder of the brain.
Who gets it?
Cerebral palsy affects 2 to 6 of every 1,000
infants born in the United States each year,
making it the most common handicapping disorder.
It is 10 times more common in premature infants.
It is also more likely to occur in full term, but
very small infants.
What causes it?
Cerebral palsy is not an inherited disorder; it
is caused by injury to the brain. In many cases,
doctors are unable to determine what causes the
brain injury. However, known causes that affect
the brain of the fetus or newborn include a poor
supply of oxygen to the brain during development
or during delivery; premature birth; difficult
labor or traumatic delivery; early separation of
the placenta or umbilical cord damage; mother and
baby having different blood types; and extremely
high bilirubin levels that are untreated. Cerebral
palsy can be caused during pregnancy if the mother
develops an infection, such as rubella or HIV;
abuses drugs or alcohol; contracts the herpes
virus; develops toxoplasmosis from exposure to cat
feces or undercooked meat; is anemic; or suffers
physical trauma that affects the infant. During
the first five years of life, cerebral palsy can
be caused by an infection that affects the brain,
such as meningitis or encephalitis; severe
convulsions; head trauma; severe dehydration, and
exposure to toxins. However, approximately 90
percent of all cases of cerebral palsy are caused
by brain injury during the prenatal period (before
labor begins).
What are the symptoms?
The symptoms of cerebral palsy are usually not
noticeable at birth. However, as children with
cerebral palsy develop they do not meet normal
developmental milestones, such as sitting
unsupported or crawling, within predictable times
because the muscles do not function normally. The
symptoms of cerebral palsy range from mild
clumsiness to severe contortions of the arms and
legs. Cerebral palsy is classified into five main
types, depending upon the nature of the movement
disorder and the pattern of the limbs involved.
Cerebral palsy classification:
- Spastic. Symptoms include stiff, weak
muscles; abnormal posture; and poor fine motor
control.
- Athetoid. Symptoms include
spontaneous, slow muscle movements.
- Hypotonic. Symptoms include floppy
muscles.
- Ataxic. Symptoms include poor
coordination and balance, with shaky movements.
- Dystonic. Two of the above types,
usually spastic and athetoid, are mixed. This
type occurs in many children.
The pattern of the limbs involved is classified
as hemiplegia, which affects the arm and leg on
only one side of the body; diplegia, which affects
mainly both legs; and quadriplegia, which affects
both arms and both legs. So, a child could have
spastic diplegia, or ataxic hemiplegia.
Some children with cerebral palsy may also have
seizures; speech, vision, and hearing problems;
learning disabilities; and attention deficit
and/or hyperactivity disorder (ADD/ADHD). Two
thirds of all cases have some degree of mental
retardation. These conditions are not necessarily
a component of cerebral palsy, but result from the
effect of brain abnormalities on other areas of
brain function. Some symptoms of cerebral palsy
can cause additional complications. For example,
spastic muscle movement can cause orthopedic
problems, such as hip dislocation, curvature of
the spine, or shortened muscles (contractures).
Drooling, cavities, and gum disease are more
common in people with cerebral palsy because of
tightness in the mouth and jaw and difficulty with
coordination. Constipation is also common.
How is it diagnosed?
Cerebral palsy is usually difficult to detect
during early infancy. If your doctor notices
problems with muscle development, spasticity, or
poor coordination, he or she will carefully
monitor your child’s development. While there is
no laboratory test to identify cerebral palsy,
your doctor may order studies such as computed
tomography (CT) or magnetic resonance imaging (MRI)
of the brain, blood tests, and tests that involve
electrical stimulation of the muscles to rule out
any other disorders with symptoms similar to
cerebral palsy.
What is the treatment?
There is currently no cure for cerebral palsy.
The goal of treatment is to make your child as
independent as possible. Physical therapy will
help keep muscles stretched and improve balance
and muscle control, Orthopedic surgery may be
necessary for the child to be able to walk with
the aid of braces or crutches. Surgery may also be
needed to correct vision problems. Hearing
problems are treated with hearing aids. Speech
therapy may help make your child easier to
understand and improve eating problems. Children
with severe speech difficulties can be taught to
use computers and picture boards to communicate.
Children with seizures can take anticonvulsant
drugs, which can also help with spastic muscle
movements. Spasticity can also be treated with
muscle relaxing drugs. One such drug, baclofen,
can be delivered at regular intervals through a
pump implanted under the skin. Many children with
cerebral palsy are able to attend regular schools,
which can also help encourage independence.
Occupational therapy is also an important
component of treatment that helps children with
cerebral palsy become self-sufficient adults.
Because the symptoms of cerebral palsy can cause
behavioral and emotional problems, many children
benefit from counseling or behavior therapy.
Massage therapy may also provide relief to
children and adults with painful muscle
contractions. Good nutrition, regular visits to
the medical specialists involved in your child’s
treatment, and understanding are important
components of successful treatment. While cerebral
palsy is not fatal, it can affect a person’s
lifespan in more severe cases. However, most
children with cerebral palsy live into adulthood.
Self-care tips
Because most cases of cerebral palsy occur
before birth and many cases have no identifiable
cause, there is no definite way to prevent
cerebral palsy. However, you can decrease the risk
during pregnancy by avoiding drugs and alcohol,
seeking regular prenatal healthcare, identifying
and treating infections immediately, and following
a healthy diet. If your child has been diagnosed
with cerebral palsy, provide him or her with daily
opportunities for physical and social development.
Follow your doctor’s treatment program and help
your child to develop his or her abilities fully
through appropriate therapy.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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