Cerebral palsy (commonly referred to as CP) affects normal movement in different parts of the body and has many degrees of severity. The word “cerebral” refers to the brain’s cerebrum, which is the part of the brain that regulates motor function. “Palsy” describes a paralysis of voluntary movement in certain body parts. CP causes problems with posture, gait, muscle tone and coordination of movement.
Some children with CP also have coexisting conditions, like vision and hearing impairment. These disorders are caused by brain damage and are not a direct result of having cerebral palsy.
Cerebral palsy does not generally affect life expectancy. Depending on how the condition is managed, motor skills can improve or decline throughout the lifetime. Although CP varies in each individual, most children with this disability are still able to have full, rich lives.
Cerebral Palsy and Motor Control
The brain controls all types of motor function that allow people to live as independently as possible. Motor control can be voluntary, such as reaching out to shake someone’s hand. It can also be involuntary, such as the reflex when a doctor taps a spot just below a patient’s knee. When the motor control centers in the brain are damaged, voluntary and involuntary motor skills do not function properly. This abnormality limits control and coordination of movement in children with cerebral palsy.
Common Cerebral Palsy Myths
- Children with CP can’t hear or understand. Sometimes the brain injuries that cause cerebral palsy can affect hearing and language. However, just because someone struggles with speech does not mean they can’t hear or understand.
- Children with CP are confined to wheelchairs. While some children with cerebral palsy require the assistance of a wheelchair, most are able to walk independently or with crutches.
- CP keeps getting worse. Although cerebral palsy affects normal development of the brain before or shortly after birth, this brain damage doesn’t get worse. Proper care and treatment can improve mobility over time.
- Children with CP lack intelligence. Some children with cerebral palsy may also develop learning disorders as a result of damage to their brain. However, many CP patients have average or above-average intelligence.
- CP is curable. This is no cure for this condition, but there are many treatments to help children with cerebral palsy live a full life.
Causes and Risk Factors
Cerebral palsy is caused by damage to the fetal or infant brain. It occurs when there is neurological damage before, during, or within five years of birth that prevents the brain from developing properly. Damage to the parts of the brain that control motor function causes children with CP to struggle with posture, balance and movement. Although this disability affects muscle movement, it isn’t caused by problems with the actual muscles or nerves—it is strictly caused by developmental brain damage.
The first question parents often ask is: what caused my child’s brain injury? There are many issues that may cause a brain injury.
Common Causes of Cerebral Palsy:
- Bacterial and viral infections
- Bleeding in the brain (hemorrhaging)
- A lack of oxygen to the brain before, during or after birth (asphyxia)
- Prenatal exposure to drugs and alcohol, mercury poisoning from fish and toxoplasmosis from raw/undercooked meat
- Head injuries sustained during birth or in the first few years of infancy
Not every case of cerebral palsy has a clear cut explanation. It’s estimated that 20 to 50 percent of cases have unknown causes.
Infants born prematurely are at a higher risk of developing cerebral palsy because of complications that arise more often in premature births, such as bleeding in the brain. Estimates show that 10 to 30 percent of people with cerebral palsy were born prematurely—a lower birth weight corresponds with a higher risk of CP.
Risk Factors for Developing Cerebral Palsy:
- Abnormal deliveries, such as a breech birth (feet first)
- Maternal diabetes or high blood pressure
- Poor maternal health
Cerebral Palsy Caused by Birth Injuries
Some children develop cerebral palsy as the result of a birth injury caused by negligence. These cases are rare and usually the product of a delivery room meltdown. Parents who suspect their child was injured due to malpractice have the right to pursue a lawsuit. An attorney can evaluate the facts of the case to determine if there is enough legal evidence to suggest medical neglect during the child’s delivery. If you’re considering filing a claim, it is important to find an attorney who specializes in birth injury cases caused by negligence.
Signs and Symptoms
The signs and symptoms of cerebral palsy are different for every child. Some symptoms are hardly noticeable, while others are more intense. The severity of a child’s brain injury affects the symptoms that develop.
The most common signs and symptoms of cerebral palsy are:
- Problems with movement on one side of body
- Stiff muscles
- Exaggerated or jerky reflexes
- Involuntary movements or tremors
- Lack of coordination and balance
- Problems swallowing or sucking
- Difficulty with speech (dysarthria)
- Contractures (shortening of muscles)
- Delayed motor skill development
- Gastrointestinal problems
Damage to a developing brain can cause issues other than the movement problems associated with cerebral palsy. Therefore, those with CP often develop co-occurring conditions as a result of their brain injury.
Other conditions that may be present alongside cerebral palsy include:
- Vision or hearing impairment
- Learning disorders
- Abnormal perception of feeling or pain
- Attention deficit hyperactivity disorder (ADHD)
- Inability to communicate through speech
Types of Cerebral Palsy
There are many different forms of cerebral palsy. CP is classified by the type and location of movement problems. There are also different levels of severity in each individual, which leads to the variations in each case of cerebral palsy.
Types of Movement Problems
- Spastic (70% of cases). The most common type of cerebral palsy is known as spastic cerebral palsy. It is caused by damage to the brain’s motor cortex and features stiff, exaggerated movements.
- Athetoid/dyskinetic (10%). This type is caused by injury to the brain’s basal ganglia (which controls balance and coordination). Children with this type of cerebral palsy experience difficulty holding themselves up and often exhibit involuntary tremors.
- Ataxic (10%). Ataxic cerebral palsy is characterized by lack of coordination and balance caused by damage to the cerebellum (the part of the brain that connects to the spine).
- Mixed (10%). Some cases of cerebral palsy can be mixed, exhibiting symptoms of several different types.
Location of Movement Problems
- Monoplegia – One limb
- Diplegia (sometimes called paraplegia) – Two limbs, usually legs
- Hemiplegia – One side of body
- Quadriplegia – Whole body (face, arms, legs, torso)
- Double hemiplegia – Whole body, but used to distinguish those whose arms are more affected than their legs
These classifications illustrate the myriad of cerebral palsy types and how distinct each individual is. One person may be diagnosed with spastic diplegia, for instance, while another is diagnosed with athetoid/dyskinetic hemiplegia.
Cerebral palsy isn’t diagnosed until a child begins exhibiting signs and symptoms. It takes a while for a diagnosis of cerebral palsy to be made. Parents and grandparents are usually the first to notice delays in a child’s development. However, every child develops at his or her own pace, so doctors often hesitate to make an immediate diagnosis.
Children who have experienced some kind of brain trauma can recover fully, or at least partially, because younger brains have a higher healing capability than adult brains. There is still a lot of room for a child’s recovery before six months of age. Most healthy children stabilize around two or three years of age if they experienced brain damage. The majority of diagnoses are made between 12-18 months of age.
Several imaging tests may be used to diagnose cerebral palsy, including:
- Magnetic resonance imaging (MRI)
- Computed tomography scan (CT)
- Electroencephalogram (EEG)
- Cranial ultrasound
If you’re concerned that your child is showing developmental signs of cerebral palsy, we can help you find a specialist to receive an accurate diagnosis.
Treatment for Cerebral Palsy
Treatment for cerebral palsy is twofold—there is treatment early in life and lifelong management.
Early treatment for children with cerebral palsy is important because the developing brain and body are more resilient. There are more opportunities to correct or improve some of the child’s conditions during this time.
Treatment isn’t focused on curing or fully correcting the child’s issues. Rather, it’s about nurturing a child’s development so they can live as independently as possible. In fact, many children with cerebral palsy are completely self-sufficient and have satisfying, meaningful lives. Treating the issues that coincide with CP is the best way to ensure the highest quality of life for the child.
Children with cerebral palsy can improve their motor skills with the help of therapy and other treatments. Parents should seek out a multidisciplinary team of specialists to effectively treat their child.
The multidisciplinary team may include:
- Developmental pediatricians
- Psychologists (to assess ability and behavior)
- Orthopedic surgeons
- Physical therapists
- Respiratory therapists
- Speech therapists
- Occupational therapists .