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Cerebral Palsy

What is cerebral palsy?

Cerebral palsy (CP) is a group of disorders that cause problems with using the muscles and moving the body. Someone with cerebral palsy may also have seizures and learning problems. There may also be problems with hearing, seeing, or the sense of touch.

What is the cause?

Damage to the brain before or after birth can affect how the brain works. The brain may lose some of its ability to control movement and posture. Most often the brain damage happens before birth. Sometimes it happens when a baby is born or after birth. Some possible causes of the damage are:

  • An infection during pregnancy, such as rubella (German measles)
  • Abnormal development of the brain before birth
  • A problem with different blood types in the mother and baby (Rh incompatibility)
  • Severe jaundice at birth
  • Bleeding in the brain
  • Premature birth
  • A lack of oxygen at some time during pregnancy or birth
  • A brain infection, severe convulsions, or a bad head injury

Often the cause of CP is hard to find and may never be known. In the past, if healthcare providers could not find another cause, they concluded that babies had CP because they did not get enough oxygen during birth. However, research has shown that most babies who don’t get enough oxygen during birth don’t have cerebral palsy. Only 5 to 10% of the babies born with cerebral palsy had problems during birth.

What are the symptoms?

A child will show signs of CP in the first few years of life. The effects of CP can be mild to severe. The symptoms are different from person to person. They may change over time. Some symptoms of CP are:

  • Muscles that are hard to move
  • Trouble with fine motor tasks, such as writing or cutting with scissors
  • Trouble walking normally
  • Unusual posture
  • Poor balance or coordination
  • Shaking of one or more arms and legs that cannot be controlled
  • Writhing movements
  • Grimacing or drooling
  • Trouble with speech
  • Trouble controlling the bladder and bowels

Trouble controlling body movements is sometimes called spasticity.

How is it diagnosed?

There is no specific test for CP. The diagnosis is often made by ruling out other possible problems. Cerebral palsy is usually diagnosed during the first 2 years of life from the medical history, symptoms, a physical exam, and observing the child.

If the symptoms are mild, it can be hard to be sure of the diagnosis before the age of 4 or 5 years. It is especially hard to tell if a child has CP before he or she is 6 months old.

To look for a cause, scans of the brain may be done, such as:

  • Computed tomography (CT scan), which uses X-rays and a computer to make a picture of the brain
  • Magnetic resonance imaging (MRI), which uses a magnetic field and radio waves to make a picture of the brain
  • Ultrasound, which uses sound waves to show structures of the brain

How is it treated?

Early and ongoing treatment can lessen the effects of CP. Treatment may include therapy, counseling, medicine, equipment aids, and educational programs.

Physical therapy, speech therapy, and occupational therapy

A very important part of treatment is therapy for movement, speech, and daily tasks.

  • Physical therapy is used for muscle training and exercising. It helps keep the muscles from getting too weak. It also helps avoid a common and serious problem called contracture. Contracture means the muscles, ligaments, and tendons are stuck in a rigid, abnormal position. Contracture can cause problems with balance and use of the muscles, preventing movement of joints, such as the elbow and knee. Contractures can become permanent without treatment.

    Braces can help--for example, by supporting joints when the muscles are not very strong.

  • Speech therapy helps improve speaking, eating, chewing, and swallowing. Special techniques and devices such as computers can also help communication with others.
  • Occupational therapy can make it easier for someone with CP to take care of themselves.

Counseling

Counseling is helpful for family members and caretakers, as well as the person with CP. It can help you recognize and cope with stress, frustration, depression, and other emotions.

Medicine

Your healthcare provider may prescribe medicines to treat abnormal muscle movement and help control seizures. This is important because sometimes seizures can be dangerous.

Equipment aids

Glasses may help with crossed eyes and vision problems. A hearing aid can help hearing problems.

Often people with CP need help with getting around. For example, they may need walkers, wheelchairs, or other equipment to help them get places, stay in certain positions, or perform some tasks.

There are tools that help people with CP do various activities, such as feeding and dressing themselves.

Surgery

Sometimes surgery can help vision problems or lengthen muscles and tendons.

Education

If a child with CP is 3 years old or younger, ask your healthcare provider about early intervention programs (EIPs). Many states offer EIPs for young children with CP. Some states also offer special education classes for children between the ages of 3 and 5 years. Children with disabilities have priority for admission to Head Start programs.

For older children ask about special education classes and individual education plans (IEPs). Find out about special services that may be available. Local schools may provide physical, occupational, or speech therapy.

It can be helpful for children who have CP to spend time with all types of children, including those who don’t have CP as well as those who do.

How long will the effects last?

Cerebral palsy cannot be cured. However, with therapy to help maintain movement, strength, and activities of self-care, it usually does not get worse over time. Treatment can improve everyday life and independence.

How can caregivers care for or support someone with cerebral palsy?

Be sure all medicine prescribed by the healthcare provider is taken.

Do what you can to help the person with CP overcome any barriers to learning and having a full life. You can do this by working with a support team of healthcare providers, therapists, social workers, and others.

Find out about groups that can provide more information and help.

What can I help prevent cerebral palsy?

Some causes of cerebral palsy may be avoided by:

  • Preventing head injures. Use car safety seats when a child is riding in a car and helmets during bicycle rides.
  • Treating jaundice in a newborn.
  • Preventing Rh incompatibility. Check with your healthcare provider to see if you need medicine for this problem during pregnancy and about other precautions you can take before or during each pregnancy.

Where can I get more information?

Some resources are:

You can also check with your healthcare provider, hospital, and local agencies for the handicapped for more information.

Developed by RelayHealth.
Pediatric Advisor 2013.2 published by RelayHealth.
Last modified: 2012-09-17
Last reviewed: 2012-01-04
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2013 RelayHealth and/or its affiliates. All rights reserved.
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