Cerebral Palsy in Children
Cerebral palsy (CP) is a brain
(neurological) disorder that causes problems with normal motor function. It's a lifelong
condition that affects how the brain and muscles communicate. CP affects body movement,
muscle control, coordination, reflexes, posture, and balance. These problems are caused
by damage to or abnormal development of certain brain areas. But many children with
have normal intelligence. CP can range in severity, but it doesn’t get worse over
CP doesn't get better over time either. With diagnosis and treatment, children can
how to manage their condition.
CP occurs when there's abnormal
development of or damage to areas of the brain that control motor function. This can
happen before or during birth (congenital CP). Most CP cases are congenital. Less
commonly, CP can happen after birth. This is called acquired CP and usually happens
an infection or head injury.
In many cases, the exact cause of
CP isn't known. It may be the result of a problem, such as:
- Lack of oxygen to the brain
- Genetic condition
- Bleeding in the brain
- Severe jaundice
- Head injury
A child is more at risk for CP because of any of the following:
- Preterm birth (before 37 weeks)
- Inflammation of the placenta or
amniotic fluid from an infection (chorioamnionitis)
- Blood clotting disorder
- Very low birth weight, especially
under 3.3 pounds
- Infection with bacteria or
- Chemical or substance abuse during
- Bleeding in the brain
- Complications of labor and delivery,
in rare cases
Symptoms can occur a bit differently in each child. A child may have muscle weakness,
poor motor control, or shaking (spasticity) of the arms or legs. A child may also
have muscle stiffness in the form of stiff legs or clenched fists.
The symptoms depend on what type of CP a child has. The types and symptoms include:
Spastic diplegia. Di means 2.This is spasticity of the
legs in most cases, but sometimes the arms. Diplegia is also called paraplegia.
Spastic quadriplegia. This is also called tetraplegia.
Quad and tetra mean 4. This is spasticity of all arms and legs.
Spastic hemiplegia. Hemi means half. This is spasticity
that affects 1 side of the body, such as the right arm and right leg.
Spastic double hemiplegia. This is spasticity on both
sides of the body. The amount of spasticity is different on each side.
Athetoid CP. This is also called dyskinetic CP. This is
movement that can’t be controlled (involuntary). The movement is usually twisting
Ataxic CP. This affects balance, leading to unsteady
walking. It also affects fine motor coordination. This makes it hard to do things,
such as writing.
Babies with CP are often slow to reach developmental motor milestones. These may include
learning to roll over, sit, crawl, or walk. They may also keep certain reflexes that
normally disappear in early infancy.
Children with CP may have
additional problems. But these aren't signs or symptoms of CP. CP refers only to the
motor dysfunction. The additional problems may include:
- Vision, hearing, or speech
- Learning disabilities and behavior problems
- Intellectual disability
- Breathing problems
- Bowel and bladder problems
- Bone problems including scoliosis (a
sideways curvature of the spine)
The symptoms of CP can be like
other health conditions. Make sure your child sees their healthcare provider for a
A diagnosis of CP isn't usually
made until a child is at least age 6 to 12 months. This is when a child should be
reaching developmental milestones. These include sitting, standing, walking, and hand
and head control. The healthcare provider will ask about your child’s symptoms and
health history. They'll give your child a physical exam.
Your child may also have tests, such as:
Nervous system exam. This checks reflexes and brain and
MRI. This imaging test uses large magnets and a computer
to make detailed images of organs and tissues in the body. It does not use X-rays.
This imaging test is often used to assess CP.
Feeding studies. These tests use X-rays or videos to see
what happens from the time food enters your child’s mouth until after your child
Electroencephalogram (EEG). This checks electrical
activity in the brain.
Gait lab analysis. This looks at your child’s walking
CT scan. This test uses X-rays and a computer to make
detailed images of the body. A CT scan shows detailed images of any part of the body,
including the bones, muscles, fat, and organs. CT scans are more detailed than
Genetic studies. These tests look for health conditions
that can run in families.
Metabolic tests. These tests check for the lack of
specific enzymes that are needed to maintain the normal function of the body.
Treatment will depend on your
child’s symptoms, age, and general health. It'll also depend on how severe the condition
is. CP is a lifelong condition that has no cure. Because of this, your child’s
healthcare providers will work to:
- Prevent or lessen problems
- Make the most of a child's abilities
A child is treated by a healthcare team that may include:
Pediatrician or family health care
This is a child’s primary care provider.
Orthopedic surgeon. This is a surgeon who treats muscles, ligaments, tendons, and bones.
Neurologist. This is a provider who
treats conditions of the brain, spinal cord, and nerves.
Neurosurgeon. This is a provider who
treats the brain and spinal cord.
Ophthalmologist. This is a provider
who treats eye problems.
Dentist. This is a provider who
treats mouth and teeth problems.
Nurse. This is a provider who often
works with other healthcare providers.
Physiatrist. This is a provider who
specializes in physical medicine and rehabilitation.
Orthotist. This is a professional who makes braces and splints.
Rehabilitation team. These include physical, occupational, speech, and audiology therapists.
Management of CP may include:
- Positioning aids to help a child sit, lie down, or stand
- Braces and splints to prevent deformity and to give support or protection
- Medicines given by mouth or injection
to help decrease spasticity in the muscles
- Surgery to treat orthopedic problems,
such as curvature in the back, hip dislocation, ankle and foot deformities, and
- Surgery to treat spasticity
Talk with your child’s providers
about the risks, benefits, and possible side effects of all treatments.
Possible complications vary widely
from child to child. Treatment for complications will depend on your child’s symptoms,
age, and general health. It'll also depend on how serious the condition is. Your child’s
healthcare provider will discuss treatment choices with you.
Because healthcare providers don’t
know fully what causes congenital CP, little can be done to prevent it. CP related
gene problems can’t be prevented. But you can do certain things that might help reduce
- Be as healthy as possible before and
during pregnancy. Get early and regular prenatal care.
- Don't smoke during pregnancy.
- Get vaccinated for certain diseases
that can harm a developing baby.
After birth, acquired CP is often caused by an infection or injury. Some of these
cases can be prevented by helping keep your baby healthy and safe:
- Keep your baby’s vaccines
- Take steps to prevent injuries by
always using a car seat, babyproofing your living areas, and watching your young
child when in or near water.
CP is a lifelong condition that
doesn't have a cure. It can range in severity, but it doesn’t get worse over time.
full extent of CP usually isn't fully known right after birth. It can become clearer
a child grows and develops. With diagnosis and treatment, children can learn how to
manage their condition.
Your child’s healthcare providers
will work to prevent deformities or keep them to a minimum. They'll also work to help
your child make the most of their capabilities. You can help your child strengthen
self-esteem and be as independent as possible. Physical and occupational rehabilitation,
plus extra support in school, can help a child function as well as possible.
When to Call a Healthcare Provider
Call the healthcare provider right
away if your child has:
- Symptoms that don’t get better, or get worse
- New symptoms
- Cerebral palsy (CP) is a brain (neurological) disorder that causes problems with normal
motor function. It affects body movement, muscle control, coordination, reflexes,
posture, and balance.
- In many cases, the exact cause of CP
isn't known. Most cases happen before or during birth (congenital CP). CP that occurs
after birth usually happens from an infection or head injury.
- CP can range in severity, but it doesn’t get worse over time. With diagnosis and treatment,
children can learn how to manage their condition.
- Symptoms can vary in each child and depend on the severity of CP. Many children with
CP have normal intelligence. A child may have muscle weakness, poor motor control,
or shaking (spasticity) of the arms or legs. A child may also have stiff legs or clenched
- CP is a lifelong condition that
doesn't have a cure. A child is treated by a healthcare team. Treatment may include
rehab, positioning aids, braces, splints, medicines, or surgery.
Tips to help you get the most from a visit to your child’s healthcare provider:
- Know the reason for the visit and what you want to happen.
- Before your visit, write down questions you want answered.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments,
or tests. Also write down any new instructions your provider gives you for your child.
- Know why a new medicine or treatment
is prescribed and how it will help your child. Also know what the side effects
- Ask if your child’s condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if your child does
not take the medicine or have the test or procedure.
- If your child has a follow-up appointment, write down the date, time, and purpose
for that visit.
- Know how you can contact your child’s provider after office hours. This is important
if your child becomes ill and you have questions or need advice.