Cerebral palsy is a umbrella type term referring to abnormalities of motor control or movement caused by damage to a child’s brain early in the course of development. Cerebral palsy occurs in 1 in every 300 children (Source: Center for Disease Control). Cerebral palsy is caused by faulty development of or damage to motor areas in the brain that disrupts the brain’s ability to control movement and posture. The brain injury can occur before birth, during birth, or in the first few months following birth. Physical symptoms typically appear in the first few years of life. Cerebral palsy is usually diagnosed within the first year or two following birth. Stroke in young children often results in a movement disorder very similar to that resulting from cerebral palsy.
The signs of cerebral palsy differ from person to person and may change over time. Signs of cerebral palsy may include the following:
- child is slow to reach developmental milestones such as learning to roll over, sit up, crawl, smile, or walk
- weakness in one (hemiplegia) or more limbs (arms or legs)
- standing and walking on tiptoe
- difficulty with fine motor tasks (such as writing or using scissors)
- difficulty maintaining balance
- walking with an abnormal gait, with one foot or leg dragging
- involuntary movements
- excessive drooling
Some people with cerebral palsy are also affected by other secondary medical conditions, including seizures, learning differences, and behavioral or emotional challenges. Cerebral palsy does not always cause serious disabilities.
Early signs of cerebral palsy usually appear before 3 years of age. Infants with cerebral palsy are frequently slow to reach developmental milestones such as learning to roll over, sit, crawl, smile, or walk. Cerebral palsy may be congenital or acquired after birth.
Several of the causes of cerebral palsy that have been identified through research are:
- head injury,
- jaundice,
- Rh incompatibility,
- rubella (German measles)
- and stroke (caused by a variety of conditions, some causes unknown)
Doctors diagnose cerebral palsy by
- testing motor skills and reflexes,
- looking into medical history, and
- employing a variety of specialized tests.
Although its symptoms may change over time, cerebral palsy by definition is not progressive, so if a patient shows increased impairment, the problem may be something other than cerebral palsy.
There is no standard therapy that works for all children with cerebral palsy. Some of the therapies used to treat children with cerebral palsy include:
- Physical therapy,
- occupational therapy,
- oral medications
- botulinum toxin
- speech therapy,
- behavioral therapy,
- drugs used to control seizures and muscle spasms,
- special braces or orthotics can compensate for muscle imbalance,
- splinting to improve muscle function,
- orthopedic surgery to correct contractures or improve function
- mechanical aids to help overcome impairments,
- counseling for emotional and psychological needs
The upper motor neuron syndrome of cerebral palsy leads to several types of muscle over activity, including spasticity. Reducing this muscle over-activity may be an important goal of treatment. This can improve comfort and function and help prevent future musculoskeletal complications such as contractures. Early prevention of contractures may reduce the need for corrective surgery.
Other Resources
Diagnostic assessment of the child with cerebral palsy – 2008 Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society
Cerebral Palsy The following brief description of this condition contains an overview of material discussed in much more depth in a book Cerebral palsy; A guide for care by Miller, Bachrach, et al published by Hopkins Press
Cerebral Palsy: Hope Through Research NINDS
Cerebral Palsy International Research Foundation
American Academy for Cerebral Palsy and Developmental Medicine
Center for Cerebral Palsy Spasticity St. Louis Children’s Hospital
How Can I Help? CP Booklet
Cerebral Palsy Fact Sheet 2 NICHCY
Ontario Federation for Cerebral Palsy
SCOPE Disability organization in England and Wales
National Institute on Disability and Rehabilitation Research
Cerebral palsy after perinatal arterial ischemic stroke
Antenatal risk factors for cerebral palsy
Can We Prevent Cerebral Palsy? Karin Nelson, MD
Stress and adaptation in mothers of children with cerebral palsy
Intrauterine exposure to infection and risk of cerebral palsy in very preterm infants.
Cerebral palsy in childhood: 250 cases report
Cerebral palsy in twins: a national study
Pain in children with cerebral palsy: common triggers and expressive behaviors To obtain parents’ identification and description of the behaviors, health care procedures and daily living situations associated with pain in children with cerebral palsy. Canada.
Minocycline markedly protects the neonatal brain against hypoxic-ischemic injury
Brain reorganisation in cerebral palsy: a high-field functional MRI study. 1 subject, 15 years old, with perinatal left-sided hemiparesis.
