Cerebral Palsy
Cerebral palsy (CP) is a group of neurologic disorders that cause problems with movement, balance, and posture. The first part of the name, cerebral, means having to do with the brain. The second part, palsy, means weakness or problems with using the muscles.
CP can range from mild to severe. The brain damage and the disabilities it causes are permanent. But treatments can improve the lives of people who have the condition. For example, treatments can help to improve their motor skills and ability to communicate.
CP is caused by abnormal development or damage to the developing brain. When this development or damage happens before birth, it is called congenital CP. Most CP is congenital, and its causes may include:
- Gene changes (variants)
- Brain malformations
- Infections or fevers in the pregnant parent
- An injury to the developing baby
CP can also happen during or after birth. CP that happens more than 28 days after birth is called acquired CP. Its causes can include:
- Brain damage in the first few months or years of life
- Infections, such as meningitis or encephalitis
- Problems with blood flow to the brain, for example from a stroke or abnormal blood vessels
- Head injuries, for example from a car accident, a fall, or child abuse
In some cases, the cause of congenital or acquired CP is unknown.
There are different types of CP:
- Spastic cerebral palsy, which is the most common type. It causes increased muscle tone, stiff muscles, and awkward movements. Sometimes it only affects one part of the body. In other cases, it can affect both arms and legs, the trunk, and the face.
- Dyskinetic cerebral palsy, which causes problems controlling the movement of the hands, arms, feet, and legs. This can make it hard to sit and walk.
- Ataxic cerebral palsy, which causes problems with balance and coordination.
- Mixed cerebral palsy, which means that you have symptoms of more than one type.
There is no cure for CP, but treatment can improve the lives of those who have it. It is important to begin a treatment program as early as possible.
A team of health professionals will work with you and your child to develop a treatment plan. Common treatments include:
- Medicines
- Surgery
- Assistive devices such as braces and walkers
- Physical, occupational, recreational, and speech therapy
Diagnosing CP involves several steps:
- Developmental monitoring (or surveillance) means tracking a child’s growth and development over time. If there are any concerns about your child’s development, they should have a developmental screening test as soon as possible.
- Developmental screening involves giving your child a short test to check for motor, movement, or other developmental delays. If the screenings are not normal, the provider will recommend more evaluations.
- Developmental and medical evaluations are done to diagnose which disorder your child has. To make the diagnosis, your provider:
- Will check your child’s motor skills, muscle tone, reflexes, and posture
- Will ask about their medical history
- May order lab tests, genetic tests, and/or imaging tests
You cannot prevent the genetic problems that can cause CP. But it may be possible to manage or avoid some of the risk factors for CP. For example:
- If you are pregnant, make sure that you are vaccinated against infections that could cause CP in your developing baby.
- Get regular prenatal care, which can reduce the risk of preterm birth or having a low birthweight baby. It can also help you manage any health conditions that could raise the risk of CP.
- Use car seats for your baby to prevent head injuries that could cause CP.
Certain medical conditions or events that can happen during pregnancy and delivery may increase a baby’s risk of congenital cerebral palsy. These may include:
- Being born too small.
- Being born too early.
- Being born a twin or other multiple birth.
- Being conceived by in vitro fertilization (IVF) or other assisted reproductive technology (ART).
- Infections.
- Health problems in the pregnant parent, such as thyroid problems and seizures.
- Severe newborn jaundice.
- Having complications during birth.
- Rh incompatibility.
- Exposure to toxic chemicals during pregnancy.
There are many different types and levels of disability with CP. So the signs can be different in each child. These signs usually appear in the early months of life. They may include:
- Developmental delays. Your child may be slow to reach developmental milestones such as learning to roll over, sit, crawl, or walk.
- Abnormal muscle tone. Your child may seem floppy, or they may be stiff or rigid.
- An unusual posture or favoring one side of the body when reaching, crawling, or moving.
- Stiff or tight muscles and exaggerated reflexes (spasticity).
- Shaking (tremor) of arms, legs, hands, or feet.
- Sudden, uncontrolled movements.
It’s important to know that children without CP can also have these signs. Contact your child’s health care provider if your child has any of these signs, so you can get a correct diagnosis.
References
Cerebral Palsy – MedlinePlus – https://medlineplus.gov/cerebralpalsy.html
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