Damage to the developing brain, usually before birth, causes this disorder of movement, muscle tone or posture.
Cerebral palsy is a group of disorders that affect movement and muscle tone or posture. It's caused by damage that occurs to the immature, developing brain, most often before birth.
Signs and symptoms appear during infancy or preschool years. In general, cerebral palsy causes impaired movement associated with exaggerated reflexes, floppiness or spasticity of the limbs and trunk, unusual posture, involuntary movements, unsteady walking, or some combination of these.
People with cerebral palsy can have problems swallowing and commonly have eye muscle imbalance, in which the eyes don't focus on the same object. They also might have reduced range of motion at various joints of their bodies due to muscle stiffness.
The cause of cerebral palsy and its effect on function vary greatly. Some people with cerebral palsy can walk; others need assistance. Some people have intellectual disabilities, but others do not. Epilepsy, blindness or deafness also might be present. Cerebral palsy is a lifelong disorder. There is no cure, but treatments can help improve function.
Signs and symptoms of cerebral palsy can vary greatly from person to person. Cerebral palsy can affect the whole body, or it might be limited primarily to one or two limbs, or one side of the body. Generally, signs and symptoms include problems with movement and coordination, speech and eating, development, and other problems.
Damage to the brain can contribute to other neurological problems, such as:
The brain disorder causing cerebral palsy doesn't change with time, so the symptoms usually don't worsen with age. However, as the child gets older, some symptoms might become more or less apparent. And muscle shortening and muscle rigidity can worsen if not treated aggressively.
It's important to get a prompt diagnosis for a movement disorder or delays in your child's development. See your child's doctor if you have concerns about episodes of loss of awareness of surroundings or of unusual bodily movements or muscle tone, impaired coordination, swallowing difficulties, eye muscle imbalance, or other developmental issues.
Cerebral palsy is caused by abnormal brain development or damage to the developing brain. This usually happens before a child is born, but it can occur at birth or in early infancy. In many cases, the cause isn't known. Many factors can lead to problems with brain development. Some include:
A number of factors are associated with an increased risk of cerebral palsy.
Certain infections or toxic exposures during pregnancy can significantly increase cerebral palsy risk to the baby. Inflammation triggered by infection or fever can damage the unborn baby's developing brain.
Illnesses in a newborn baby that can greatly increase the risk of cerebral palsy include:
While the potential contribution from each is limited, additional pregnancy or birth factors associated with increased cerebral palsy risk include:
Muscle weakness, muscle spasticity and coordination problems can contribute to a number of complications either during childhood or in adulthood, including:
Most cases of cerebral palsy can't be prevented, but you can reduce risks. If you're pregnant or planning to become pregnant, you can take these steps to keep healthy and minimize pregnancy complications:
Rarely, cerebral palsy can be caused by brain damage that occurs in childhood. Practice good general safety. Prevent head injuries by providing your child with a car seat, bicycle helmet, safety rails on the bed and appropriate supervision.
Signs and symptoms of cerebral palsy can become more apparent over time, so a diagnosis might not be made until a few months to a year after birth. In some cases where the signs and symptoms are mild, diagnosis may be delayed longer.
If your family doctor or pediatrician suspects your child has cerebral palsy, he or she will evaluate your child's signs and symptoms, monitor growth and development, review your child's medical history, and conduct a physical exam. Your doctor might refer you to specialists trained in treating children with brain and nervous system conditions, such as a pediatric neurologist, pediatric physical medicine and rehabilitation specialist, and child developmental specialist.
Your doctor might also order a series of tests to make a diagnosis and rule out other possible causes.
Brain-imaging technologies can reveal areas of damage or abnormal development in the brain. These tests might include the following:
If your child is suspected of having seizures, an EEG can evaluate the condition further. Seizures can develop in a child with epilepsy. In an EEG test, a series of electrodes are attached to your child's scalp. The EEG records the electrical activity of your child's brain. It's common for there to be changes in normal brain wave patterns in epilepsy.
Tests of the blood, urine or skin might be used to screen for genetic or metabolic problems.
If your child is diagnosed with cerebral palsy, you'll likely be referred to specialists to test your child for other conditions often associated with the disorder. These tests can identify problems with:
The type of cerebral palsy is determined by the main movement disorder experienced, but several movement disorders can occur together. The most common type of cerebral palsy is spastic cerebral palsy, which includes stiff muscles and exaggerated reflexes. Other types of cerebral palsy include movement disorders involving poor balance and coordination (ataxic) and difficulty controlling voluntary muscles (dyskinetic).
After making the diagnosis of cerebral palsy, your doctor may use a rating scale tool, such as the Gross Motor Function Classification System, to determine function and severity of mobility, posture and balance. This information can help in selecting treatments.
Children and adults with cerebral palsy may require lifelong care with a medical care team. Besides a pediatrician or physical medicine and rehabilitation specialist (physiatrist) and possibly a pediatric neurologist to oversee your child's medical care, the team might include a variety of therapists and mental health specialists. These experts give special attention to needs and issues that are more common in people with cerebral palsy and can work together with your primary care provider. Together you can develop a treatment plan.
There is no cure for cerebral palsy. However, there are many treatments options that may help improve your child's daily functioning. Selecting care will depend on his or her specific symptoms and needs, and needs may change over time. Early intervention can improve outcomes.
Treatment options can include medications, therapies, surgical procedures and other treatments as needed.
Medications that can lessen muscle tightness might be used to improve functional abilities, treat pain and manage complications related to spasticity or other cerebral palsy symptoms.
Muscle or nerve injections. To treat tightening of a specific muscle, your doctor might recommend injections of onabotulinumtoxinA (Botox), or another agent. The injections will need to be repeated about every three months.
Side effects can include pain at the injection site and mild flu-like symptoms. Other more-serious side effects include difficulty breathing and swallowing.
Oral muscle relaxants. Drugs such as baclofen, tizanidine (Zanaflex), diazepam (Valium) or dantrolene (Dantrium) are often used to relax muscles.
In some cases, baclofen is pumped into the spinal cord with a tube (intrathecal baclofen). The pump is surgically implanted under the skin of the abdomen.
Talk to your doctor about benefits and risks and possible side effects of recommended medication options.
A variety of therapies play an important role in treating cerebral palsy:
Physical therapy. Muscle training and exercises can help your child's strength, flexibility, balance, motor development and mobility. You'll also learn how to safely care for your child's everyday needs at home, such as bathing and feeding your child. Your therapist can provide guidance on how you can continue muscle training and exercise at home between therapy visits.
For the first 1 to 2 years after birth, both physical and occupational therapists work on issues such as head and trunk control, rolling, and grasping. Later, both types of therapists are involved in wheelchair assessments.
Braces, splints or other supportive devices might be recommended for your child to help with function, such as improved walking, and stretching stiff muscles.
Surgery may be needed to lessen muscle tightness or correct bone abnormalities caused by spasticity. These treatments include:
As needed, medications and other treatments may be recommended for seizures, pain, osteoporosis, mental health conditions, and problems with sleep, oral health, feeding and nutrition, bladder incontinence, vision, or hearing.
As your child with cerebral palsy becomes an adult, his or her health care needs can change. In addition to general health screenings recommended for all adults, ongoing health care includes evaluation and treatment for conditions that are more common in adults with cerebral palsy. These can include:
Some children and adolescents with cerebral palsy use some form of complementary or alternative medicine. These are therapies that are unproved and have not been adopted into routine clinical practice. If you're considering a complementary or alternative medicine or therapy, talk with your doctor about potential risks and benefits.
When a child is diagnosed with a disabling condition, the whole family faces new challenges. Here are a few tips for caring for your child and yourself:
In addition to addressing health needs, caring for your adult loved one with cerebral palsy may include planning for current and future lifestyle needs, such as:
If your child has cerebral palsy, how you learn about your child's condition can depend on the severity of the disabilities, when signs and symptoms started, and whether there were risk factors during pregnancy or delivery.
Here's some information to help you get ready for your child's appointment with his or her doctor.
Before your appointment make a list of:
Take a relative or friend with you, if possible, to help you remember the information you receive.
Questions to ask your doctor can include:
Don't hesitate to ask other questions during your appointment.
Your doctor is likely to ask you questions, including: