Cerebral Palsy: Symptoms, Causes, Types, and Treatments

Cerebral palsy (CP) refers to a group of disorders that affect muscle movement and coordination. In many cases, vision, hearing, and sensation are also affected.

The word cerebral means having to do with the brain. The word palsy means weakness or problems with body movement.

CP is the most common cause of motor disabilities in childhood. According to the Centers for Disease Control and Prevention (CDC), it affects at least 1.5 to 4 out of every 1,000 children worldwide.

The symptoms of CP vary from person-to-person and range from mild to severe. Some people with CP may have difficulty walking and sitting. Other people with CP can have trouble grasping objects.

The symptoms can become more severe or less severe over time. They also vary depending on the part of the brain that was affected.

Some of the more common signs include:

Most children are born with CP, but they may not show signs of a disorder until months or years later. Symptoms usually appear before a child reaches age 3 or 4.

Call your doctor if you suspect your child has CP. Early diagnosis and treatment are very important.

Abnormal brain development or injury to the developing brain can cause CP. The damage affects the part of the brain that controls body movement, coordination, and posture.

The brain damage usually occurs before birth, but it can also happen during birth or the first years of life. In most cases, the exact cause of CP isnt known. Some of the possible causes include:

Certain factors put babies at an increased risk for CP. These include:

There are different types of CP that affect various parts of the brain. Each type causes specific movement disorders. The types of CP are:

Spastic CP is the most common type of CP, affecting approximately 80 percent of people with CP. It causes stiff muscles and exaggerated reflexes, making it difficult to walk.

Many people with spastic CP have walking abnormalities, such as crossing their knees or making scissorlike movements with their legs while walking. Muscle weakness and paralysis may also be present.

The symptoms can affect the entire body or just one side of the body.

People with dyskinetic CP have trouble controlling their body movements. The disorder causes involuntary, abnormal movements in the arms, legs, and hands.

In some cases, the face and tongue are also affected. The movements can be slow and writhing or rapid and jerky. They can make it difficult for the affected person to walk, sit, swallow, or talk.

Hypotonic CP causes diminished muscle tone and overly relaxed muscles. The arms and legs move very easily and appear floppy, like a rag doll.

Babies with this type of CP have little control over their head and may have trouble breathing. As they grow older, they may struggle to sit up straight as a result of their weakened muscles. They can also have difficulty speaking, poor reflexes, and walking abnormalities.

Ataxic CP is the least common type of CP. Ataxic CP is characterized by voluntary muscle movements that often appear disorganized, clumsy, or jerky.

People with this form of CP usually have problems with balance and coordination. They may have difficulty walking and performing fine motor functions, such as grasping objects and writing.

Some people have a combination of symptoms from the different types of CP. This is called mixed CP.

In most cases of mixed CP, people experience a mix of spastic and dyskinetic CP.

Cerebral palsy is classified according to the Gross Motor Function Classification System (GMFCS). The World Health Organization (WHO) and the Surveillance of Cerebral Palsy in Europe developed the GMFCS as a universal standard for determining the physical capabilities of people with CP.

The system focuses on:

The five levels of the GMFCS increase with decreasing mobility:

Level 1 CP is characterized by being able to walk without limitations.

A person with level 2 CP can walk long distances without limitations, but they cant run or jump.

They may need assistive devices, such as leg and arm braces, when first learning to walk. They also may need to use a wheelchair to get around outside of their home.

A person with level 3 CP can sit with little support and stand without any support.

They need handheld assistive devices, such as a walker or cane, while walking indoors. They also need a wheelchair to get around outside of the home.

A person with level 4 CP can walk with the use of assistive devices.

Theyre able to move independently in a wheelchair, and they need some support when theyre sitting.

A person with level 5 CP needs support to maintain their head and neck position.

They need support to sit and stand, and they may be able to control a motorized wheelchair.

A doctor will diagnose CP by taking a complete medical history, performing a physical exam that includes a detailed neurological exam, and evaluating the symptoms. Additional testing can also be performed:

If your doctor confirms CP, they may refer you to a specialist who can test for neurological problems that are often associated with the disorder. These tests may detect:

People with CP may have other problems, such as:

The goal of treatment is to improve limitations and prevent complications. Treatment may include assistive aids, medications, and surgery.

Assistive aids include:

Oral anticonvulsants and muscle relaxants are commonly used as first-line treatments for CP. Your doctor might prescribe:

Your doctor might also suggest local injections of botulinum toxin type A (Botox) or intrathecal baclofen therapy, where the drug is delivered by an implantable pump.

Orthopedic surgery may be used to relieve pain and improve mobility. It may also be needed to release tight muscles or to correct bone abnormalities caused by spasticity.

Selective dorsal rhizotomy (SDR) might be recommended as a last resort to reduce chronic pain or spasticity. It involves cutting nerves near the base of the spinal column.

Other types of treatment for CP include:

Although stem cell therapy is being explored as a potential treatment for CP, research is still in the early stages.

Theres no cure for CP, but the condition can often be treated and managed effectively. The specific type of treatment varies from person to person. Some people with CP may not need very much assistance, and others might need extensive, long-term care for their symptoms.

Regardless of the severity of the condition, treatment can improve the lives of those with CP. The following can help many people enhance their motor skills and ability to communicate:

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Cerebral Palsy: Symptoms, Causes, Types, and Treatments