Cerebral Palsy (CP)

What Is Cerebral Palsy?

Cerebral palsy (CP) is a problem that affects muscle tone, movement, and coordination. It happens when the brain can’t properly send messages to muscles about how to move in smooth or well-coordinated ways. CP can also affect other body functions that involve motor skills and muscles, like breathing, bladder and bowel control, eating, and talking.

There are different types of CP. Some people have one type, or a mix of:

1. spastic cerebral palsy, which causes stiffness and trouble moving
2. dyskinetic (athetoid) cerebral palsy, which causes uncontrolled movements
3. ataxic cerebral palsy, which causes a problem with balance and depth perception (judging the distance between two objects)

There is no cure for CP, but a child's quality of life can improve with:

• treatment that may involve medicine or surgery
• therapy, including physical therapy, occupational therapy, and speech therapy
• special equipment to help kids get around and communicate with others

Cerebral palsy does not get worse over time.

What Causes Cerebral Palsy?

The cause of CP isn't always known. But many cases happen when a child's brain is still developing, such as before birth or in early infancy. This may be due to:

• infections or other medical problems during a woman’s pregnancy
• a stroke either in the womb or after birth
• untreated jaundice (a yellowing of the skin and whites of eyes)
• genetic disorders

In rare cases, CP happens because something goes wrong during a child's birth.

Premature babies (babies born early) have a higher chance of having CP than full-term babies. So do other low-birthweight babies and multiple births, such as twins and triplets.

Areas of the brain that affect learning can also be affected. This can lead to learning disabilities. Brain damage also can happen from:

• lead poisoning
• bacterial meningitis
• poor blood flow to the brain
• being shaken as an infant (shaken baby syndrome)
• an injury from an accident (like a car accident)
  

In rare cases, CP happens after a problem during childbirth.

How Is Cerebral Palsy Diagnosed?

Babies who are born early or who have health problems that put them at risk for cerebral palsy are watched for signs of the condition. Doctors look for:

• developmental delays, like not reaching for toys by 4 months or sitting up by 7 months
• problems with motor skills, like being unable to crawl, walk, or move arms and legs in the usual way
• uncoordinated movements
• muscle tone that is too tight or too loose
• infant reflexes (like the palmar grasp, or "hands in fists" reflex) that stay beyond the age at which they're usually gone

What Problems Does CP Cause?

A range of physical problems can happen with CP. Some kids have a lot of trouble with movement, while others don't. It depends on how much the brain was damaged. The damage can be partial, for example, affecting only the part of the brain that controls walking. Or it can affect a larger area, like the parts that control walking, talking, and understanding speech.

Brain damage that causes CP also can affect other brain functions and lead to problems like:

• visual impairment or blindness
• hearing loss
• food aspiration (the sucking of food or fluid into the lungs)
• gastroesophageal reflux (spitting up)
• speech problems and/or drooling
• sleep disorders
  
• osteoporosis (weak, brittle bones)
• behavior problems
• seizures

How Is Cerebral Palsy Treated?

There's no cure for cerebral palsy. But resources and therapies can help kids grow and develop to their greatest potential.

As soon as CP is diagnosed, a child can begin therapy for movement and other areas that need help, such as learning, speech, hearing, and social and emotional development. Many will need assistive devices like braces or wheelchairs.

Medicine helps kids who have a lot of muscle pain and stiffness. They can take medicine by mouth, G-tube, or get it through a pump (the baclofen pump) placed under the skin.

Surgery can help fix dislocated hips and scoliosis (curved spine), which are common in kids with CP. Leg braces help with walking.

Kids can improve their bone health by having a diet that's high in calcium, vitamin D, and phosphorus. These nutrients help keep bones strong. Doctors, dietitians, and speech-language therapists can work with families to make sure kids get enough of the right nutrients and suggest changes to their diets or mealtime routines, if needed.

What Else Should I Know?

Kids with CP often need to see many different medical specialists for care. That team may include doctors and surgeons, other providers like physical assistants, nurses, therapists, psychologists, educators, and social workers.

Even if many medical specialists are needed, it's still important to have a primary care provider or a medical home. This provider will take care of your child's routine health care and also help you coordinate care with other doctors.

Where Can Caregivers Get Help?

Taking care of a child with cerebral palsy can feel overwhelming at times. Not only do kids with CP need a lot of attention at home, they also need to go to many medical visits and therapies. Don't be afraid to say yes when someone asks, "Can I help?" Your family and friends really do want to be there for you.

To feel less alone and to connect with others who are facing the same challenges, find a local or online support group. You also can get information and support from CP organizations, such as:

• Cerebral Palsy Foundation
• United Cerebral Palsy

Staying strong and healthy is not only good for you, but also for your child and your whole family.

Looking Ahead

Living with cerebral palsy is different for every child. To help your child move and learn as much as possible, work closely with your care team to develop a treatment plan. Then, as your child grows and their needs change, adjust the plan as needed.

These guides can help as you plan for each stage of childhood and early adulthood:

• Cerebral Palsy Checklist: Birth to Age 5
• Cerebral Palsy Checklist: Ages 6 to 12
• Cerebral Palsy Checklist: Ages 13 and Up