What Is Cerebral Palsy?

Cerebral palsy is the most common childhood disability in the United States.¹ According to the Cerebral Palsy Alliance, there are currently 17 million people living with cerebral palsy worldwide. 

The exact cause of the condition is not known for the majority of people affected. However, it results from a brain injury that occurs before the cerebrum is fully developed. For 80% of cerebral palsy cases, these brain injuries are acquired prior to birth, which is why the cause may be unclear. 

Cerebral palsy can affect an individual’s balance, posture, communication, learning, sleep and movement.¹ The severity of cerebral palsy symptoms differs from person to person. Currently, there is no cure for this lifelong disability, but treatments that can improve a person’s quality of life are available. 

Overview

Cerebral palsy is an umbrella term for a group of lifelong neurodevelopmental conditions that begin during infancy or preschool years and cause physical disability. The disabilities are acquired before, during or soon after birth. 

As the severity and symptoms of cerebral palsy differ on a case-by-case basis, a personalised approach to treatment is essential.² Most commonly, cerebral palsy is associated with impaired movement and posture. 

Types of cerebral palsy

According to the Cerebral Palsy Alliance, there are multiple names that describe the type of cerebral palsy an individual has. These names are used to describe either the part of the brain affected or the part of the body affected.

Spastic cerebral palsy

Spastic cerebral palsy is by far the most common type of cerebral palsy, accounting for 70%-80% of all cerebral palsy diagnoses.³ It is associated with damage to a region of the brain called the motor cortex. The motor cortex is responsible for generating brain signals that direct voluntary body movement.⁴

Dyskinetic cerebral palsy 

Dyskinetic cerebral palsy accounts for 10-20% of cerebral palsy diagnoses. It arises from damage to structures in the brain known as the basal ganglia.³ The basal ganglia are located near the centre of the brain and are responsible for motor control (control of reflexes and voluntary movement).⁵

Ataxic cerebral palsy

Ataxic cerebral palsy accounts for just 5-10% of cases, making it the rarest form of the condition. It is caused by damage to the cerebellum, a portion of the brain at the back of the head, which also plays a role in motor control.⁶ Most commonly, the symptoms of ataxic cerebral palsy primarily affect balance and coordination.³ 

Causes of cerebral palsy

Cerebral palsy is caused by a brain injury or failure of the brain to fully develop before, during or just after birth.⁷ Damage to the brain before birth is thought to cause approximately 75% of cerebral palsy cases. Current research suggests that between 6% and 8% of cerebral palsy cases are caused by asphyxia (inadequate oxygen supply) during labour and birth.⁸

Other known causes of cerebral palsy include brain defects that occur in the womb, disruption of blood supply to the unborn child, and infections in the mother during the first and second trimesters of pregnancy.⁸ 

Cerebral palsy can also be acquired after birth. In these cases, it is either caused by infection or injury. In developing countries, malaria, septicaemia and meningitis infections are major causes of cerebral palsy.⁸

Signs and symptoms of cerebral palsy

Some signs and symptoms of cerebral pasly are not noticeable immediately after birth. However, they may become obvious as your child develops (between the ages of two and three). Signs and symptoms given by the Cerebral Palsy Alliance are listed below.

Immediately after birth or within the first year of life:

• Feeding or swallowing difficulties
• Excessive drooling
• Developmental delay (unable to sit up or roll over by 6 months)
• ‘Floppiness’ when picked up
• Poor posture, muscle control, and reflexes
• Unable to hold their own head up when sitting with support or lying on stomach
• Preference for using one side of the body
• Stiffness and muscle spasms

In toddlers and children:

• Not walking by 18 months
• Delay in speaking (not forming simple sentences by 24 months)
• Weak arms or legs
• Walking on tiptoes or unusual gait
• Movement seems clumsy, fidgety, or jerky
• Uncontrolled random movements
• Struggling with fine motor skills (e.g. buttoning clothing and using utensils)

Other symptoms may include:

• Epilsepy
• Hearing problems
• Issues with vision
• Abnormal pain and/or touch sensations
• Difficulty with bladder and bowel control
• Mental health conditions

Management and treatment for cerebral palsy

Curently, there is no cure for cerebral palsy. However, as this condition is non-progressive and individual treatment is used to target specific symptoms and improve their overall quality of life.

As each child with cerebral palsy may experience varying severities and types of symptoms, a personalised approach to treatment offers the best outcome. Following diagnosis of cerebral palsy, a team of health professionals will work with you and your child to develop a treatment plan. 

Commonly, treatment plans involve a combination of physical therapy, surgery, medicine, speech therapy, braces, and occupational therapy. Your team of health professionals will be able to talk through the risks and benefits of the treatments they offer.³

Diagnosis of cerebral palsy

Cerebral palsy is largely diagnosed based on the presence of symptoms, medical history, and issues you have had pre- and post-natally.

Your doctor may also order MRI or CT scans to look for signs of cerebral palsy.⁷

Risk factors

As the specific cause of cerebral palsy can be difficult to define, there are no known risk factors in over 30% of cerebral palsy diagnoses.⁷ The primary risk factor for developing cerebral palsy is anything that may cause brain damage or injury before the brain is fully developed. This includes before birth and within the first few months of life.

Studies have suggested that there are four groups with a statistically higher risk of cerebral palsy. These groups are: 

• Males 
• Premature babies 
• Small babies 
• Multiple births (e.g. twins and triplets)

Complications

As described in the signs and symptoms section, cerebral palsy is associated with a variety of both physical and mental health conditions.People with the condition may experience bullying and feelings of isolation. This can in turn lead to depression and anxiety.

In addition, conditions such as arthritis, diabetes, and heart conditions are more prevalent in those with cerebral palsy.

FAQs

Can cerebral palsy be prevented?

Cerebral palsy cannot be completely prevented. However, reducing the likelihood of early birth, treatment with magenesium sulphate for those about to deliver a baby early, or cooling babies who have experienced asphyxia during birth can reduce the risk of cerebral palsy.

How common is cerebral palsy?

Cerebral palsy is the most common childhood disability, with 17 milllion people living with the condition worldwide.

When should I see a doctor?

If you are worried about your child having cerebral palsy or not meeting their early developmental milestones, you should arrange an appointment with your healthcare provider.

Summary

To summarise, cerebral palsy is the most common childhood disability worldwide. It can cause both physical and mental disability, and symptoms depend on the severity of the condition. 

It cannot be cured, but cerebral palsy is non-progressive, meaning it should not worsen over time. Additionally, treatments are available to alleviate symptoms and improve quality of life.