Cerebral Palsy

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KEY POINTS

• Cerebral palsy (CP) is a group of disorders that causes problems with balance and with moving and using the muscles. CP is caused by damage to the part of the brain that controls muscles. Most children who have CP are born with it.
• Cerebral palsy cannot be cured. Treatment can help your child use and strengthen muscles and may include therapy, counseling, medicine, braces and other devices and sometimes surgery.
• Get support. Talk with family and friends. Join a support group in your area.

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What is cerebral palsy?

Cerebral palsy (CP) is a group of disorders that causes problems with balance and with moving and using the muscles.

What is the cause?

CP is caused by damage to the part of the brain that controls muscles. Most children who have CP are born with it. A small number of children get CP after a brain injury or infection. The brain loses some of its ability to control movement and posture. The damage is not repairable, and can cause permanent disability. Some possible causes of the damage are:

• An infection during pregnancy, such as rubella (German measles)
• Problems with the way the brain develops before birth
• A problem with different blood types in the mother and baby (Rh incompatibility)
• Severe jaundice at birth
• Premature birth
• A lack of oxygen at some time during pregnancy or birth

Often the cause of CP is not known.

What are the symptoms?

The effects of CP can be mild to severe. The symptoms are different from person to person and may change over time. Symptoms may include:

• Muscles that are hard to move or muscles that are very weak
• Trouble with fine motor tasks, such as writing or cutting with scissors
• Poor balance or coordination, which may cause trouble walking or standing up straight
• Shaking, jerking, or writhing movements that cannot be controlled
• Grimacing or drooling
• Trouble with speech
• Trouble controlling your bladder and bowels
• Trouble hearing or seeing
• Learning problems
• Seizures

How is it diagnosed?

Cerebral palsy is usually diagnosed during the first 6 months to 2 years of life from the medical history, symptoms, a physical exam, and observation of your child. If the symptoms are mild, it can be hard to be sure of the diagnosis before the age of 4 or 5 years.

Your child may have tests or scans to check for other possible causes of the symptoms, such as an infection or a tumor.

How is it treated?

Cerebral palsy cannot be cured. Treatment can help your child keep the ability to use and control their muscles. Treatment may include therapy, counseling, medicine, educational programs, and sometimes surgery.

Physical therapy, speech therapy, and occupational therapy

Physical therapy and occupational therapy help your child use and strengthen muscles. These types of therapy can make it easier for your child to learn to take care of himself. Your child may learn how to use walkers or wheelchairs to get places or stay in certain positions. Braces can also help by supporting joints when your child’s muscles are not very strong. Your child may learn to use tools to help with daily activities, such as jar openers, buttonhooks, or household items with large handles.

Physical therapy also helps avoid a common and serious problem called contractures. Contractures mean the muscles and other tissues are stuck in a rigid, abnormal position. Contractures can cause problems with balance and use of the muscles. It can keep you from being able to move joints, like your elbow and knee. Contractures can become permanent if they are not treated.

Speech therapy helps improve speaking, eating, chewing, and swallowing. Special techniques and devices, such as computers or a special board covered with symbols of everyday objects and activities to which a child can point to indicate his or her wishes.

Counseling

Counseling can help your child cope with stress, frustration, depression, and other emotions.

Medicine

Your healthcare provider may prescribe medicines to treat abnormal muscle movement and help control seizures.

Education

Ask your child’s healthcare provider about early intervention programs (EIPs) for young children. Many states offer EIPs for children with CP. Some states also offer special education classes for children between the ages of 3 and 5 years. Children with disabilities have priority for admission to Head Start programs.

Usually children with CP can go to public school and the school district provides all needed services. These include working with a speech therapist, occupational therapist, school psychologist, social worker, school nurse, or aide. You may want to visit public schools in your area to see the type of programs they offer to special-needs children.

A team of professionals will help evaluate your child and put a plan together. You may also ask your healthcare provider to review the plan. Ask and learn about all the services that may be available for your child.

Surgery

Sometimes surgery can help vision problems or severe muscle problems.

How can I help my child?

• Look for your child’s strengths. No one knows what your child may be able to do in time, so don’t set your expectations too low. Encourage your child to try new things.
• Get support. Talk with family and friends. Join a support group in your area.
• Keep all appointments for provider visits or tests.
• Contact your healthcare provider if your child has new or worsening symptoms.
• A healthy lifestyle may help. Talk to your healthcare provider about your child's personal and family medical history and lifestyle habits. This will help you know what you can do to lower your child's risk for complications of cerebral palsy. For example, you can help your child:
  • Eat a healthy diet. Ask your provider about the benefits of talking to a dietitian to learn what your child needs in a healthy diet.
  • Try to keep a healthy weight. If your child is underweight, talk with your healthcare provider about healthy ways to gain weight.
  • Stay fit with the right kind of exercise.
  • Learn ways to manage stress.
  • Try to get at least 7 to 9 hours of sleep each night depending on the child’s age.
• See a mental health professional to help you cope with stress.
• Learn as much as you can about cerebral palsy. You can get more information from:
  • National Institute of Neurological Disorders and Stroke
    800-352-9424
    https://www.ninds.nih.gov/
  • United Cerebral Palsy (UCP)
    800-872-5827
    http://ucp.org

How can I help prevent cerebral palsy?

In some cases, you may not be able to prevent cerebral palsy, but you may be able to manage or avoid some of the risk factors.

• Prevent head injuries. Use car safety seats when your child is riding in a car. Make sure your child wears a helmet when skiing, or riding a bike, skateboard, or scooter. Never throw, hit, shake, or hurt a child.
• Newborns should be checked and treated for jaundice if needed.
• If you plan to get pregnant, be as healthy as possible before the pregnancy. Stay up to date with immunizations. Ask your healthcare provider if you need an immunization for chicken pox (varicella) and mumps, measles, and rubella (MMR).
• If you are pregnant and are Rh negative, you may need medicine to prevent Rh incompatibility.