Cerebral palsy

Cerebral palsy (CP) is a broad term that includes a group of physical and sometimes cognitive disabilities that interfere with your child's physical function. It is a lifelong condition that affects communication between the brain and muscles, causing trouble with a variety of activities including speaking, eating, sitting, walking, and using the hands.

CP is usually diagnosed in early childhood and, while there is no cure, a wide range of treatments and therapies are available to help your child achieve greater independence.

Causes

Cerebral palsy is the result of an injury to an immature brain often due to a stroke, infection, or accident. Other causes can include brain malformation or low oxygen. Premature babies have a higher risk of developing CP.

Types of Cerebral palsy

Spastic: The most common type of movement disorder in people with CP is spasticity. This refers to tightness or resistance to stretch. Additionally, children with spastic CP have weakness and trouble coordinating their movements. Spasticity can affect one or more areas of your child's body, making muscles tight and difficult to use. Treatment likely would include therapy, bracing and possibly oral or injectable medication. Sometimes children with spastic CP can benefit from an intrathecal baclofen pump – a battery-powered device surgically implanted to deliver medication into the spine – or selective dorsal rhizotomy, a cutting of carefully selected sensory nerves. Additionally, orthopedic surgery may help to maintain proper alignment of your child's spine or limbs.

Dystonic: Your child's dystonic CP causes twisting postures that can interfere with the use of arms and legs as well eating and speaking. As with all children with CP, those with dystonic CP benefit from physical, occupational and speech therapy. There are oral and injectable medications for dystonia, and sometimes intrathecal or intraventricular baclofen pumps are recommended as well.

Ataxic: Children with ataxic CP experience problems with coordination and balance, which can cause difficulties with walking and arm use. The Children's team can develop a varied, personalized treatment program to help your child gain and maintain maximum independence. This may include physical therapy to increase strength, balance and coordination. There are no specific medications for ataxia, but special weighted devices and garments, as well as walkers and wheelchairs, may be very helpful.

Mixed cerebral palsy: When symptoms of spasticity, ataxia and/or dystonia appear together, it is called mixed cerebral palsy. Different symptoms may appear with varying degrees of severity. No two children with CP are alike, so your child's treatment program will be tailored specifically to his or her needs. Treatment may involve physical therapy, speech-language pathology, occupational therapy, neuropsychology, medication, braces, equipment or a combination of these and other treatments.

Additionally, CP can be described by the body areas it affects most. Diplegia means that arms are affected more than the legs and is most common in people who were born prematurely. Hemiplegia means one side of the body is more affected, and quadriplegia means all four limbs are affected. People with CP may have seizures, learning disabilities, and vision and hearing challenges.

Diagnosis

Cerebral palsy is a clinical diagnosis, meaning there is no one test that can diagnose it. Your child's doctor will take a detailed history, examine him or her carefully, and may ask for an MRI of the brain or other tests.

Treatment

CP is a lifelong condition. There is no medicine or surgery that can repair the damage to the brain, but there are a number of things the team at Children's can do to help your child. Medications can reduce the abnormal movements, therapy can be used to strengthen weak muscles and improve mobility, equipment can be prescribed to maximize function, and surgery can be performed to maintain proper alignment of bones and to reduce tone.
Our team includes pediatric experts in orthopedics, neurosurgery, and physical medicine and rehabilitation. We work together to identify and address the unique needs of each child.

Long-term outlook

Individuals with cerebral palsy have a wide range of physical and cognitive abilities. With age it becomes easier to determine where on the spectrum your child will likely be. Regardless of severity, the team at Children's is committed to maximizing your child's function and quality of life.