Cerebral palsy (sa-REE-brul PAWL-zee) is a group of several conditions characterized by a loss or limitation of movement or other nerve functions caused by brain injuries that typically occur before, during, or shortly after birth.
Marsha could not help comparing her baby to the others at the park. At 10 months of age, Sam could hardly sit up on his own, but most of the other babies Sam's age were crawling and pulling up to a standing position. Marsha also noticed that Sam often felt stiff when she picked him up. When Marsha took Sam to the doctor and described his symptoms, the doctor suspected that Sam had a form of cerebral palsy. Sam's doctor explained that cerebral palsy occurs when parts of the brain that control movement are injured or fail to develop properly during pregnancy.
Cerebral palsy is not a single condition but instead identifies a group of movement disorders caused by a brain injury. The period before birth and shortly after birth is typically defined as the perinatal period. At some point during this time, the developing brain tissue may be injured by trauma * or by diseases such as meningitis * or encephalitis * . Brain damage may also result from severe dehydration * , lack of oxygen, or a variety of other problems. In some cases, ill health in the mother while she is pregnant may lead to cerebral palsy in her child. In addition, infants who are born prematurely have a higher risk of developing cerebral palsy.
According to the United Cerebral Palsy Research and Educational Foundation, 764,000 U.S. children and adults have cerebral palsy, and 10,000 new cases of cerebral palsy are diagnosed in the United States each year.
Cerebral palsy is divided into three main types based on symptoms, although many people may have symptoms that span more than one type.
Spastic (SPAS-tik) syndromes are the most common form of cerebral palsy and account for 70 to 80 percent of cases. People with spastic syndromes move in a stiff or jerky way. Spastic movements may affect one limb, one side of the body, both legs, or both arms and legs, and the affected limbs are usually underdeveloped and have rigid muscles. For those people with mild cases, the symptoms may only become obvious during certain activities such as running, whereas those with severe cerebral palsy may require a wheelchair. People with spastic syndromes also may experience seizures * , partial or full loss of movement (paralysis), sensory abnormalities, and problems with speech, hearing, and vision.
Athetoid, or dyskinetic, cerebral palsy affects 10 to 20 percent of patients. Individuals with this form of the disease experience slow, writhing, involuntary muscle movements in the arms and legs, meaning their movements happen automatically as in a reflex rather than by choice. The symptoms usually increase with stress and disappear when the person is sleeping.
Ataxic cerebral palsy is the least common form, affecting about 5 to 10 percent of people with the disease. This form is characterized by weakness, uncoordinated movements, and shaking, and often leads to difficulties with rapid and fine motor movements.
Many people with cerebral palsy, even some who experience very severe physical disabilities, have normal intelligence, but about two-thirds have intellectual impairments, according to the National Institute of Neurological Disorders and Stroke. Some of these children may attend regular classes but have trouble with reading or math, while others may need special learning assistance.
As of 2015, there was no assessment to test for cerebral palsy before a baby is born. In fact, physicians are often unable to make a clear diagnosis until a child is six months to two years old, and this is frequently aided by a parent's own observations and concerns. A doctor will typically perform a physical examination that includes a test of the child's reflexes, often by tapping specific tendons in the body with a reflex hammer, to see if the child's brain and nervous system are functioning properly. In individuals with spastic symptoms of cerebral palsy, the reflex responses are more pronounced. In some instances, simple bending of a leg or arm can trigger it to jump. The exaggerated reflex response may arise from damage to the upper motor neurons, nerve cells that run from an area called the motor cortex, which lies within the brain's cerebral cortex (the main thought-processing region) to the spinal cord. The neuronal damage affects the ability of the motor cortex to control voluntary muscle movements * . The doctor's exam may also include an evaluation of the child's gait, or walking pattern, detailed inquiries about perinatal * health history, and various diagnostic tests, by such means as x-rays, magnetic resonance imaging, or computed tomography.
In addition, because children who are born prematurely with very low birthweights (less than two pounds) are more prone to cerebral palsy, physicians and parents should be vigilant in monitoring the children's progress over time.
Depending on the symptoms, a doctor may prescribe muscle relaxants to reduce muscle tone and the related spastic movements or medications to control seizures. Occasionally, a doctor may recommend surgery to treat disease-related muscle, hip, or extremity problems.
Because the cause of cerebral palsy is unknown in the majority of cases, no definite prevention methods are available. Nonetheless, an expectant mother can increase the chances that her baby will be healthy by eating properly, getting regular checkups, and refraining from activities such as smoking, drinking alcohol, or drug use that may harm the fetus. After giving birth, a parent can take steps to provide the child with a safe environment that reduces the potential for accident or injury.
Cerebral palsy is a lifelong disorder. The extent of disability caused by cerebral palsy varies with the severity of the symptoms. Some people have mild forms that are barely noticeable. For example, a child may have a limp when walking or running. Other people have more severe symptoms and may require a wheelchair to get around or experience severe intellectual disability. While severely affected persons may need long-term care, such as institutionalization, a large proportion of people with cerebral palsy lead full and complete lives. Most children with cerebral palsy engage in many of the activities their friends enjoy, including attending school, participating in summer camp, reading, listening to music, talking on the phone, using the computer, and playing sports. As they grow older, many continue their education at college, enter the job market, form personal relationships, and raise their own children.
See also Birth Defects: Overview • Brain Injuries • Disability • Epilepsy
Baniel, Anat. Kids Beyond Limits: The Anat Baniel Method for Awakening the Brain and Transforming the Life of Your Child With Special Needs. New York, NY: Perigee Books, 2012.
Centers for Disease Control and Prevention. “Cerebral Palsy (CP).” http://www.cdc.gov/ncbddd/cp/index.html (accessed November 27, 2015).
Cerebral Palsy Foundation. 3 Columbus Circle, 15th Floor, New York, NY 10019 Telephone: 212-520-1686. Website: http://yourcpf.org (accessed November 27, 2015).
United Cerebral Palsy. 1660 L St. NW, Suite 700, Washington, DC 20036. Toll-free: 800-872-5827. Website: http://www.ucp.org (accessed November 27, 2015).
* trauma refers to a wound or injury, whether psychological or physical. Psychological trauma refers to an emotional shock that leads to lasting psychological damage.
* meningitis (meh-nin-JY-tis) is an inflammation of the meninges, the membranes that surround the brain and the spinal cord. Meningitis is most often caused by infection with a virus or a bacterium.
* encephalitis (en-seh-fuh-LYE-tis) is an inflammation of the brain, usually caused by a viral infection.
* dehydration (dee-hi-DRAY-shun) is a condition in which the body is depleted of water, usually caused by excessive and unreplaced loss of body fluids, such as through sweating, vomiting, or diarrhea.
* seizures (SEE-zhurs) are sudden bursts of disorganized electrical activity that interrupt the normal functioning of the brain, often leading to uncontrolled movements in the body and sometimes a temporary change in consciousness.
* voluntary muscle movements are those physical actions, such as moving a hand or blinking an eyelid, over which an individual has conscious muscle control.
* perinatal (per-ee-NAY-tal) means existing or occurring around the time of birth, with reference to the fetus.