Cerebral palsy

Cerebral palsy (likewise called CP) is a group of conditions that affects the parts of your brain that command your muscles. This can cause problems with movement, posture (standing up straight) and residual.

Some but not all children with CP also may accept other weather, like intellectual and developmental disabilities. These  are problems with how the brain works that can crusade a person to have trouble or delays in concrete development, learning, communicating, taking care of himself or getting along with others.

About i in 300 children (less than one pct) has CP. Near children are diagnosed past the time they're 2 years old.

CP is the well-nigh mutual cause of movement bug in childhood. In that location are 4 kinds of CP that are based on the type of motility problems a child has.

What is spastic CP?

Spastic ways tight or stiff muscles, or muscles that spasm (get tight). This is the nigh common kind of CP. About 4 in five children (lxxx percent) with CP accept spastic CP. These children accept stiff muscles and may accept awkward body movements.

Signs and symptoms of spastic CP include:

  • Tight muscles that do not stretch
  • Trouble walking, crossing knees, having a scissor-like walk or walking on toes
  • Tight joints
  • Weak muscles or no movement in a group of muscles

There are three kinds of spastic CP:

  1. Spastic diplegia. Children with this kind have muscle stiffness mostly in the legs. They may have trouble walking because tight muscles in the hips and legs crusade their legs to plow in and cross at the knees (also chosen scissoring). These children may demand a walker or leg braces to help them move from place to place.
  2. Spastic hemiplegia. This kind unremarkably affects ane side of the body. The arm and leg on the affected side may be shorter and thinner than the other side of the body. These children often walk later than others and may walk on tip-toe. Some have a curved spine (besides phone call scoliosis), seizures or speech bug.
  3. Spastic quadriplegia. This is the most serious kind of spastic cerebral palsy. It affects near of the body, including all arms and legs, the torso (the trunk's midsection) and the face. These children normally can't walk and they oft have intellectual disabilities, trouble speaking and seizures.

Are in that location other kinds of CP?

Yes. Other kinds of CP include:

  • Dyskinetic CP (includes athetoid CP, choreoathetoid CP and dystonic CP). Children with this kind of CP have muscle tone that ranges from being too tight to as well loose. This can crusade uncontrolled movements that can be tedious and twisting or quick and jerky. Children with dyskinetic CP may have problems controlling the movements of their hands, artillery, feet and legs. This makes information technology hard to sit down and walk. Some of these children too have trouble speaking. Issues in their confront and tongue muscles may make them frown or drool.
  • Ataxic CP. This type of CP is rare. These children have problems with residual and coordination. They may be unsteady when they walk. They also may have tremors (shaking muscles) when they make quick movements or movements that need a lot of control, like writing.
  • Mixed CP. This is when a child shows symptoms of more than one type of CP. The most common type of mixed CP is spastic-dyskinetic CP.

How practise you know if your baby has CP?

CP tin can exist different in each child. Some children have balmy CP. They may have some bad-mannered body movements and need trivial or no special assist. Other children have more serious CP. They may need a lot of special intendance their whole lives. CP doesn't get worse over time, only its symptoms can change.

Some but non all babies with CP often have developmental delays. This means your kid doesn't reach developmental milestones when expected. A developmental milestone is a skill or activity that about children tin can do at a certain age. Milestones include sitting, walking, talking, having social skills and having thinking skills. Tell your kid'southward health care provider if you notice whatsoever of these signs in your baby at these ages:

Younger than 6 months

  • His head falls back when you pick him up from lying on his back.
  • He feels strong or floppy.
  • He seems to push away when yous hold him.
  • His legs go strong legs and cross or "scissor" when you pick him up.

Older than six months

  • He doesn't roll over.
  • He can't bring his hands together.
  • He has trouble bringing his easily to his mouth.
  • He reaches with but one hand while keeping his other hand in a fist.

Older than 10 months

  • He crawls past pushing off with one hand and ane leg while dragging the other hand and leg.
  • He scoots around on his bottom or hops on his knees, but does not crawl on all fours.

Older than 1 year

  • He can't clamber.
  • He tin't stand upwards with support.

If you think your baby has developmental delays or other signs of CP, talk to her provider. Diagnosing CP usually happens in three steps.

  1. Developmental monitoring. Your baby's provider checks her growth and development over fourth dimension. If your babe shows signs and symptoms of CP, her provider recommends developmental screening.
  2. Developmental screening. These tests check for developmental delays, like problems with movement. The American Academy of Pediatrics recommends that all children have developmental screening tests during their well-baby visits at 9 months, 18 months and 24 or xxx months.
  3. Developmental and medical evaluations. If results of your infant'southward screening tests aren't normal, your infant's provider recommends developmental and medical evaluations. These can exist done by your baby's provider or by a child neurologist. This is physician with special training in treating brain weather in babies and children.

Your baby's provider also may recommend these tests for your baby:

  • Blood tests
  • Computed tomography (as well called CT scan). This test uses special 10-rays to make a picture of your baby'southward brain.
  • Electroencephalogram (likewise called EEG). This exam records electrical activity in your baby's brain. It tin can assist diagnose epilepsy, which sometimes happens in children with CP. Epilepsy is a seizure disorder that affects how the nerve cells in your brain piece of work.
  • Magnetic resonance imaging (also called MRI). MRI is a medical exam that makes a detailed picture show of the inside of your body.
  • Ultrasound. This test uses sound waves and a estimator screen to show a picture of your baby within the womb.

How is CP treated?

Y'all can work with a team of health care providers to figure out your child'south needs and come up upwards with a treatment plan. Members of the team can include:

  • Pediatrician. This is a doctor who has special training to take care of babies and children.
  • Child neurologist. This is a doc who has special training in treating brain conditions in babies and children.
  • Social worker. This is a person with special training to help people solve problems and make their lives better.
  • Psychologist. This is a person with special training to have care of people with emotional or mental health problems, like depression.
  • Orthopedic surgeon. This is a dr. with special training exercise surgery on bones and muscles.
  • Physical therapist. This is a person with special grooming to create exercise programs for your child.
  • Occupational therapist. This is a person who can teach your child how to practise everyday things, like eating, getting dressed and writing.
  • Voice communication and language pathologist. This professional can assistance your kid speak more clearly or communicate in other ways.
  • Special education teacher. This person has special grooming to help your child with learning.

Your child's treatment plan may include special equipment to help with movement and getting around. These tin include a walker, leg or arm braces, a wheelchair or scooter. He may as well demand a special estimator to help him communicate.

Your child may need medicines to assist relax muscle spasms, including:

  • Diazepam (Valium®), baclofen (Lioresal®), dantrolene (Dantrium®) and tizanidine (Zanaflex®). Your child takes these by mouth.
  • Baclofen, a medicine that your kid gets through a pump placed under his skin. The pump releases the medicine into the fluid that surrounds the spinal cord.
  • Botox® (too called botulinum toxin). Your child gets this through a needle.

If your kid has severe spasms and medicines don't help, your baby'south provider may recommend surgery called selective dorsal rhizotomy. This is when a surgeon cuts some of the nerves at the base of the spine. Information technology may help with muscle spasms and help your kid sit down, stand, walk or motility around more easily.

What wellness problems are common for people with CP?

People with CP may have these health problems:

  • Constipation. This is when you have painful gas or it'south difficult to have a bowel movement.
  • Drooling
  • Feeling pain, particularly in adults. Pain is near common in the hips, knees, ankles and back.
  • Problems urinating
  • Seizures
  • Throwing up
  • Trouble breathing
  • Trouble swallowing, sucking or eating
  • Trouble talking, seeing or hearing

What causes CP?

CP happens when your baby has encephalon damage or there are issues in how your baby'southward brain develops. Most children with CP have congenital CP. This means they have CP at nativity. In many of these children, nosotros don't know what the exact cause of CP is.

Changes in genes that touch on brain development may play a role in causing CP. Genes are a part of your body's cells that stores instructions for the way your body grows and works. Genes are passed from parents to children. A factor change (also called mutation) is a change to the instructions that are stored in a cistron.

The encephalon harm that leads to CP can happen earlier birth, during labor and nascence or later on nascence, while the brain is still developing. Your baby may be more likely than other babies to develop CP before nascency if:

  • You're pregnant with multiples (twins, triplets or more). The more than babies y'all're significant with, the greater the take a chance of CP.
  • Y'all accept certain infections during pregnancy. Infections that can lead to CP include chickenpox, rubella (also called German measles), cytomegalovirus (also called CMV), toxoplasmosis, chorioamnionitis (an infection in the uterus) and infections in the placenta. The placenta grows in your uterus (womb) and supplies your baby with food and oxygen through the umbilical cord.
  • You accept a health condition, like seizures or a thyroid status. The thyroid is a gland in your neck that makes hormones that help your torso store and use energy from nutrient.
  • Your blood and your baby'south blood are incompatible (can't exist together). This puts your baby at risk of Rh disease, which tin can cause serious problems — even death — for your baby. You tin can get a blood test during pregnancy to see if your blood and your baby's claret are incompatible.
  • You come in contact with a harmful substance, like mercury. During pregnancy, don't eat fish with loftier levels of mercury, similar swordfish, king mackerel, shark and tilefish.
  • Your baby doesn't get enough oxygen in the womb. This tin happen if the placenta isn't working properly or it tears away from the wall of the uterus earlier birth.
  • Your baby has haemorrhage in the encephalon. Sometimes a babe has a stroke in the womb that causes bleeding in her brain. Stroke happens when a blood clot (a mass or clump of blood) blocks a blood vessel that brings claret to the brain, or when a blood vessel in the brain bursts open up. Claret clots in the placenta, weak claret vessels and high blood pressure during pregnancy tin cause a baby to have a stroke in the womb.

Your infant may be more likely than other babies to develop CP during labor and birth if:

  • He'southward in the breech position at the start of labor. This is when your infant's bottom or feet are facing down right earlier nativity.
  • He doesn't get plenty oxygen during labor and birth. This can happen if in that location are problems with the umbilical string or you lot have a health condition, like uterine rupture. Uterine rupture is when the uterus tears during labor. This happens very rarely.
  • He's born prematurely. This is when a baby is born besides early on, before 37 weeks of pregnancy.
  • He's built-in with low birthweight or he's built-in pocket-sized for gestational age (also called SGA). Low birthweight means a infant weighs less than 5 pounds, 8 ounces at birth. SGA means a babe is smaller than normal based on the number of weeks he'due south been in the womb.

Babies who accept certain wellness weather later birth are more likely than others to develop CP. These weather condition include:

  • Severe jaundice, especially if it'southward not treated early. Jaundice is when your babe's eyes and pare look xanthous. A babe has jaundice when her liver isn't fully developed or isn't working well. Some blood diseases, like Rh disease, tin can cause astringent jaundice and brain damage in babies.
  • Head injuries. A babe may go a head injury from being in a car accident or falling and hitting her head.
  • Brain infections, like encephalitis and meningitis. Encephalitis is swelling of the encephalon; information technology'south usually acquired by a virus. Meningitis is an infection that causes swelling in the brain and spinal cord.
  • Seizures


Terminal reviewed: July, 2014