Cerebral Palsy
DEFINITION
Cerebral palsy is a disorder of movement, muscle tone or posture that is caused by an insult to the immature, developing brain, most often before birth.
Signs and symptoms appear during infancy or preschool years. In general, cerebral palsy causes impaired movement associated with exaggerated reflexes, floppiness or rigidity of the limbs and trunk, abnormal posture, involuntary movements, unsteadiness of walking, or some combination of these.
People with cerebral palsy may have difficulty with swallowing and commonly have eye muscle imbalance. People with cerebral palsy may have reduced range of motion at various joints of their bodies due to muscle stiffness.
The effect of cerebral palsy on functional abilities varies greatly. Some people are able to walk while others aren’t able to walk. Some people show normal to near normal intellectual function, but others may have intellectual disabilities. Epilepsy, blindness or deafness also may be present.
People with cerebral palsy often have underlying developmental brain abnormalities.
CAUSES
Cerebral palsy is caused by an abnormality or disruption in brain development, usually before a child is born. In many cases, the exact trigger of this abnormality isn’t known. Factors that may lead to problems with brain development include:
- Random mutations in genes that control brain development.
- Maternal infections that affect the developing fetus.
- Fetal stroke, a disruption of blood supply to the developing brain.
- Lack of oxygen to the brain (asphyxia) related to difficult labor or delivery. This is rarely a cause.
- Infant infections that cause inflammation in or around the brain.
- Traumatic head injury to an infant from a motor vehicle accident or fall.
SYMPTOMS
Signs and symptoms can vary greatly. Movement and coordination problems associated with cerebral palsy may include:
- Variations in muscle tone, such as being either too stiff or too floppy
- Stiff muscles and exaggerated reflexes (spasticity)
- Stiff muscles with normal reflexes (rigidity)
- Lack of muscle coordination (ataxia)
- Tremors or involuntary movements
- Slow, writhing movements (athetosis)
- Delays in reaching motor skills milestones, such as pushing up on arms, sitting up alone or crawling
- Favoring one side of the body, such as reaching with only one hand or dragging a leg while crawling
- Difficulty walking, such as walking on toes, a crouched gait, a scissors-like gait with knees crossing or a wide gait
- Excessive drooling or problems with swallowing
- Difficulty with sucking or eating
- Delays in speech development or difficulty speaking
- Difficulty with precise motions, such as picking up a crayon or spoon
- The disability associated with cerebral palsy may be limited primarily to one limb or one side of the body, or it may affect the whole body. The brain disorder causing cerebral palsy doesn’t change with time, so the symptoms usually don’t worsen with age, although the shortening of muscles and muscle rigidity may worsen if not treated aggressively.
Other neurological problems
Brain abnormalities associated with cerebral palsy also may contribute to other neurological problems. People with cerebral palsy may also have:
- Difficulty with vision and hearing
- Intellectual disabilities
- Seizures
- Abnormal touch or pain perceptions
- Oral diseases
- Mental health (psychiatric) conditions
- Urinary incontinence
When to see a doctor
It’s important to get a prompt diagnosis for any movement disorder or possible delays in your child’s development. See your child’s doctor if you have any questions or concerns about muscle tone, muscle movement, coordination or other developmental issues.
