Cerebral Palsy

Cerebral palsy (CP) is a group of neurologic (brain) disorders that affect the way the brain communicates with muscles. This can lead to lifelong challenges with movement, strength and balance. CP is typically characterized by muscle tightness, also known as spasticity. It is most often diagnosed at a very early age and occurs in about three out of every 1,000 babies born.

There are three different types of CP:

• Spastic cerebral palsy: This is the most common type of CP involving spasticity or resistance when trying to move an arm or leg.
• Dystonic (or athetoid) cerebral palsy: Dystonic movements are uncontrolled, purposeless and often rigid in nature that can occur in the arms, legs or back.
• Ataxic cerebral palsy: Ataxia is difficulty with coordination of movement and can affect any part of the body. It may appear as if the child is clumsy or always off balance.

Causes and Symptoms

The specific cause of cerebral palsy is often unknown. It occurs when there is abnormal development or damage to areas of the brain that control movement. These issues usually develop when the baby is still in the womb but can happen at any time during birth or the first few years of life.

Many factors can increase the risk for CP, including:

• Prematurity
• Bleeding in the brain
• Low birth weight
• Infections of the body or brain
• Substance abuse or trauma during pregnancy

Common symptoms of CP include:

• Weakness or stiffness in certain parts of the body
• Delayed developmental milestones, such as rolling over, sitting, crawling, walking or talking
• Uncontrolled shaking in arms and legs
• Difficulty with eating or drinking and poor weight gain
• Frequent lung infections
• Difficulty with learning, focusing or behavior
• Problems with hearing or speaking
• Vision or eye problems (being “cross-eyed” or having a “lazy eye”)
• Seizures
• Curvature of the spine (called scoliosis)

Diagnosis

As there is no specific test for CP, a diagnosis is made through an assessment of the patient’s medical history and a physical exam. A definitive diagnosis is often delayed until a child is at least 6 to 12 months, as babies develop and change so rapidly during this early time. Additional information is sometimes gathered via an MRI (magnetic resonance image) to capture brain images or through genetic and metabolic testing.

Treatment

There is currently no cure for CP, but there are treatments to help minimize symptoms. Physical, occupational, speech and behavioral therapy are the most important treatments because they encourage and support movement, mobility, motor skills and speech.

Equipment such as leg braces, walkers or wheelchairs can also greatly help with mobility. We offer a Spasticity Clinic to help manage muscle tightness with medications such as Botox®, which is injected directly into the affected muscle group. Botox can provide relief by temporarily relaxing the muscle and allowing it to stretch. In some cases, surgery is a good option to help increase movement and positioning of joints in the arms, legs, hips or back.