Cerebral Palsy

Cerebral palsy (CP) is a group of disorders that affect balance, movement, and muscle tone. Cerebral means the disorder is related to the brain, and palsy refers to weakness or a muscle problem.

Types #

CP or cerebral palsy is divided into four main types, based on the movement involved:

• Spastic cerebral palsy

• Dyskinetic cerebral palsy

• Ataxic cerebral palsy

• Mixed cerebral palsy

Spastic cerebral palsy #

The most common kind is spastic CP. If you have it, your muscles are stiff or tight, or they spasm.

Doctors break down spastic CP into three groups:

Spastic diplegia #

It mostly involves muscle stiffness in the legs. Tight muscles in your legs and hips might cause trouble walking because your legs turn in at the knees. This is also called scissoring.

Spastic hemiplegia #

It means one side of your body is affected. Your arm and leg on that side may be shorter and thinner, which might cause you to walk on your tiptoes. Some people with this type have a curved spine, called scoliosis. Seizures and speech problems can also be part of spastic hemiplegia.

Spastic quadriplegia #

It means all of your limbs are affected, as well as your torso and your face. You may also have seizures and trouble speaking if you have this type of CP. It’s the most serious kind of spastic CP.

Dyskinetic cerebral palsy #

If you have dyskinetic CP, your muscle tone might be too tight or too loose. Your movements are uncontrolled: slow and twisting, or quick and jerky. If the muscles in your face or mouth are affected, you might frown, drool, and have trouble speaking.

Dyskinetic CP breaks down further into these types:

• Athetoid - Movements are writhing, slow, and curvy.

• Choreoathetoid - Movements are aimless and not controlled.

• Dystonic - Muscle tone is not normal.

Ataxic cerebral palsy #

Ataxic CP, which is rare, causes problems with coordination and balance. You might be unsteady when you walk. You might also shake, which could make it hard to do tasks that need steadiness, such as writing.

Mixed cerebral palsy #

People with this type of CP have symptoms of more than one type. Most people with mixed CP have a combination of spastic and dyskinetic.

Causes #

Some of the problems that can damage the brain or disrupt its growth include:

• Bleeding in the brain while the baby is in the womb, during birth or afterward

• A lack of blood flow to important organs

• Seizures at birth or in the first month of life

• Some genetic conditions

• Traumatic brain injuries

Some of the problems that can damage the brain or disrupt its growth include:

• Bleeding in the brain while the baby is in the womb, during birth or afterward

• A lack of blood flow to important organs

• Seizures at birth or in the first month of life

• Some genetic conditions

• Traumatic brain injuries

Symptoms #

Because there are very mild and very severe forms of cerebral palsy, a wide range of symptoms could signal this condition. Often, delays in baby milestones that are linked to muscle usage may be signs of CP. Examples include rolling over, sitting up, standing, and walking. But not all delays in milestones mean your baby has cerebral palsy.

Some symptoms may show up at birth, while others may take longer to appear. In babies younger than 6 months, those signs include:

• When you pick your baby up from sleeping (on their back), their head falls backward.

• They feel stiff or floppy.

• When cradled in your arms, they extend their back and neck, almost as if pushing away from you.

• When you pick them up, their legs get stiff and cross over each other (scissor).

If your baby is older than 6 months, warning signs can include:

• They can’t roll over.

• They can’t bring their hands together.

• They have trouble bringing their hands to their mouth.

• When they reach, it’s with only one hand. The other stays in a fist.

Diagnosis #

• Blood tests - Other health problems may cause symptoms that can look like CP. Your doctor may offer blood tests to rule out other conditions.

• CT scan - A CT scan uses X-ray technology to make images of the brain.

• MRI uses a strong magnet, not X-rays - It uses no radiation and can make higher-quality images than a CT scan. This can be helpful if the damage is hard to detect, but it may not always be needed.

• Ultrasounduses sound waves to make an image of your baby’s brain. It may not be as helpful as an MRI at finding slight problems in the brain, but it’s an easier test for your baby to take. It can be done only in very young babies, before the soft spot gets too small.

• EEG (electroencephalogram) - For this test, small electrodes will be stuck to your baby’s head to measure their brain waves. Sometimes, this exam can help diagnose epilepsy (seizure disorder), which is somewhat common in children with cerebral palsy.

Treatment #

Physical Therapy #

Your child’s doctor may want to send them to physical therapy as early as possible so they can learn how to move with better balance, strengthen their muscles or maintain their current muscle tone. They’ll do exercise to help stretch their muscles, which may reduce spasms. They’ll get a special exercise program that’s tailored to their need.

Occupational Therapy #

It’s harder to complete daily tasks like getting dressed, brushing teeth, using scissors and writing on the classroom board when you have movement issues. An occupational therapist can give your child extra help with chores like these, based on their own needs, to help them improve at the tasks that they does at home and at school. They will also help put into place adaptive technology to support your child in the classroom.

Speech Therapy #

Some children with cerebral palsy have trouble speaking well because the muscles that work their mouths are affected. If your child needs help, a speech and language therapist may help them learn to form words and speak more clearly. If your child isn’t able to speak, they can learn other ways to communicate, such as sign language.

Medicine #

Cerebral palsy often causes muscle spasms in different parts of the body. Your child’s doctor may prescribe medicine to relax those muscles and make it easier for them to move around with more control. The type of drug they will receive depends upon their symptoms and how mild or severe the condition is.

Surgery #

Children whose muscles are very stiff or spastic may have surgery to lengthen some leg muscles or tendons. This can make walking easier and less painful. Doctors may hold off on this type of surgery until a child has reached a certain age or level of development. This can help ensure that the surgery doesn’t lead to long-term problems.