Cerebral palsy (CP) is a group of chronic disorders that affect your child’s ability to control movement. It appears in infancy and early childhood. Generally, the nerve damage does not worsen over time, but the muscle, joint and skeletal effects can get worse without treatment.
CP occurs as a result of damage to areas of the brain that direct movement. This damage interferes with the brain's ability to control movement and posture. Other areas of the brain controlling thinking, speech, vision or hearing may also be involved. CP may develop before, during or after birth.
Causes of Cerebral Palsy
A child can develop CP from the following:
- Stroke or bleeding in the baby's brain during fetal development or after birth
- Head injury or brain infection
- Abnormalities of the umbilical cord or placenta
- Lack of oxygen during or after birth
- Meningitis, encephalitis, seizures or head injury
- Genetic/metabolic abnormalities
- Mother has rubella, toxoplasmosis or cytomegalovirus while pregnant
- Mother and baby’s blood types are not compatible, causing severe jaundice
Some factors that can increase your child's risk of developing CP include:
- Premature birth
- Low birth weight
- Complicated or premature delivery
- Multiple births
- Breech birth
- In vitro fertilization (IVF)—in part due to multiple births associated with IVF
- Infection or blood clotting problems during pregnancy
- Vaginal bleeding during pregnancy
- History of CP in parent or sibling
- Seizures or intellectual disability in the expectant mother
- Cord prolapse — when the umbilical cord drops through the open cervix into the vagina ahead of the baby
- Low Apgar score — a rating of the child's condition just after birth
- Vaginal or urinary tract infection during pregnancy
- High birth weight
- Type 1 diabetes in the expectant mother
- Obesity in the expectant mother
- Small head size
Cerebral Palsy Symptoms
CP first shows up in children aged 3 years or younger. Symptoms vary depending on what areas of the brain are affected. The problems can involve one side of the body (hemiplegia), the upper or lower body (diplegia), or both the upper and lower body on both sides (quadriplegia). Occasionally the face and neck are involved.
Disabilities can be mild to severe. Although symptoms may change or progress slightly as your child grows older, your child's condition is unlikely to worsen, especially with treatment.
- Late to turn over, sit up, smile or walk
- Trouble writing, buttoning a button or other fine motor activities
- Difficulty walking or standing
- Tight, spastic muscles
- Weak muscles
- Poor balance
- Speech problems
- Unintentional body movements
- Difficulty swallowing
Some people with CP suffer from other medical disorders as well, including:
- Intellectual disabilities
- Learning disabilities
- Vision or hearing problems
- Failure to thrive
- Decreased ability to feel pain or identify items by touch
- Problems with bowel and bladder control
- Skin breakdown
- Low bone density and fractures
Diagnosis and Treatment at UVA
If you suspect that your child has CP, we will test your child’s motor skills and reflexes. We may also use the following tests:
- Electroencephalogram (EEG) to test the electrical activity in your child’s brain
- CT scan
- MRI scan
Treating Cerebral Palsy
There is no cure for CP. Therapy aims to help your child reach his or her full potential. Children with CP grow to adulthood and may be able to work and live independently. We will work with you and your child to manage a CP diagnosis with the following:
- Medication can help control muscle spasm, seizures and prevent bone loss.
- Surgery may improve the ability to sit, stand and walk. These may include tendon transfers or lengthening, joint loosening, bone straightening and nerve surgery.
- Physical aids, like braces and splints, help reduce muscle contraction, keep limbs in correct alignment and prevent deformities. Walkers, special scooters and wheelchairs can make it easier to move around.
- Special education, designed specifically for your child's needs can improve learning. Some children do well attending regular schools with special services.
- Rehabilitation services, like speech, physical, and occupational therapies, may improve the ability to speak, move, walk and perform activities of daily living.
- Physical therapy helps strengthen muscles and improve fitness.
- Family services can help your child and your family cope with CP. Counselors help parents learn how to modify behaviors. Caring for a child with CP can be stressful. Some families find support groups helpful.
Preventing Cerebral Palsy
It’s possible to prevent your child from developing many types of CP by the following:
- Before getting pregnant, receive a vaccination for rubella.
- Seek early prenatal care.
- Receive testing for blood-type problems when pregnant. Get treatment if tests reveal incompatible blood types.
- Do not smoke, drink alcohol or use drugs while pregnant.
- Insist that the child wear a helmet when riding a bicycle.
- Seek help if you have, or want to, hurt the child.
- Keep poisons away from your child.
- Closely supervise bathing.
- Get your child immunized at the recommended time.
- If your baby becomes sick, call the doctor right away.
- For infants with brain injury at birth, hypothermia to lower body temperature can reduce the risk of tissue injury and long-term problems.