What is cerebral palsy?
Cerebral palsy is a group of permanent neurological disorders affecting movement and co-ordination - cerebral relating to the brain, and palsy referring to various types of paralysis.
It is the most common cause of disability in early childhood. One in 400 children will be diagnosed with cerebral palsy every year as a result of injury to the brain before, during or shortly after birth.
Cerebral Palsy varies significantly from person to person; some children or adults may have a mild form, while others will be severely disabled. Common impairments affect muscle control, tone, reflexes, posture and balance.
What causes cerebral palsy?
There is no one main cause of cerebral palsy but it is due to an injury to the brain. Some of the more frequent reasons for injury include:
- Limited or interrupted oxygen supply
- Bleed on the baby’s brain or trauma to the head
- Mother catching an infection while pregnant, such as rubella or chicken pox
- Genetic changes which affect brain development
- Stroke in the womb or after birth
- Premature or difficult birth
Other rarer causes of cerebral palsy are blood type incompatibility and infections such as meningitis.
Are there different types of cerebral palsy?
Because of the sophistication of the brain, cerebral palsy is a complex neurological disorder with a range of subdivisions. But generally speaking, there are three main types of cerebral palsy. Some people may experience a mix of all three types.
- Spastic –the most common types of CP where muscle tone is tight and stiff, reducing range of movement. This can be painful, especially when muscles go into spasm involuntarily. Spastic CP generally affects walking and reflexes.
- Dyskinetic or Athetoid – sometimes called non-spastic CP where muscles have fluctuating tone. This can lead to involuntary movement in the face, torso and limbs; there may be lack of control over the tongue, vocal cords, and breathing. Dyskinetic CP can cause floppy limbs and problems with posture.
- Ataxic – this generally affects balance, co-ordination and spatial awareness. People with Ataxic CP can usually walk but movement may be shaky or tremored.
Depending on where in the brain the injury occurred, CP can affect different parts of the body and you may hear the terms hemiplegia (1 side of the body), monoplegia (1 limb), diplegia (2 limbs), or quadriplegia (all 4 limbs).
Are there any risk factors for cerebral palsy?
Prematurity, a low birth weight under 2.5lbs, and twin or multiple births increase the risk of a child having cerebral palsy. Maternal and paternal age may also increase risk, especially if the mother is under 20 or over 40.
Other risks include poorly treated maternal hyperthyroidism, early onset pre-eclampsia, and foetal growth restrictions.
How will I know if my child has cerebral palsy?
Symptoms may not be obvious until a child is a few years old, but concerns may be raised if a child is not meeting gross motor milestones such as sitting by eight months or walking by 18 months.
Other possible signs include:
Stiff or floppy limbs
- Weak arms or legs
- Fidgety, jerky or clumsy movements
- Walking on tiptoes
- Problems with vision, hearing, speech and swallowing
There are a number of associated conditions a person with cerebral palsy may experience. Half of people with CP will have a learning disability, a third may have epilepsy and one in four have behavioural problems. Some have issues with sleep, communication, feeding, and continence.
If you suspect your child has cerebral palsy or are concerned with their development, your GP should discuss their medical history and birth with you and refer them for examinations if CP is suspected. Diagnosis may be by way of brain scans, such as cranial ultrasound, MRI or CT scans to examine the brain. Other tests include an EEG to monitor brain activity, EMG to look at muscles and nerves, and blood tests.
What is the prognosis for a child diagnosed with cerebral palsy?
There is no cure for cerebral palsy but the initial brain injury does not get worse with age. Most live well into adulthood and can lead fulfilled, independent lives with the right support. However, cerebral palsy can put a strain on the body, particularly bones and joints.
Children with cerebral palsy should have medical needs assessed by community care teams and receive support from the Department of Health and local authority. This may include NHS-funded physiotherapy, speech and language therapy, or occupational therapy. Any care plans should be continually reassessed with age or as needs change.