Cerebral palsy (CP) is a group of disorders that affect a person’s ability to move and maintain balance and posture. CP is the most common motor disability in childhood. Cerebral means having to do with the brain. Palsy means weakness or problems with using the muscles. CP is caused by abnormal brain development or damage to the developing brain that affects a person’s ability to control his or her muscles. Show
The symptoms of CP vary from person to person. A person with severe CP might need to use special equipment to be able to walk, or might not be able to walk at all and might need lifelong care. A person with mild CP, on the other hand, might walk a little awkwardly, but might not need any special help. CP does not get worse over time, though the exact symptoms can change over a person’s lifetime. All people with CP have problems with movement and posture. Many also have related conditions such as intellectual disability; seizures; problems with vision, hearing, or speech; changes in the spine (such as scoliosis); or joint problems (such as contractures). Types of Cerebral PalsyDoctors classify CP according to the main type of movement disorder involved. Depending on which areas of the brain are affected, one or more of the following movement disorders can occur:
There are four main types of CP: Spastic Cerebral PalsyThe most common type of CP is spastic CP. Spastic CP affects about 80% of people with CP. People with spastic CP have increased muscle tone. This means their muscles are stiff and, as a result, their movements can be awkward. Spastic CP usually is described by what parts of the body are affected:
Dyskinetic Cerebral Palsy (also includes athetoid, choreoathetoid, and dystonic cerebral palsies)People with dyskinetic CP have problems controlling the movement of their hands, arms, feet, and legs, making it difficult to sit and walk. The movements are uncontrollable and can be slow and writhing or rapid and jerky. Sometimes the face and tongue are affected and the person has a hard time sucking, swallowing, and talking. A person with dyskinetic CP has muscle tone that can change (varying from too tight to too loose) not only from day to day, but even during a single day. Ataxic Cerebral PalsyPeople with ataxic CP have problems with balance and coordination. They might be unsteady when they walk. They might have a hard time with quick movements or movements that need a lot of control, like writing. They might have a hard time controlling their hands or arms when they reach for something. Mixed Cerebral PalsySome people have symptoms of more than one type of CP. The most common type of mixed CP is spastic-dyskinetic CP. Early SignsThe signs of CP vary greatly because there are many different types and levels of disability. The main sign that a child might have CP is a delay reaching motor or movement milestones (such as rolling over, sitting, standing, or walking). Following are some other signs of possible CP. It is important to note that some children without CP also might have some of these signs. In a Baby Younger Than 6 Months of Age
In a Baby Older Than 6 Months of Age
In a Baby Older Than 10 Months of Age
Tell your child’s doctor or nurse if you notice any of these signs. Learn more about developmental milestones that children should reach from birth to 5 years of age Screening and DiagnosisDiagnosing CP at an early age is important to the well-being of children and their families. Diagnosing CP can take several steps: Developmental MonitoringDevelopmental monitoring (also called surveillance) means tracking a child’s growth and development over time. If any concerns about the child’s development are raised during monitoring, then a developmental screening test should be given as soon as possible. Developmental ScreeningDuring developmental screening a short test is given to see if the child has specific developmental delays, such as motor or movement delays. If the results of the screening test are cause for concern, then the doctor will make referrals for developmental and medical evaluations. Developmental and Medical EvaluationsThe goal of a developmental evaluation is to diagnose the specific type of disorder that affects a child. Learn more about screening and diagnosis Treatments and Intervention ServicesThere is no cure for CP, but treatment can improve the lives of those who have the condition. It is important to begin a treatment program as early as possible. After a CP diagnosis is made, a team of health professionals works with the child and family to develop a plan to help the child reach his or her full potential. Common treatments include medicines; surgery; braces; and physical, occupational, and speech therapy. No single treatment is the best one for all children with CP. Before deciding on a treatment plan, it is important to talk with the child’s doctor to understand all the risks and benefits. Visit the NINDS Cerebral Palsy Information Page to learn more about treatments for CP external icon Intervention ServicesBoth early intervention and school-aged services are available through our nation’s special education law—the Individuals with Disabilities Education Act (IDEA). Part C of IDEA deals with early intervention services (birth through 36 months of age), while Part B applies to services for school-aged children (3 through 21 years of age). Even if your child has not been diagnosed with CP, he or she may be eligible for IDEA services. Learn more about IDEA Services Causes and Risk FactorsCP is caused by abnormal development of the brain or damage to the developing brain that affects a child’s ability to control his or her muscles. There are several possible causes of the abnormal development or damage. People used to think that CP was mainly caused by lack of oxygen during the birth process. Now, scientists think that this causes only a small number of CP cases. The abnormal development of the brain or damage that leads to CP can happen before birth, during birth, within a month after birth, or during the first years of a child’s life, while the brain is still developing. CP related to abnormal development of the brain or damage that occurred before or during birth is called congenital CP. The majority of CP (85%–90%) is congenital. In many cases, the specific cause is not known. A small percentage of CP is caused by abnormal development of the brain or damage that occurs more than 28 days after birth. This is called acquired CP, and usually is associated with an infection (such as meningitis) or head injury. Learn more about causes and risk factors for CP If You’re ConcernedIf you think your child is not meeting movement milestones or might have CP, contact your doctor or nurse and share your concerns. If you or your doctor is still concerned, ask for a referral to a specialist who can do a more in-depth evaluation of your child and assist in making a diagnosis. At the same time, call your state’s public early childhood system to request a free evaluation to find out if your child qualifies for intervention services. This is sometimes called a Child Find evaluation. You do not need to wait for a doctor’s referral or a medical diagnosis to make this call. Where to call for a free evaluation from the state depends on your child’s age:
Learn more about early intervention ReferencesAmerican Academy of Pediatrics. Caring for your baby and young child: Birth to age five. 5th ed. Shelov SP, editor. Elk Grove Village (IL): Bantam Books; 2009. American Academy of Pediatrics Healthy Children / Cerebral Palsy American Association on Intellectual and Developmental
Disabilities Honeycutt A, Dunlap L, Chen H, Homsi G. Economic costs associated with mental retardation, cerebral palsy, hearing loss, and vision impairment: United States, 2003. MMWR Morb mital Wkly Rep. 2004;53(3): 57-59. Identifying Infants and Young Children With Developmental Disorders in the Medical Home: An Algorithm for Developmental Surveillance and Screening. Council on Children With Disabilities, Section on Developmental Behavioral Pediatrics, Bright Futures Steering Committee, Medical Home Initiatives for Children With Special Needs Project Advisory Committee. Pediatrics, July 2006. March of Dimes. Cerebral Palsy. My Child
Without Limits National Institute of Neurological Disorders and Stroke. Cerebral Palsy: Hope Through Research. NIH Publication Number 10-159, updated 5/6/10. Pellegrino, Louis. Cerebral Palsy, in Batshaw ML, Pellegrino L, Roizen NJ (eds.), Children with Disabilities, 6th Edition, Baltimore, MD, Paul H Brookes Publishing Company, 2007, pp 387-408. UCP |