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What Is Cerebral Palsy?

Cerebral palsy refers to a group of neurological disorders that affect body movement and muscle coordination. It is one of the most common motor disabilities to appear in childhood.

Cerebral palsy is a result of brain damage or abnormal brain development that affects an individual’s ability to control their muscles. It is most likely to develop within the first month following a child’s birth, or even during the first years of their life when their brain is still developing.

Doctors and scientists used to believe that cerebral palsy was predominantly a result of oxygen deprivation during birth. However, recent research suggests that this actually accounts for a small number of cases. Congenital cerebral palsy, which is caused by abnormal brain development or damage occurring before or during birth, accounts for the majority (85%-90%) of all cases.

People with severe cerebral palsy may need to use special equipment to walk. Individuals with mild cerebral palsy, on the other hand, may show few symptoms. Although this disorder does not worsen with time, its presentation can change.

Mother and daughter

Types of Cerebral Palsy

Medical professionals classify cerebral palsy based on the type of movement disorder an individual exhibits. The main types of CP include:

Spastic Cerebral Palsy

This type affects approximately 80% of patients with cerebral palsy. People with spastic cerebral palsy have increased muscle tone or stiff muscles that make their movements appear awkward. There are several subcategories that doctors diagnose based on which muscles are affected:
  • Spastic diplegia/diparesis: Muscle stiffness is mainly in the legs. Individuals may find it difficult to walk since their tight leg and hip muscles make their legs pull together, turn inward, or cross at the knees like scissors.
  • Spastic hemiplegia/hemiparesis: This type of spastic cerebral palsy, on the other hand, affects one side of an individual’s body more than the other.
  • Spastic quadriplegia/quadriparesis: This is the most severe type of spastic cerebral palsy. It affects the trunk, face, and all four limbs. Individuals with this condition may not be able to walk.

Dyskinetic Cerebral Palsy

People with dyskinetic cerebral palsy have difficulty controlling the movement of their feet, legs, arms, and hands. Their movement may be uncontrollable, slow and writhing, or rapid and jerky. It can also be difficult to sit or walk. The disorder can sometimes affect the face and tongue, making it hard to suck, swallow, and talk. Muscle tone shifts from too loose to too tight and can change from day to day or even during a single day.

Ataxic Cerebral Palsy

Ataxic cerebral palsy makes it difficult for people to balance and coordinate their movements. They can be unsteady when walking and have a hard time with fast movements and movements that require a lot of control, like writing. In addition, they may find it difficult to control their arms or hands.

Mixed Cerebral Palsy

An individual can exhibit symptoms of more than one type of cerebral palsy, such as spastic-dyskinetic cerebral palsy.

Signs of Cerebral Palsy

There are a wide variety of signs that a child may have cerebral palsy. The most common signs and symptoms are impaired coordination, movement, speech, eating, and overall development.

Movement and Coordination

Cerebral palsy affects movement and coordination, resulting in symptoms including:

Speech and Eating

 Speech and eating can be difficult for a child with cerebral palsy. They might exhibit:

Development

 A child with cerebral palsy can experience development that is delayed or unusual for their age, including:

Other Problems

Cerebral palsy affects movement and coordination, resulting in symptoms including:

As a child grows, some symptoms may become less or more apparent. Muscle rigidity and shortening, in particular, may worsen if not treated aggressively.

When to See a Doctor

You should reach out to a doctor immediately if you notice any signs of cerebral palsy in your child. For an infant below six months of age, they include:

A baby between six and 10 months of age might:

A baby older than 10 months might:

Baby
Doctor playing with a patient sitting on a wheelchair

Preparing for Your Appointment

Before you take your child in for a doctor’s appointment, be sure to prepare the following information:

The doctor should be able to answer any questions you might have and recommend certain screenings and tests.

Options for Screening and Diagnosis

Developmental Monitoring

Doctors who suspect cerebral palsy will monitor a child’s growth and development over time. At a series of appointments, they will make note of any concerns the parents have, update the child’s developmental history, and observe the child’s movement.

Developmental monitoring is crucial, especially for children at a higher risk of cerebral palsy due to low birth weight or preterm birth.

Developmental Screening
A developmental screening is a short test that can detect specific developmental delays in a child, such as movement or motor delays. It can be in the form of an interview, a questionnaire that a parent completes, or a series of tests performed by a medical professional. If your doctor has any concerns after reviewing the results of a developmental screening test, they may make referrals for further evaluations.
 

Developmental screening should be done at crucial points in a child’s development — nine months, 18 months, 24 months, and 30 months. At nine months, a doctor can identify many issues with movement, but any undetectable problems are much more likely to be clear at future screenings.

Developmental Evaluations

Developmental evaluations aim to identify the specific type of disorder that is affecting the child. A doctor will carefully assess the child’s muscle tone, motor skills, posture, and reflexes, examine movement and reflexes, and take an accurate medical history from the parents.

Cerebral palsy image

Medical Evaluations

Specific medical tests can be more conclusive than screenings. These tests can help physicians diagnose cerebral palsy and rule out other conditions.

Cranial Ultrasounds

Cranial ultrasound uses sound waves to capture images of the brain. It is typically used in the first month of an infant’s life because it is less invasive than other neuroimaging techniques. During this test, a radiologist moves a transducer (probe) above the infant’s soft spot (fontanelle) to get images of the inner fluid chambers and brain that are then displayed on a monitor.

Cranial ultrasounds typically cause no discomfort and the whole process takes about 20-30 minutes. The test does not diagnose cerebral palsy directly, but it helps evaluate other medical conditions, including excessive fluid or brain hemorrhage, that can affect an infant’s brain and lead to cerebral palsy.

CT Scan

Computerized tomography takes pictures of the infant’s brain and skull using an X-ray machine. It takes about 10-15 minutes or longer, depending on the number of images and whether or not sedation is needed.

MRI

MRI (Magnetic Resonance Imaging) takes images of a child’s brain and spine using magnetic fields. This type of neuroimaging provides detailed images and can therefore lead to a more definitive outcome than a CT scan or ultrasound.

During the procedure, a doctor will place the infant’s head in an MRI scanning machine that will take pictures of their brain. It is painless and safe but can take more time than other options. The baby must remain still during the scan, which is often difficult, so doctors often use sedation to help infants stay calm. The infant will be closely monitored to ensure their safety throughout the procedure.

Other Tests

 A doctor might order other tests and evaluations to help them diagnose cerebral palsy or linked conditions.

These tests may include: