Cerebral palsy is a permanent condition, but many therapies and treatments can help people manage their condition and improve their quality of life. Any of a person’s motor skills — skills related to any type of movement — can be affected, including fine motor skills, gross motor skills, and oral motor skills. Oral motor skills are related to anything you do with your mouth, such as eating, drinking, or chewing gum. Fine motor skills refer to tasks that use small muscles from one area of the body, usually the hands, fingers, or toes. These skills include writing, eating with silverware, curling your toes, turning a doorknob, or buttoning your shirt. Gross motor skills use many muscles throughout the body for large movements, such as jumping, running, swimming, bending, reaching, and carrying items. Examples of symptoms include stiff muscles, jerky reflexes, tremors, poor coordination or balance, trouble speaking, seizures, incontinence, stiff or “floppy” muscles, slow movement, problems with sucking or swallowing, or trouble picking things up. Learn More About the Symptoms of Cerebral Palsy
Genetic mutations can cause the brain to develop differently from typical brains and develop a lesion, or injured area.Traumatic brain injury due to a fall, car accident, or other serious accident can cause cerebral palsy.Infections in infancy, such as viral or bacterial meningitis or another condition with a severe, persistent fever, can cause inflammation in or around the brain and injure it. Severe or untreated jaundice, when the liver does not break down old red blood cells as it should, can also increase the likelihood of cerebral palsy.Improper brain development during pregnancy, which can result from multiple possible causes.Brain injury or inadequate oxygen during birth can cause cerebral palsy.Inadequate blood supply to the fetal or infant brain, called a stroke, can also injure the brain.A mother’s infection during pregnancy may cause problems that contribute to developing cerebral palsy in a growing fetus.
Some exposures or circumstances can increase the risk of cerebral palsy but may not necessarily be the sole cause of it. The following can all increase the risk of cerebral palsy:
Chickenpox (varicella), a viral infection preventable with a vaccineCytomegalovirus, a common viral infection that harms a child only if a mother first has cytomegalovirus during pregnancyHerpes, a sexually transmitted virus that can affect the placenta and cause inflammation that can damage the fetus’s nervous systemRubella (German measles), a viral infection preventable with a vaccineSyphilis, a sexually transmitted bacterial infectionToxoplasmosis, caused by a parasite in contaminated food, dirt, and cat fecesZika, a virus carried by mosquitos that can also cause microcephaly — an undersized head or brain — in a newborn
Exposure to toxic chemicals during pregnancy or early infancy, such as methylmercury or lead, raises the risk. Pregnancy and birth complications can increase risk of cerebral palsy:
Premature birth (before 37 weeks), with risk increasing the earlier the baby is bornLow birth weight (under 5.5 pounds, or 2.5 kilograms), with risk increasing the lower the weightAccording to the American College of Obstetricians and Gynecologists (ACOG), prolonged labor, typically defined as longer than 20 hours in first-time mothers, more than 14 hours for non-first-time mothers, or more than 16 hours for twins, may affect risk of cerebral palsy, though it’s not yet clear if it does.Multiples in pregnancy, such as twins or triplets; risk increases with the number of fetuses a woman is carrying and if any of them die before birth.Breech births, where the baby’s feet or buttocks — instead of the head — are closest to the birth canal when labor beginsPregnancy complications that involve respiratory or circulatory problems in the babyIt’s unclear whether injuries from forceps or vacuum extraction are associated with cerebral palsy risk.Study findings are not consistent.Difference in blood Rh factors between mother and child. The Rhesus (Rh) factor is a protein on red blood cells that most people have. If a mother does not have Rh but her fetus does, the mother’s immune system may create cells that attack her child’s blood cells, notes ACOG.
Magnetic resonance imaging (MRI) uses radio waves to create an image of the child’s brain. It does not involve radiation.A cranial ultrasound — an ultrasound of the head — can only be done in babies. Ultrasounds create images by sending sound waves into the body that bounce back.A computerized tomography (CT) scan is a type of X-ray that creates a 3D image of the brain or other parts of the body.A test called an electroencephalogram (EEG) records electrical activity in the brain to see if the person has seizures. It involves attaching electrodes to a person’s scalp.Electromyography (EMG) and nerve conduction tests look for problems in the nerves or muscles.Blood, urine, and skin tests are not always necessary. However, sometimes doctors order these tests to look for other possible conditions, such as genetic or metabolism problems.
If someone receives a diagnosis of cerebral palsy, additional tests will look for sensory or developmental problems caused by the condition:
VisionHearingSpeechMovementMental abilityOther development
People with dyskinetic, or athetoid, cerebral palsy (about 10 percent of cases) experience changes in muscle tone, causing rapid, jerky movements or slow, uncontrolled movements. The last type, ataxic cerebral palsy (about 10 percent of cases), causes difficulty primarily with balance and muscle coordination. People can also have a mixture of these three types. Even within these categories, no two cases of cerebral palsy are alike. It may affect only one arm in one person and both arms and legs in another. It may affect the face, only the feet, or the entire body. In spite of the challenges that come with having a family member with CP, couples and families who take the time to communicate with one another — and to care for themselves, as well as for the child with CP — are often able to thrive as a family. Reaching out to extended family members for support, as well as to local groups and organizations, can help a family get the emotional and practical help they need. Learn More About Functioning as a Family When a Child Has Cerebral Palsy
School and Cerebral Palsy
Parents of children with cerebral palsy need to start educating themselves early about issues related to school. Many children with cerebral palsy qualify for an individualized education program (IEP), which spells out the instruction and services a student will receive in their public school. Many students with cerebral palsy will also need assistive technologies to help with schoolwork and the support of specialists, such as occupational and speech therapists. A child’s social life is important, too. It’s important to begin conversations on these topics with the local school district before your child starts school, so that teachers and other staff are prepared to best serve the needs of your child. Learn More About Helping Your Child With Cerebral Palsy Succeed at School
Prognosis of Cerebral Palsy
Other factors, such as early aging, a weakened immune system, overall disabilities, and musculoskeletal disorders can affect how long a person with cerebral palsy lives as well. The major factors affecting life expectancy are:
Severity of the conditionNumber and severity of disabilitiesFeeding difficultiesIntellectual or cognitive functioningRespiratory functioningMobility difficultiesSeizuresVision and hearing impairmentQuality of medical care and treatments
Cerebral palsy will never get worse, but it will never go away either. The brain injury is permanent and cannot be healed or cured. Conditions related to cerebral palsy, however, may improve or worsen over a person’s lifetime. Physical therapy, movement aids, surgery, medication, and other treatments can all help a person manage cerebral palsy. These treatments can increase their ability to do certain tasks and live independently. Cerebral palsy does not cause death except in very rare severe cases in infants or very young children. Most people with cerebral palsy will need an interdisciplinary team of healthcare providers, including a pediatrician, neurologist, mental health practitioner, orthopedic surgeon, physical therapist, speech therapist, occupational therapist, and others. Speech therapy, physical therapy, and occupational therapy can help develop life and communication skills. And special education professionals and assistive technology experts can help people with cerebral palsy reach their educational and vocational goals. A person with cerebral palsy may take medication to treat seizures or muscle problems, and they may also undergo surgery on their muscles, spine, brain, eyes, or abdomen.
Medication Options
A wide range of medications are used to treat different symptoms or complications of cerebral palsy:
Drugs called anticholinergics are used to help with uncontrolled movements. They work by blocking the chemicals in the brain that cause the movements.Botulinum toxins are neuromuscular blocker medications made from bacteria. They can reduce uncontrolled movements in muscles for three to six months.Medications used to stop or reduce seizures are called anticonvulsants. Sometimes people may need to change their anticonvulsant medications if the one they are taking stops working.Benzodiazepines are another group of drugs that are sometimes used short-term to treat a treat a seizure. They are not usually taken long-term.Muscle relaxers, called antispastics, can be prescribed to loosen stiff muscles, tremors, and similar symptoms. They can also increase range of motion in someone with cerebral palsy.Anti-inflammatories can treat different types of pain that people with cerebral palsy may experience. This includes abdominal pain, muscle or joint pain, pain after a surgery, and pain caused by other treatments, such as an injection or feeding tube placement.Antidepressants are drugs used to treat depression or anxiety in people with cerebral palsy.Constipation is common in children with cerebral palsy, so laxatives and stool softeners may be prescribed to help with bowel movements.
Alternative and Complementary Therapies
Learn More About Treatment for Cerebral Palsy: Medication, Complementary Therapies, Surgery Options, and More
Assistive Technologies for Cerebral Palsy
Assistive technologies are any item or system used to maintain or improve the functioning of an individual with a disability. People with cerebral palsy can benefit from a range of technologies, from high-tech, computerized devices that help with mobility or communication to low-tech equipment that helps with tasks of daily living. Some people can also benefit from technology that improves hearing or vision. Learn More About Assistive Technologies for Cerebral Palsy The following are activities pregnant women can do to reduce risk:
Get appropriate prenatal care and attend all appointments, so your doctor is alerted early to problems such as preterm labor, placenta problems, and other risk factors.Receive treatment for pregnancy complications, such as preeclampsia, gestational diabetes, anemia, and placenta problems, notes MyChildWithoutLimits.org.Get all vaccines recommended before or during pregnancy to prevent infections that may increase risk of cerebral palsy.Avoid activities that increase risk of toxoplasmosis, per the CDC.Use mosquito repellent and other protections (such as air-conditioning and long sleeves and pants) in areas affected by Zika, notes the CDC.Get Rh factor testing. If negative, get the recommended treatment.Avoid smoking, drinking, illicit drugs, and unnecessary medication.Avoid exposure to X-rays unless absolutely necessary.Eat a healthy diet that includes all necessary vitamins and minerals.
After birth, parents and caregivers can reduce risk with the following behaviors:
Be sure your child receives all recommended vaccines, which prevent infections that could cause cerebral palsy.Educate yourself about shaken baby syndrome, also called abusive head trauma, notes the National Center on Shaken Baby Syndrome, and have a support network in place to help you adjust to parenthood and understand your baby’s behavior, notes the CDC.Follow child safety guidelines, such as using a car seat, a safe crib without recalls, a bicycle helmet while riding, and similar safeguards.
Severe muscle tightening and shortening, which can slow, interrupt, or deform the growth of boneMalnutrition due to feeding difficulties, sometimes leading to growth and bone problemsDepression or other mental health problems related to coping with the effects of cerebral palsyLung disease from breathing problemsAdditional movement or neurological disordersOsteoarthritis, where cartilage and then bones break down over timeLow bone density, called osteopenia, which can increase risk of fracturesImbalance of eye muscles
Learn More About the Complications of Cerebral Palsy: How It Affects Your Body in the Short and Long Term Cerebral palsy is typically thought of as a childhood disorder. But most children with cerebral palsy live into adulthood, and many of those adults work, have families, and are active in their communities. Still, adults with cerebral palsy do not grow out of the neurological problems they had as children, and many contend with additional health problems, as well. Common health issues among adults with CP include weakness, chronic pain, and repetitive strain injuries. Depression is also common among adults with cerebral palsy. Engaging with peer support groups and connecting with national patient organizations can help adults with cerebral palsy find the care they need and stay socially active with what can be an isolating condition. Learn More About Cerebral Palsy in Adulthood Cerebral Palsy Foundation The Cerebral Palsy Foundation works to connect medical institutions, industry partners, researchers, practitioners, and administrators with individuals with cerebral palsy and their families to bring about changes that will improve the lives of people with cerebral palsy today and eventually prevent the condition from occurring. United Cerebral Palsy The mission of United Cerebral Palsy is to be a resource for individuals with cerebral palsy and other disabilities, and to promote inclusion, independence, and the ability to be productive for this population. The March of Dimes The March of Dimes website contains helpful information about cerebral palsy, and the organization runs several programs that try to reduce cerebral palsy and other conditions caused at birth. Child Neurology Foundation The Child Neurology Foundation brings together healthcare providers, researchers, patients, families, caregivers, volunteers, and advocates to improve the lives of children with neurological problems. Easterseals Easterseals is a large nonprofit organization that provides services to people with disabilities, including early intervention, childcare for children of all abilities and conditions, rehabilitation services, and training, education, and job placement services. National nonprofits such as the Cerebral Palsy Foundation and United Cerebral Palsy can help. So can medical professionals who treat cerebral palsy, clinics that specialize in cerebral palsy, special education professionals, and assistive technology experts. Learn More About Cerebral Palsy Resources
