What is cerebral palsy?

Cerebral palsy (CP) is the name for a group of nerve problems that make it hard for a child to control movement.

CP is caused by injury to the brain. In most cases, this injury happens before birth.

The way your child is affected may be different than how other children are affected. For some children, it causes a limp. Others have little or no control over their arms and legs or other parts of the body. To find out more about how the disease affects your child, your doctor may do more tests.

You and your doctor can work together to create a treatment plan for your child. This plan can help manage symptoms. It can also help your child be as independent as possible. The plan will probably include physical therapy. It may also include medicines and other therapies.

Learning that your child has CP isn't easy. And raising a child who has it can be hard. It may help to join a support group or talk with other parents who have a child with special needs, so you don't feel alone. You may also want to try counseling. It could help you understand and deal with all the emotions you may feel.

Your child's range of abilities depends on the type of cerebral palsy (CP) they have and how severe it is. Problems may appear, change, or increase as your child grows. Although CP can't be cured, treatment can help your child make the most of their abilities and physical strength.

CP causes problems with body movement and posture. But symptoms can vary. Some people may limp, while others may have little to no control over some body parts. In some cases, the symptoms of CP are noticed at birth. In others, symptoms aren't clear until early childhood.

Even though CP can't be cured, treatment can help people make the most of their abilities and physical strength and improve their quality of life. Treatment can also prevent other problems caused by CP.

Treatment varies by the person. It changes as needed. In general, treatment focuses on ways to maintain or improve a person's quality of life and overall health.

Regular visits with your child's doctors are important to monitor your child's condition.

Treatment for CP includes:

Physical therapy.

This can help your child get around as much as possible. It often continues throughout your child's life. It may help prevent the need for surgery.

Medicines.

They can help control some of the symptoms of CP, prevent or minimize problems caused by CP, and treat other medical conditions related to CP.

Surgery.

It may sometimes be used for a person with severe problems. Surgery may help reduce muscle stiffness or spasms. It may also allow more flexibility and control of the affected limbs and joints.

Devices and equipment.

These include braces, casts, and splints. The type of devices used depends on a child's needs. The devices maintain or improve how well joints move, help strengthen muscles and relax overactive (spastic) muscles, and help with daily activities.

Pain management.

This helps your child with short- and long-term pain.

Physical therapy and special equipment may be used together. One example is constraint-induced movement therapy, also called shaping. This encourages a child to move more by presenting interesting activities or objects and giving praise and rewards when a child tries to use the less-functioning muscles.

Ongoing treatment for CP focuses on continuing and adjusting current treatments and adding new treatments as needed.

Working with others involved with your child's care, understanding your child's needs and rights, and taking care of yourself and other family members are all important parts of treatment.

Other treatments

Other treatments may also be needed, depending on specific needs.

• Occupational therapy helps children, teens and adults adapt.
• Speech therapy helps control the mouth muscles. This treatment can be of great help to children with speech or eating problems.
• A registered dietitian can provide nutritional counseling when a child has problems eating or isn't gaining weight.
• Both massage therapy and hatha yoga are designed to help relax tense muscles, strengthen muscles, and keep joints flexible.
• Therapies to help learning and sensory development may benefit babies and young children. Some also help people of other ages.
• Behavioral therapy may help some school-age children with CP learn ways to communicate with others.
• Biofeedback may be useful as part of physical therapy or on its own. Some who use the technique learn how to control muscles or reduce tension.

You may hear about a wide range of controversial treatments for CP, such as electrical stimulation and special diets. Be sure to talk to your doctor about any type of treatment you are considering for your child. Some of these treatments can cause harm.

Many people who have CP benefit from using specific devices and equipment. These may include special crutches, orthotics, casts, standers, special seats, walkers, wheelchairs, and special shoes. There may be other methods used to help with specific problems. These items can help maintain or improve joint mobility. Or they can help strengthen muscles and relax overactive (spastic) muscles. They can also help with daily activities.

The type of device that is used depends on a child's needs. For example, a child may get a cast after surgery. Or a child may get a cast to restrict movement in one area to strengthen muscles and tendons in another part of the body. If both legs are affected by CP, a child can learn to move around with the help of special equipment. These may include a scooter board (a device used to self-propel while lying down), a modified stroller, or a wheelchair.

The cause of CP sometimes isn't known. But links have been found between CP and certain conditions during pregnancy, birth, and early childhood. Some of these can be prevented.

Before and during pregnancy

Staying healthy before and during pregnancy can help lower the risk that a brain injury will occur in a developing baby. Here are some tips for healthy habits before and during pregnancy.

• Eat nutritious foods.
• Don't smoke.
• Avoid contact with harmful substances.
• See your doctor regularly.

For babies and young children

Help prevent CP in your young child by lowering your child's risk for getting a brain injury.

• Try to prevent accidents, like nonfatal drowning. This helps keep your home safe as your child grows and develops.
• Learn the signs of jaundice in newborns.
• Know how to prevent lead poisoning.
• Keep your child away from people who have serious contagious illnesses, such as meningitis.
• Make sure your child's immunizations are up-to-date.

The doctor will do a physical exam and ask you about your family's health history and your child's past health. You may be asked about your child's growth and development. The doctor may ask about any problems you may have noticed. Parents are often the first to notice that their baby has problems with certain abilities and skills.

Your doctor may also do tests, such as lab tests or an MRI of your child's head. Or your doctor may look at ultrasound pictures of the brain. These tests can sometimes help the doctor find the cause of CP.

If your child has a severe form of CP, a doctor may be able to find the problem within the first few weeks of your child's life. But even when a baby has CP at birth, the signs may not be noticed until the child is 1 to 3 years old.

Medicines can help control some of the symptoms of CP. They can also prevent or minimize problems caused by CP and treat other medical conditions related to CP.

Treatments for muscle spasms are the most common medicines used for people who have CP. Some are called antispasmodics. They can help relax tight muscles and reduce muscle spasms. Most are taken by mouth. Some are injected directly into stiff or spastic muscles. These medicines include baclofen, diazepam and botulinum toxin.

Anticonvulsants help prevent or control seizures. These medicines include lamotrigine and oxcarbazepine.

Anticholinergics help some people who have CP who have body movements that they can't control (dystonic cerebral palsy) or who drool often. These medicines include benztropine and glycopyrrolate.

Stool softeners and mild laxatives may help treat constipation. This is a common problem for people who have CP.

Surgery for people who have CP may help reduce muscle stiffness or spasms. It may also allow more flexibility and control of the affected limbs and joints.

The main surgery choices are:

• Orthopedic surgery (for muscles, tendons, and joints). It's done to increase range of motion. Surgery to treat spinal curves (scoliosis) or to prevent or treat hip dislocation is also done.
• Selective dorsal rhizotomy. This is the cutting of nerves of affected limbs for contracture or other mobility problems. This is usually considered only for children who have severe muscle tightness in the legs.

Other surgeries include:

• Surgery for various other orthopedic problems. These surgeries vary depending on the specific problems involved. For example, some children may need surgery to correct uneven leg length.
• Medicine-related surgery. A small pump is surgically placed under the skin in the belly. This pump delivers medicines directly into the fluid surrounding the spinal cord.

Cerebral palsy (CP) is a problem that makes it hard for a child to control movement. It's caused by injury to the brain. Usually this injury happens before birth. The brain injury that causes CP doesn't get worse over time, but symptoms may start, change, or become more severe as a child grows.

Some children with CP may have complications, such as seizures, joint problems, or bowel or bladder problems. Other medical conditions, such as vision or hearing problems, are often associated with CP. Sometimes these conditions are known right away. In other cases, they aren't found until a child gets older.

People with CP are at risk for lung disease. For example, severe CP causes problems with eating. If food is inhaled into the lungs, the risk of lung infection (pneumonia) increases.

CP is caused by an injury to or abnormal development of the brain. In many cases, the exact cause isn't known. The injury or abnormality may occur during pregnancy or birth or within the first 2 to 3 years of life.

• During pregnancy or birth, possible causes can include genetic problems, infections, or health problems in the mother or baby. Problems related to labor and delivery may also be a cause. Health problems in a newborn, such as untreated low blood sugar, may cause brain damage that leads to CP.
• In an early birth (premature birth), CP is related to the brain's development. For example, babies born too early are at risk for bleeding in the brain.
• Within the first 2 or 3 years of life, CP is usually related to brain injury. It may be caused by a serious illness, trauma, or a lack of oxygen to the brain.