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Cerebral palsy

Definition

Cerebral palsy is a group of disorders that can involve brain and nervous system functions, such as movement, learning, hearing, seeing, and thinking.

There are several different types of cerebral palsy, including spastic, dyskinetic, ataxic, hypotonic, and mixed.

Alternative Names

Spastic paralysis; Paralysis - spastic; Spastic hemiplegia; Spastic diplegia; Spastic quadriplegia

Causes

Cerebral palsy is caused by injuries or abnormalities of the brain. Most of these problems occur as the baby grows in the womb. But they can happen at any time during the first 2 years of life, while the baby's brain is still developing.

In some people with cerebral palsy, parts of the brain are injured due to a low level of oxygen (hypoxia) in the area. It is not known why this occurs.

Premature infants have a slightly higher risk of developing cerebral palsy. Cerebral palsy may also occur during early infancy as a result of several conditions, including:

In some cases, the cause of cerebral palsy is never determined.

Symptoms

Symptoms of cerebral palsy can be very different between people with this group of disorders. Symptoms may:

Symptoms are usually seen before a child is 2 years old. Sometimes symptoms begin as early as 3 months. Parents may notice that their child is delayed in reaching developmental stages such as sitting, rolling, crawling, or walking.

There are several different types of cerebral palsy. Some people have a mixture of symptoms.

Symptoms of spastic cerebral palsy, the most common type, include:

The following symptoms may occur in other types of cerebral palsy:

Other brain and nervous system symptoms:

Eating and digestion symptoms:

Other symptoms:

Exams and Tests

A full neurological exam is critical. In older people, testing cognitive function is also important.

The following other tests may be performed:

Treatment

There is no cure for cerebral palsy. The goal of treatment is to help the person be as independent as possible.

Treatment requires a team approach, including:

Treatment is based on the person's symptoms and the need to prevent complications.

Self and home care include:

Putting the child in regular schools is recommended, unless physical disabilities or mental development makes this impossible. Special education or schooling may help.

The following may help with communication and learning:

Physical therapy, occupational therapy, orthopedic help, or other treatments may also be needed to help with daily activities and care.

Medications may include:

Surgery may be needed in some cases to:

Support Groups

Stress and burnout among parents and other caregivers of cerebral palsy patients is common. Seek support and more information from organizations that specialize in cerebral palsy.

Outlook (Prognosis)

Cerebral palsy is a lifelong disorder. Long-term care may be required. The disorder does not affect expected length of life. The amount of disability varies.

Many adults are able to live in the community, either independently or with different levels of help.

Possible Complications

When to Contact a Medical Professional

Call your health care provider if symptoms of cerebral palsy develop, especially if you know that an injury occurred during birth or early infancy.

Prevention

Getting the proper prenatal care may reduce the risk of some rare causes of cerebral palsy. In most cases though, the injury causing the disorder is not preventable.

Pregnant mothers with certain medical conditions may need to be followed in a high-risk prenatal clinic.

References

Johnston MV. Encephalopathies. In: Kliegman RM, Stanton BF, St. Geme JW III, et al., eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 591.

Murphy KP. The adult with cerebral palsy. Orthop Clin N Am. 2010;41:595–605.

Nass R, Ross G. Developmental disabilities. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley’s Neurology in Clinical Practice. 6th ed. Philadelphia, Pa: Elsevier Saunders; 2012:chap 61.

Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Practice parameter: pharmacologic treatment of spasticity in children and adolescents with cerebral palsy (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology. 2010;74:336-343.


Review Date: 8/22/2013
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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