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Cook Children's

Cerebral palsy

Learning that your child has cerebral palsy (CP) can be a life altering moment for you and your family. Suddenly all the plans for childhood and beyond are changing quickly and it can be hard to know where to turn and what to do next.

The neurologists at Cook Children's Medical Center are experts in the treatment and care of cerebral palsy. From birth through young adulthood, we're here to remove as many obstacles as possible in order to help you and your child overcome challenges and lead a life with as few limitations as possible.

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.

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What is cerebral palsy?

Cerebral palsy (CP) is a disorder that affects muscle tone, movement, and motor skills (the ability to move in a coordinated and purposeful way). CP is usually caused by brain damage that occurs before or during a child's birth, or during the first 3 to 5 years of a child's life.

The brain damage that leads to cerebral palsy can also lead to other health issues, including vision, hearing, and speech problems, and learning disabilities.

Cerebral palsy affects muscle control and coordination, so even simple movements — like standing still — are difficult. Other vital functions that also involve motor skills and muscles — such as breathing, bladder and bowel control, eating, and learning — may also be affected when a child has CP. Cerebral palsy does not get worse over time.

Types of cerebral palsy

Cerebral palsy is classified 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 palsy
Spastic CP is the most common and affects about 80 percent of children and adults with CP. Children with spastic CP have increased muscle tone. This means their muscles are stiff and, as a result, their movements can be awkward. Spastic CP is usually described by what parts of the body are affected:

Dyskinetic cerebral palsy (also includes athetoid, choreoathetoid, and dystonic cerebral palsies)
If your child is diagnosed with dyskinetic CP, he or she may 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 your child may have 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 palsy
Ataxic CP causes problems with balance and coordination. Your child 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, and this may result in dropping things.

Mixed cerebral palsy
Sometimes children, teens, and adults will have symptoms of more than one type of CP. The most common type of mixed CP is spastic-dyskinetic CP.

Who gets it?

Cerebral palsy is one of the most common congenital (existing before birth or at birth) disorders of childhood. Less than one percent of children are born with it. About 500,000 children and adults of all ages in the United States have the condition.

What are the causes?

The exact causes of most cases of CP are unknown, but many are the result of problems during pregnancy in which the brain is either damaged or doesn't develop normally. This can be due to infections, maternal health problems, a genetic disorder, or something else that interferes with normal brain development. Problems during labor and delivery can cause CP in some cases. but this is the exception.

Premature babies — particularly those who weigh less than 3.3 pounds (1,510 grams) — have a higher risk of CP than babies that are carried full-term, as are other low birth weight babies and multiple births, such as twins and triplets.

Brain damage in infancy or early childhood can also lead to CP. A baby or toddler might suffer this damage because of lead poisoning, bacterial meningitis, malnutrition, being shaken as an infant (shaken baby syndrome), or being in a car accident while not properly restrained.

 Some injuries that may damage the nervous system include:

What are the symptoms of cerebral palsy?

The following are the most common symptoms of cerebral palsy. However, each child may experience different symptoms and have one or more of the following:

How is cerebral palsy diagnosed?

CP may be diagnosed very early in an infant known to be at risk for developing the condition because of premature birth or other health problems. If your child is at risk, your pediatrician and neurology team will follow your child closely from birth so that they can identify and address any developmental delays or problems with muscle function that might indicate that your child has CP.

In many case, it may be difficult to diagnose the disorder, especially in the first year of life. Often doctors aren't able to diagnose CP until they see a delay in normal developmental milestones (such as reaching for toys by 4 months or sitting up by 7 months), which can be a sign of CP.

Abnormal muscle tone, poorly coordinated movements, and the persistence of infant reflexes beyond the age at which they are expected to disappear also can be signs. If these developmental milestones are only mildly delayed, the diagnosis of CP may not be made until the child is a toddler.

If your doctor does suspect that your child has cerebral palsy, a complete medical history, including a family medical history, and physical exam will be performed. Diagnostic testing may include the following:

Since cerebral palsy is a life-long condition that is not correctable, management includes focusing on preventing or minimizing deformities and maximizing the child's capabilities at home and in the community. Positive reinforcement will encourage the child to strengthen his/her self-esteem and promote as much independence as possible.

The full extent of the problems is usually not completely understood immediately after birth, but may be revealed as the child grows and develops.

How is cerebral palsy treated?

When it comes to cerebral palsy, treatment is focused on helping your child achieve maximum independence. Your child’s treatment plan will depend on the severity of his or her physical and mental challenges. Because no two children or CP patients are alike, an expert team of neurologists, neuropsychologists, orthopedists and occupational and physical therapists will work together with you and your child to design a program of care just for your child.

We focus on different kinds of therapy that can help your child achieve their maximum potential in growth and development. As soon as CP is diagnosed, your child can begin therapy for movement, learning, speech, hearing, and social and emotional development.

In addition, medication, surgery, or braces can help improve muscle function. Orthopedic surgery can help repair dislocated hips and scoliosis (curvature of the spine), which are common problems associated with CP. Severe muscle spasticity can sometimes be helped with medication taken by mouth or administered via a pump (the baclofen pump) implanted under the skin.

A variety of medical specialists might be needed to treat the different medical conditions. For example, a neurologist might be needed to treat seizures or a pulmonologist might be needed to treat breathing difficulties. Our team of specialists will work closely with you and your pediatrician to coordinate the care of your child. We also recommend downloading our free Family Medical Planner. It has everything you need to organize all your child’s records, appointments, prescriptions and more, and help your coordinate care with family and caregivers.

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We are here to help.

If your child has been diagnosed, you probably have lots of questions. Call our offices at: 682-885-2500 to schedule an appointment, refer a patient or speak to our staff.

 
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