What is cerebral palsy?
Cerebral palsy is a condition that affects body movements due to brain injury. The injury can happen before, during or after birth and does not get worse over time.
The brain damage affects body movement and posture. It often shows up as either floppy or stiff muscles, or involuntary muscle movements.
Cerebral palsy can affect movement, coordination, muscle tone and posture. It can also be associated with impaired vision, hearing, speech, eating and learning.
The damage to the brain is permanent. There is no cure. Life expectancy is normal or near normal in mild cerebral palsy, but the effects of cerebral palsy can cause stress to the body and premature ageing.
What are the types of cerebral palsy?
There are 4 main types of cerebral palsy.
- Spastic, in which the muscles are weak and stiff and movements are awkward. Either or both arms or legs may be affected, on the same side of the body or different.
- Dyskinetic (athetoid), in which the muscles move uncontrollably or cause involuntary postures. This is caused by the muscles of the arms, legs and body contracting and relaxing. If muscles of the face and tongue are affected, talking is difficult and this may cause drooling.
- Ataxic, in which movements appear jerky and clumsy due to problems with balance and coordination. It can lead to unsteady walking and difficulty with rapid movement. People with ataxic cerebral palsy may also experience involuntary shaking of the hands.
- Mixed, in which the person shows a range of the above characteristics.
What are the symptoms of cerebral palsy?
Cerebral palsy causes a range of symptoms. The most common ones are:
- being stiff or floppy
- having exaggerated reflexes
- muscle weakness
- lack of muscle coordination
- uncontrolled body movements
- problems with balance and coordination
- problems with swallowing, sucking or eating
- using one side of the body to reach for things
- delay in learning to speak
These symptoms can be mild or severe. They usually appear in a child’s first 2 years of life.
People with cerebral palsy may or may not have other conditions such as intellectual disability, epilepsy, delayed growth, spinal deformities, and troubles with seeing, hearing and speaking.
What causes cerebral palsy?
Cerebral palsy occurs when there is damage to the developing brain in the area that controls muscle tone (the motor cortex). An injury to the fetus is sometimes caused by low oxygen levels, poor circulation, infection or trauma. In some cases, the brain fails to develop normally in the fetus.
Depending on the damage, cerebral palsy affects people in different ways and to different extents.
Risk factors for cerebral palsy are:
- prematurity and low birth weight
- some pregnancy complications
- an infection caught by the mother during pregnancy
- prolonged loss of oxygen during pregnancy or childbirth, or severe jaundice after birth
- injury or bleeding in the baby's brain
- mutations in the genes that affect the brain's development
- being a twin, triplet or other multiple birth
The cause remains unknown for most babies with cerebral palsy. There is no single cause of cerebral palsy.
When should I see my doctor?
Children with cerebral palsy tend to miss developmental milestones such as crawling, walking and talking. You may be worried about cerebral palsy if your child is slow to develop physical skills or has tight or floppy muscles or an unusual posture. For example, if your child is not walking by 12 to 18 months and is not speaking simple sentences by 24 months, or if they display some of the signs of cerebral palsy listed above, you may need to speak to your early childhood nurse or doctor.
For more information on signs that your child may have cerebral palsy, visit the Cerebral Palsy Alliance website.
How is cerebral palsy diagnosed?
Your doctor might consider a diagnosis of cerebral palsy based on your child’s symptoms and examination. They will talk to you and your child, and examine them physically, and run tests including hearing and vision. They may refer you to a paediatrician.
Other tests for cerebral palsy may include imaging of the brain, such as ultrasound, CT scan, or MRI. These tests help to distinguish between cerebral palsy and other possible causes. You may have a referral for blood tests to exclude other causes of muscle problems. If your child has other associated conditions, such as epilepsy, there may be another range of tests such as EEG (brain activity test).
It may take repeated tests and visits to the doctor to arrive at a definitive diagnosis of cerebral palsy. Particularly in mild cases, diagnosis may take months or even years. Although this can be very frustrating, the time is needed. It’s important to get the diagnosis right. Also, the signs and symptoms of cerebral palsy don’t change with time. It may be important to wait and see whether things get better or worse, in which case it’s probably a different condition.
Usually, a confirmed diagnosis of cerebral palsy is made by the time a child is 2.
How is cerebral palsy managed?
Even though cerebral palsy cannot be cured, a lot can be done to manage the condition. Children, in particular, can benefit from the services of a team of health professionals to help with:
- speech, seeing and hearing
- eating and drinking
- control of bladder and bowel
- emotional wellbeing
Physiotherapists and occupational therapists can help with everyday tasks like sitting, walking, dressing and using the toilet. They may suggest casts, splints or orthotics, and give exercises to help strengthen muscles. As well as expert advice, they can help with equipment such as walking frames, wheelchairs and modified shoes.
Medicines such as Botox, diazepam or baclofen may be able to help relax stiff or overactive muscles, reducing pain and improving mobility. Medicines may be given as tablets, injections or via surgically implanted pumps.
There are special braces to help with muscle imbalance, and surgery and mechanical aids to help overcome other impairments. Medicines may be needed for epilepsy, pain, sleep or eating disorders due to the cerebral palsy.
There are also experts who can help with learning, communication and emotional issues that are often experienced by people with cerebral palsy.
For more information on the different treatments for cerebral palsy, visit the Cerebral Palsy Alliance website.
Particular issues for adults
Adults with cerebral palsy who work may find that their working conditions need to be adapted, with flexible hours, more rest time and changes to the physical environment. Mobility can be an issue, especially in transferring from one place to another, such as from bed to sitting. An assessment of the environment by an occupational therapist may help enable a person to get around any disabling issues.
Sexual function can also be an issue. Find out more about sex and disability.
Can cerebral palsy be prevented?
There is still no way to prevent cerebral palsy. However, making it law to wear seatbelts and use pool fencing and giving rubella vaccinations have all brought the rate of cerebral palsy down in Australia.
Sometimes babies who are at high risk of cerebral palsy may receive medications or be treated with cooling therapy to reduce the risk or severity of the condition.
Resources and support
The Cerebral Palsy Alliance provides therapies, life skill programs, equipment and support for people with cerebral palsy and their families.
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Last reviewed: October 2020