Cerebral Palsy

Cerebral palsy (CP) is a group of neurologic conditions that happens when your brain doesn’t develop as expected or gets injured before, during or soon after birth.

CP affects movement, posture and coordination. It may cause permanent disabilities.

While the brain injury doesn’t worsen over time, symptoms and physical challenges may change as your child grows.

CP affects about 3 out of every 1,000 children in the United States. There’s no cure for CP. But treatment focuses on managing symptoms and improving daily life, comfort and independence. Your care team will work with you to create a plan that fits your needs.

Types of cerebral palsy

The main types of CP include:

• Spastic: It causes stiff muscles and spasms.
• Dyskinetic: It causes trouble controlling movements.
• Ataxic: It causes problems with balance and coordination.
• Mixed: It includes features of more than one type.

Providers also describe CP by which parts of your body it affects:

• Diplegic: This affects your legs more than your arms.
• Quadriplegic: This affects both arms and both legs.
• Hemiplegic: This affects one side of your body more than the other.
• Monoplegic: This affects one limb.
• Paraplegic: This affects your legs.

Causes of cerebral palsy

Cerebral palsy happens when your baby’s brain doesn’t develop as expected or experiences damage. The damage can happen before birth, during birth or shortly after birth.

Sometimes, providers can identify the exact cause. Other times, they can’t find a clear reason. Your child’s provider can explain what may have happened in your child’s case.

Before birth (prenatal causes)

These happen during fetal development:

• The brain doesn’t form as expected (congenital brain malformations)
• Chromosomal abnormalities
• Infections (intrauterine infections)
• Stroke (intrauterine stroke)

During birth (perinatal causes)

These happen around the time of delivery:

• Not enough oxygen or blood flow to the brain (hypoxic-ischemic injury)
• Central nervous system infections
• Stroke
• Brain damage from very high levels of jaundice (kernicterus)

Shortly after birth (postnatal causes)

These happen in the first months or years of life:

• Trauma
• Brain or spinal cord infections
• Not enough oxygen to the brain (anoxic injury)
• Stroke

Is cerebral palsy genetic?

CP isn’t usually a genetic condition. Most cases happen because of abnormal brain development or a brain injury before, during or shortly after birth.

But genetics can play a role in some cases. Chromosomal abnormalities or genetic susceptibility (a higher chance of developing a condition because of your genes) may contribute. Providers may recommend genetic testing if your child has specific physical features, brain malformations or a biological family history.

Risk factors

Certain factors may increase your baby’s risk of developing this condition. These include:

• Preterm birth
• Low birth weight
• Brain bleed
• Brain tissue damage (periventricular leukomalacia or periventricular infarcts)

Certain conditions during pregnancy may increase the risk, such as:

• Substance use disorder
• Preeclampsia
• Infections
• Multiples (twins, triplets, etc.)

Having one or more risk factors doesn’t mean your child will develop CP, but it might increase the chance. Your provider can explain your child’s specific risks and what they mean.

Complications

This condition can lead to complications over time, including:

• Bone and joint problems (like hip dislocation or scoliosis)
• Bowel and bladder issues
• Breathing problems
• Epilepsy
• Growth issues
• Hearing loss or vision loss
• Intellectual disability
• Low bone density and weaker bones (osteopenia)
• Pain
• Trouble speaking clearly

As your child gets older, this condition may also weigh on their mental health. They may develop symptoms of depression and anxiety. Seeing a mental health provider, like a therapist or counselor, may help them cope.

How doctors diagnose cerebral palsy

Healthcare providers diagnose this condition by reviewing your child’s medical history and doing a detailed physical exam. They’ll ask about pregnancy and birth history, developmental milestones, like sitting or walking, and any known biological family history or risk factors.

Providers often order a brain MRI. These imaging tests create detailed pictures of your child’s brain. It can show areas of abnormal development or injury. In newborns, providers may use a cranial ultrasound to look for bleeding or certain types of brain damage.

Your child’s provider can tell you what tests they recommend and why they are necessary.

When is cerebral palsy diagnosed?

A diagnosis usually happens between 1 and 2 years of age. Sometimes, it happens sooner if your child has a high-risk case.

Cerebral palsy treatments

There isn’t a cure for cerebral palsy, but treatment may help your child move better and stay comfortable. Your child’s care team will set realistic goals and adjust them over time.

Common treatments include:

• Physical therapy: This helps improve strength, balance and coordination.
• Speech therapy: This may help if your child has issues that affect their ability to talk.
• Family-centered therapy: Providers work closely with your family to support your daily routines and goals.
• Medications: Different medications are available to help manage symptoms and complications as they arise.
• Surgery: Surgery may help manage symptoms in moderate to severe cases.

Your child’s treatment plan will depend on their specific symptoms, strengths and goals. Your care team will guide you through each step.

Cerebral palsy medications

Your child’s provider might recommend medicines based on their specific needs. Some options might include:

• Antiseizure medications: These may regulate seizures if your child has epilepsy.
• Bowel and bladder medications: These help with constipation or incontinence.
• Medications for stiff muscles: Your child may take medicines like baclofen or get botulinum toxin injections to relax tight muscles.
• Pain medications: These may reduce discomfort and keep your child more comfortable.

Cerebral palsy surgery

In moderate to severe cases, your child may need surgery. Options could include:

• A baclofen pump to reduce muscle tightness
• Tendon release surgery to improve movement
• Orthopaedic surgery to correct hip or spine problems

When should I see my child’s healthcare provider?

Call your child’s provider right away if you notice:

• Developmental delays or a loss of skills they already had
• Sudden changes in movement, speech or thinking
• Sensory issues with vision, hearing or feeling
• Low muscle tone (your child feels very floppy and weak)
• Seizures (for the first time)

Cerebral palsy prognosis

CP is a permanent, lifelong condition that affects each child differently. Your child’s outlook mostly depends on the type, how quickly they gain motor skills and their thinking abilities.

Motor development, especially walking, is an important part of their prognosis. Studies show that many children who walk on their own do so by age 3. Children who walk with support may reach that milestone by age 9. If your child isn’t walking by age 9, they’re unlikely to walk even with support.

If your child is able to walk, they may do so with or without support. Support may look like crutches, a walker or a cane. Some people use a wheelchair for mobility.

Walking ability varies widely. Some may be able to walk short distances but use a wheelchair for longer distances or when they feel tired. Your provider can help you understand what to expect based on the type and severity.

Cerebral palsy life expectancy

Many people with this condition live into adulthood. Life expectancy depends on how severe the condition is and whether your child has other serious health issues.

Breathing problems, like aspiration pneumonia (a lung infection caused by food or liquid going into your lungs), are common health concerns in severe cases.

Your care team can help you understand what to expect based on your child’s specific health needs.

Can cerebral palsy be prevented?

You can’t always prevent this condition. Many cases happen for reasons that are out of your control. If you’re wondering whether something could have been done differently, those feelings are understandable.

Some steps may help lower the risk:

• Get regular prenatal care. Seeing your provider during pregnancy helps monitor your health and the fetus’s development.
• Work to reduce the risk of preterm birth. Babies born too early or at a low birth weight have a higher risk of CP. Your provider can help manage conditions that may lead to early delivery.
• Follow your provider’s guidance during pregnancy. Taking good care of yourself also takes care of the fetus.

Even when families do everything right, CP can still happen. What matters most is early support and care to help your child thrive.