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Cerebral palsy

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

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.

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Central nervous system and peripheral nervous system

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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 those areas. 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 mix of symptoms.

Spastic cerebral palsy is the most common type. Symptoms include:

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

Other brain and nervous system symptoms may include:

Eating and digestion symptoms:

Other symptoms:

Exams and Tests

The health care provider will perform a full neurologic exam. In older people, testing cognitive function is also important.

Other tests may be performed as needed, most often to rule out other disorders:

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.

Medicines 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 life-long 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

Cerebral palsy may lead to the following health problems:

When to Contact a Medical Professional

Call your 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.

Related Information

Muscle function loss
Blue discoloration of the skin
Encephalitis
Meningitis
Head injury - first aid
Subdural hematoma
Spasticity
Seizures
Intellectual disability
Walking abnormalities
Movement - uncoordinated
Enteral nutrition - child - managing problems
Gastrostomy feeding tube - bolus
Jejunostomy feeding tube

References

Colver A, Fairhurst C, Pharoah PO. Cerebral palsy. Lancet. 2014;583(9924):1240-1249. PMID: 24268104 www.ncbi.nlm.nih.gov/pubmed/24268104.

Johnston MV. Encephalopathies. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 598.

Nass R, Sidhu R, Ross G. Autism and other developmental disabilities. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 90.

Oskoui M, Shevell MI, Swaiman KF. Cerebral palsy. In: Swaiman K, Ashwal S, Ferriero DM, et al, eds. Swaiman's Pediatric Neurology: Principles and Practice. 6th ed. Philadelphia, PA: Elsevier; 2017:chap 97.

Verschuren O, Peterson MD, Balemans AC, Hurvitz EA. Exercise and physical activity recommendations for people with cerebral palsy. Dev Med Child Neurol. 2016;58(8):798-808. PMID 26853808 www.ncbi.nlm.nih.gov/pubmed/26853808.

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Review Date: 8/7/2017  

Reviewed By: Amit M. Shelat, DO, FACP, Attending Neurologist and Assistant Professor of Clinical Neurology, SUNY Stony Brook, School of Medicine, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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