Cerebral palsy

Cerebral palsy

Cerebral palsy is a condition caused by either damage to the brain, or abnormal development of the brain. This damage normally occurs before birth or during a child’s early development. Cerebral palsy is not normally progressive in nature.

Cerebral palsy usually causes abnormal muscle tone and movement. The main types of abnormal muscle tone are:

Spastic cerebral palsy

This is the most common type of abnormal muscle tone. Someone with spastic cerebral palsy is likely to experience a tightening of the muscles throughout the body. This tightening can be persistent or intermittent. The amount of stiffness experienced will vary from person to person.

Dyskinetic cerebral palsy

Individuals with this type of muscle tone may have dystonia or more rarely athetosis.

This describes a type of abnormal muscle control where the muscles can shift from tight to floppy without warning, resulting in involuntary movements.

Ataxic cerebral palsy

This is the least common type of cerebral palsy. It can be identified by shaky movement and poor balance. Someone with ataxic cerebral palsy may struggle with fine motor movements and coordination, like writing or using cutlery. They may have a tremor that increases with activity, and struggle with balance. This can make standing or sitting in an upright position difficult.

Mixed cerebral palsy

Someone with mixed cerebral palsy may have signs of more than one type of abnormal muscle tone at the same time.

Symptoms of cerebral palsy

The symptoms of cerebral palsy can vary from person to person and are dependent on the type of brain injury or abnormality. Someone with cerebral palsy may:

• struggle with movement and balance, and may be unable to walk
• struggle to speak, and possibly need to use electronic aids
• have difficulties with eating, drinking and swallowing
• have problems with their vision
• experience pain symptoms
• experience fatigue (tiredness)
• have problems with their sleep
• have epilepsy
• have a learning disability
• display behavioural problems
• have bladder control problems
• have problems with their digestive system (constipation)
• struggle to control their saliva
• struggle to process information from their senses

A person with cerebral palsy may have secondary symptoms. These are caused by the impact of the condition on their body, rather than directly by cerebral palsy. These can include:

• tightness in joints and muscles
• dislocations
• a change in their physical abilities
• changes in the amount of pain they experience
• increased fatigue

Causes of cerebral palsy

Cerebral palsy is caused by damage to the brain during pregnancy, birth or early development.

There are some things that can increase the risk of a child developing cerebral palsy. These include:

• premature birth (being born early)
• neonatal encephalopathy (caused by lack of oxygen to the brain in pregnancy or around the time of birth)
• stroke or bleeding in the baby’s brain during pregnancy or after birth
• infection during pregnancy or after birth
• meningitis
• head injuries

It’s not always possible to tell why a child has developed cerebral palsy.

A child can develop cerebral palsy despite their parents having done everything right during pregnancy and childbirth. The parents of a child with cerebral palsy are not to blame.

Diagnosing cerebral palsy

There isn’t one single test that can diagnose cerebral palsy. Your medical professional will need to see how your child develops over time to make a diagnosis. They may also use tests such as brain scans to confirm the diagnosis.

Coping with waiting for a diagnosis

Waiting for a diagnosis can be very stressful for parents. It’s natural to feel anxious when your child is unwell. NHS inform has advice on dealing with anxiety and stress, and information on where to go to find support for your mental wellbeing.

Most children are diagnosed by two years old. Some children are diagnosed earlier if they’ve spent time in medical settings, for example children who were born premature.

To diagnose cerebral palsy, your medical professional will examine your child’s medical history, and how well they can move, balance, and react. They may also use scans like an MRI to see if there’s any sign of damage or abnormal development of the brain.

Living with cerebral palsy

While cerebral palsy is a non-progressive condition (it doesn’t normally get worse over time), it may not stay the same throughout life. Symptoms can change with age, even in adulthood.

Contact your GP if:

• you or your child is experiencing a change in condition
• you or your child’s symptoms are getting worse

Cerebral palsy doesn’t normally shorten life expectancy. People with cerebral palsy often go on to live long, rich and rewarding lives.

There are resources and treatments available to help both children and adults with cerebral palsy. Everyone with cerebral palsy will have individual needs and these needs may change over time. Your healthcare professional will help you find treatments and resources that work for you or your child.

Physiotherapy

Targeted physiotherapy can help you or your child improve and maintain posture, coordination, strength and balance. Physiotherapists may recommend specialist mobility equipment and advise about the use of orthotic splints.

Occupational therapy

Occupational therapists help people who struggle to complete everyday tasks find new ways of completing them. They can show you or your child how to break down activities into smaller movements, helping build confidence. Occupational therapists also have good knowledge of the medical aids and technologies available to help you or your child.

Speech and language therapy

If you or your child is struggling to talk, a speech and language therapist can help. They have a range of techniques that can help people improve at talking, like helping you or your child learn to shape a sound. Some speech therapists will recommend the use of specialist communication aids.

If you or your child is having issues with swallowing, a speech and language therapist can also help by performing an assessment and making recommendations.

Orthotics

An orthotic device is a piece of equipment that supports a part of the body. This can help improve you or your child’s ability to move and be active.

Orthotics can help with a wide range of the physical problems that can be caused by cerebral palsy. Some will only be used for a short period of time, while others may be used throughout you or your child’s entire life. The need for them can also change with time.

An orthotist will examine you or your child’s ability to move and make recommendations according to you or your child’s personal needs.

Mental health support for those with cerebral palsy

If you have cerebral palsy and need support with your mental health, there are services available through the NHS.

Mental wellbeing support for the parents of children with cerebral palsy

Finding out that your child has cerebral palsy can be very overwhelming for parents. You may feel anxious about the future and isolated from other parents. There are resources available from NHS inform that can help you cope with the emotions you’re feeling. If you’re feeling isolated, an online support group might help you feel less alone.

Medication

Although medication cannot cure cerebral palsy, some types may help ease some of the symptoms, like muscle relaxants for those with spastic or dystonic cerebral palsy. Speak to your healthcare provider for further information about medication.

Surgery

Surgery may be recommended to help with certain symptoms of cerebral palsy. For example, surgery on muscles, bones and nerves can help mobility. Speak to your healthcare provider for further information on surgical options.