Cerebral Palsy

What is cerebral palsy?

Cerebral palsy, or CP, is a term used to describe a group of disorders that cause problems with using your muscles and moving your body. CP appears in the first few years of life and usually does not get worse over time. Someone with cerebral palsy may also have seizures, learning problems, mental retardation, or problems with hearing, seeing, or the sense of touch.

How does it occur?

There are many possible causes of CP. Faulty development or damage to the brain can affect the parts of the brain that control movement and posture.

Often the brain damage happens before birth. Sometimes it happens during delivery or soon after birth. Some possible causes of brain damage in a baby or child are:

• an infection during pregnancy, such as rubella (German measles)
• Rh incompatibility (a problem with blood types in the mother and baby)
• severe jaundice
• bleeding in the brain
• premature birth
• a lack of oxygen at some time during pregnancy or delivery
• a brain infection, severe convulsions, or a bad head injury.

CP may also happen because of problems with development of the baby's brain early in pregnancy. Often the cause of CP is hard to figure out and may never be known.

What are the symptoms?

CP can be mild, moderate, or severe. The symptoms differ from person to person and may change over time. Some symptoms of CP are:

• stiff muscles that are hard to move
• trouble with fine motor tasks, such as writing or cutting with scissors
• trouble walking normally
• unusual posture
• poor balance or coordination
• shaking of an arm and leg that can't be controlled
• writhing movements
• grimacing or drooling
• trouble with speech.

The problem with controlling body movements is sometimes called spasticity.

How is it diagnosed?

Cerebral palsy is diagnosed during infancy or childhood from the medical history, symptoms, and a physical exam. There is not a specific test for it. The diagnosis is often made by ruling out other medical problems.

It is more difficult to tell if your child has CP during the first 6 months of life. But the sooner treatment begins the better.

Scans of the brain may be done to look for a cause, such as:

• computed tomography (CT scan), which uses x-rays and a computer to create a picture of the brain
• magnetic resonance imaging (MRI), which uses a magnetic field and radio waves to produce a picture of the brain
• ultrasound, which uses sound waves to show structures of the brain.

How is it treated?

Early and ongoing treatment can lessen the effects of CP. Treatment may include therapy, counseling, medicine, equipment aids, and educational programs.

Therapy

A very important part of treatment is therapy for movement, speech, and practical tasks. This may include physical therapy, speech therapy, and occupational therapy.

Physical therapy is used for muscle training and exercising. It helps prevent weakening of the muscles from lack of use. It also helps avoid a common and serious problem called contracture. Contracture means the muscles become fixed in a rigid, abnormal position. Contracture can cause problems with balance and a loss of previous abilities. Braces also help. Sometimes surgery is done to lengthen muscles and tendons.

Speech therapy helps improve speaking and other activities that use the mouth, such as eating. Special techniques and devices such as computers can help communication with others.

Occupational therapy helps someone with CP be more self-sufficient and independent. Spending time with other children who do not have CP can help, too.

Counseling

Counseling is helpful for family members, caretakers, and the person with CP. It can be especially helpful for recognizing stress, frustration, and other emotions and for learning methods for coping.

Medicine

Your health care provider may prescribe medicines to treat abnormal muscle movement and help control seizures. Seizures can be dangerous depending on where they occur (for example, in a swimming pool) and untreated prolonged seizures may cause more brain damage.

Equipment Aids

Eye surgery or glasses may help with crossed eyes and vision problems. A hearing aid often helps hearing problems.

Often someone with CP needs help with movement and transportation. This depends on how severe the motor problems are. For example, walkers, wheelchairs, or positioning aids may be needed.

Educational Programs

If your child is 3 years old or younger, ask your provider about early intervention programs (EIPs). Many states offer EIPs for children aged 0 to 3 years with CP. Some states also offer special education classes for children between the ages of 3 and 5 years who have special needs.

For older children ask about special education classes and Individual Education Plans (IEP). Find out about any special services that may be available to you. Local schools may provide physical, occupational, or speech therapy.

How long will the effects last?

Cerebral palsy cannot be cured, but usually does not get worse over time. Treatment can help teach skills that will improve everyday life.

How should I take care of someone with cerebral palsy?

Be sure all medicine prescribed by the health care provider is taken.

Do what you can to help the person with CP overcome any barriers to learning and having a full life. You can do this by working with a support team of health care providers, therapists, social workers, and others.

Find out about groups that can provide more information and help. One resource is:

United Cerebral Palsy
Phone: (800) 872-5827
Web site: http://www.ucp.org

Check with your health care provider, hospital, and local agencies for the handicapped for more information.

What can be done to help prevent cerebral palsy?

Some causes of cerebral palsy may be avoided by:

• Preventing head injures. Use car safety seats when a child is riding in a car and helmets during bicycle rides.
• Treating jaundice in a newborn.
• Preventing Rh incompatibility. Rh-negative women should be given RhoGAM right after every delivery, miscarriage, or abortion. Pregnant Rh-negative women should receive RhoGAM after amniocentesis, after any bleeding episodes, and during the seventh month of pregnancy.
• Having shots for diseases such as rubella (German measles) before pregnancy.

Check with your health care provider about other precautions to take before or during pregnancy.