Patient Education
What is cerebral palsy?
Cerebral Palsy is the most common childhood physical disability. Cerebral Palsy is a disorder of movement and posture that appears during infancy or early childhood resulting from damage to the brain.
What are the symptoms of CP?
Symptoms of CP are not usually obvious just after a baby is born. They normally become noticeable from an early age. Parents may first notice that there are delays in reaching developmental milestones,the child might not be sitting by 8 months or walking by 18 months. They might present with clumsy movements, shaking of their hands which are known as tremors or might walk on their toes. The child may also show an unusual posture or favour one side of their body. Children can also come with atypical presentations of seizures, difficulty staying awake or falling asleep, an abnormally shaped spine , a learning disability , reduced vision and hearing loss or even something as simple as constipation and drooling. Severity of symptoms varies from child to child.
Many people think all children with CP have stiff muscles, but there are actually four main types of cerebral palsy. Each type affects movement and muscle tone in a different way:
- Spastic CP : This is the most common type. Children with spastic CP have stiff, tight muscles because their muscles contract too much. This stiffness can affect
- Both legs (diplegia), often causing toe-walking and a scissoring gait (where the knees cross like scissors).
- One arm and one leg on the same side (hemiplegia).
- All four limbs (quadriplegia).
- Dyskinetic CP (also called Athetoid CP) : Children with this type have involuntary, twisting movements or unusual postures. These movements can be slow and writhing or quick and jerky, and they may get worse with stress or excitement.
- Mixed CP : Some children show signs of more than one type of CP,usually a mix of spastic and dyskinetic CP.
- Hypotonic CP : These children have low muscle tone, meaning their bodies may feel floppy or loose. Over time, they may develop either spasticity or dyskinetic movements as they grow.
What are the causes of CP?
Cerebral palsy is often caused by brain damage that happens before, during, or shortly after birth. One of the most common causes is a lack of oxygen to the baby’s brain, also known as birth asphyxia. This can happen due to complications like problems with the placenta, a torn uterus, or issues with the umbilical cord. Babies born early (prematurely) are at higher risk because their brains are still developing, and they may experience bleeding in the brain, which is not always obvious right away. Infections during pregnancy, high blood pressure (preeclampsia), or abnormal brain development early in pregnancy can also increase the chances of brain damage.
Sometimes, CP can result from medical mistakes during pregnancy or childbirth. These include not recognizing when a baby needs to be delivered quickly by C-section, not monitoring the baby’s oxygen levels or heartbeat properly, or using delivery tools like forceps or vacuums incorrectly. Other risk factors include untreated severe jaundice after birth, prolonged or difficult labor, Rh incompatibility between mother and baby, and strong physical force used during delivery. While not all cases of CP are preventable, regular prenatal care and careful monitoring during childbirth can help reduce the risks.
Is CP progressive?
Though CP is due to damage to the developing brain, it is non-progressive. However, the symptoms due to brain damage often change with time. There are periods of fluctuating symptoms , with therapy and rehabilitation of different forms. Children with CP usually thrive in their environments.
What are the risk factors for having a CP child?
Following risk factors increase the chances that an infant will have cerebral palsy:
- Breech-position birth (or other unusual positions)
- A low APGAR score (indicating poor cardiac or respiratory function at or right after birth)
- Extreme prematurity
- Infertility treatments
- Low birth weight infant (under 5 pounds)
- Multiple babies
- Delivery complications
- Microcephaly (small head when born)
- Infant seizures (shortly after birth)
- Maternal illicit drug use or exposure to toxins
- Maternal proteinuria (excessive protein in the mother’s urine, indicating preeclampsia and high blood pressure)
- Maternal seizures (eclampsia)
- Maternal blood clotting disorders
- Maternal hyperthyroidism or hypothyroidism
- Maternal infections, including rubella, herpes, syphilis, toxoplasmosis, Zika virus, and cytomegalovirus
Is Cerebral Palsy Genetic ?
Cerebral Palsy is not a genetic disorder. There is no gene combination that ensures a child with develop CP.
How do I know whether my child has CP?
Diagnosing cerebral palsy takes time and involves watching how your child grows and develops. There isn’t one single test to confirm CP. Here’s how it usually happens:
- Watching Development
- Physical and Neurological Exams
- Brain Imaging
- Hearing and Vision Tests
- Developmental and Movement Tests
- Ruling Out Other Conditions
Diagnosis usually happens within the first 1–2 years of life, but sometimes it may take longer, especially in milder cases. Early diagnosis means early therapy, which can make a big difference in your child’s development.
What is the treatment for CP?
CP is a lifelong condition and cannot be cured. However, treatment may improve the quality of life by increasing independent mobility. A child with CP requires a multi-team approach - from a pediatrician, an orthopedic, and physical and speech therapists. The treatment not only depends on the patient's symptoms but also his age.
Patients with severe muscle contractures may require surgery to lengthen the muscle or some spinal surgery to reduce spasticity in the legs. Medication may also be given to decrease muscle spasticity. Now, botulinum toxin injections are available which when used with physical therapy, help in lengthening a muscle. Baclofen pumps are also available to control spastically for a longer period of time.
Physical therapy, which consists of special exercises may increase the movement & strength of the muscles. Occupational therapy may be required to develop skills to carry out day to day activities at home.
A variety of mechanical aids like braces, speech synthesizer may be required. For children with speech problems, speech therapy is required. In addition, medications may be required to control the seizures. Some children with learning disabilities & mental retardation may require special learning programs.
How can CP be prevented?
While not all cases of cerebral palsy can be prevented, certain steps can reduce the risk. Regular prenatal care is essential to monitor the health of both the mother and baby throughout pregnancy. Managing medical conditions such as high blood pressure, diabetes, or infections, and ensuring vaccinations are up to date, can help prevent complications that may lead to brain damage. During childbirth, timely medical care,especially in high-risk deliveries can help avoid oxygen loss or birth trauma. After birth, protecting babies from head injuries, treating severe jaundice early, and preventing infections through good hygiene and medical follow-up can further lower the risk of CP.