Cerebral palsy is a group of movement
disorders caused by damage to the motor areas of the brain during fetal
development, birth, or early infancy. It is the most common childhood disability.
Symptoms typically appear during the first months or years of life and vary greatly
from one child to another. The condition may affect the whole body, lower half of the
body, one side of the body, or just one limb. Most patients experience increased muscle
tone, which manifests as muscle stiffness, or spasticity; while a small number of children
present with floppiness instead. Some patients lack balance, coordination, while others
experience tremors or jerky involuntary movements. Various combinations of these symptoms also exist.
The degree of severity also varies - some people require assistance in almost all daily activities,
while others can be more or less independent. Cerebral palsy is a non-progressive disease,
meaning it does not worsen with age, but some symptoms may become
more apparent as the child grows. Cerebral palsy can lead to a number of associated
conditions, including: epilepsy; musculoskeletal problems; intellectual disability; feeding
problems such as difficulty sucking, chewing, swallowing and excessive drooling; speech delay
and difficulties, or impaired vision or hearing. There are many possible causes, and in each
case, the cause is often multifactorial. The risk is highest during pregnancy.
- Prenatal risk factors include gene or chromosomal mutations, premature birth
or low birth weight, multiple pregnancy, maternal infections, intrauterine infections, exposure to toxins, and conditions that may
cause bleeding in the third trimester such as preeclampsia and placental abnormalities.
- The most common perinatal cause is the lack of oxygen to the baby’s brain, known as birth
asphyxia. Problems linked to complicated labor or delivery are also associated with higher risk.
- Postnatal causes include accident, head trauma, and infections such as meningitis or encephalitis.
Diagnosis is based on physical exams and brain imaging studies, which can detect areas of damage
or abnormal development. An electroencephalogram may be performed if epilepsy is suspected. A
family history may indicate a genetic cause. There is no cure for cerebral palsy but treatments
may help relieve symptoms and improve quality of life. A number of medications are available to
treat muscle spasticity, involuntary movements; to reduce drooling, or prevent seizures.
Various therapies can help strengthen muscles, manage daily activities, develop
speech, overcome feeding difficulties, and improve overall health and fitness.
Surgical management options include: selective dorsal rhizotomy to sever nerve roots that cause
spasticity; deep brain stimulation to treat tremors, various orthopedic procedures to fix
musculoskeletal problems; and strabismus repair.
