Cerebral palsy (CP) is a term for a group of conditions where the brain does not communicate well with muscles of the body. These conditions affect a child’s ability to move, maintain balance and hold their posture. Children with CP may have additional health concerns. These concerns can include seizures and learning disabilities. The condition is lifelong.
Cerebral palsy affects one in 323 children in the United States. It is the most common physical disability in children. It is more common in boys than girls.
The effects of cerebral palsy range from mild to severe. Early diagnosis and treatment can help to improve movement, balance and life skills that bring independence.
Cerebral palsy develops because of brain damage that take place during the early stages of brain development. This damage can happen before, during or after birth, up to about the age of 3.
The damage affects the message pathways that control movement from the brain to the spinal cord. It can happen for many reasons, including:
A child’s risk for cerebral palsy is higher if they:
Experts classify cerebral palsy in many ways. Classifications help families and doctors know what kind of therapies a child needs to reach their potential.
CP can be classified by the movement problems the child has because of the disease. Looking at CP in this way, there are two main classifications (or types) of CP: hypertonic cerebral palsy and dyskinetic (or other) cerebral palsy.
Hypertonic cerebral palsy is the most common type of CP. Children with these types of CP have spasticity or dystonia, or both.
The other types are dyskinetic and other cerebral palsy. Children can have one or more of the following types:
Cerebral Palsy is also described by the parts of the body that are most affected.
For people with CP, gross motor function, hand function, visual function, communication and eating / drinking function can be described with specific scales. These scales describe function in five functional groups (called the “five strata”). They allow quick understanding of a person’s abilities. Therapists or other providers can help patients with CP and their families understand their classification(s) on these scales.
Cerebral palsy is a movement disorder. It can cause problems that are not related to movement.
For example, many children with cerebral palsy have orthopaedic conditions:
Children with CP also can have:
Doctors who specialize in cerebral palsy know to watch for early signs of these problems and provide expert care. This may help your child avoid certain problems or have less severe effects of CP.
Doctors can sometimes diagnose cerebral palsy soon after a child is born. The signs and symptoms of CP may not be seen for a few months or so after birth. Hopefully a child with CP will be diagnosed before their first birthday. But often, a diagnosis does not come until age 2 or later.
Parents are often the first to notice that a child is not reaching certain developmental milestones, such as sitting up or walking. They may recognize other problems like:
If this is your situation, think about making an appointment with your child’s primary care doctor. If the doctor shares your concerns after seeing your child, the next step may be to see a cerebral palsy specialist.
A CP specialist will:
The specialist may order medical tests to help make a diagnosis or understand what type of CP your child has. Tests can include brain imaging studies, such as magnetic resonance imaging (MRI). Sometimes an ultrasound or computed tomography (CT) scan of the brain is helpful. The doctor may order laboratory tests of your child’s blood, urine and cerebrospinal fluid. This can help screen for genetic issues or other problems.
Goals for managing cerebral palsy include:
Working on these goals early in childhood gives a child the best chance to achieve them. Effective treatment requires care over time from a team of medical specialists.
A child’s treatment plan may include:
Medications. A child may take medicines to improve movement, reduce pain or relax muscles. They may take them for other problems that are common with CP. Medicine might be taken by mouth or G-tube, as a patch, or by injection.
Physical therapy. Exercises and muscle training can help a child get stronger, become more flexible and move better. A physical therapist (PT) can help with everything related to movement and mobility. The therapist may refer your child to specialized treatment programs. A brace, splint, cast or another device may aid movement or help stretch stiff muscles. Other equipment such as canes, walkers, wheelchairs, or positioning equipment can help with mobility.
Occupational therapy. With help from an occupational therapist (OT), a child can gain independence in doing daily tasks at home and school. The child can learn skills in using a computer or technology to improve independence. OTs may focus on hand and arm function. They may assist with bracing or casting. They can help children with adaptive equipment (such as reachers, weighted spoons and computer interfaces).
Speech therapy. If a child has trouble with eating or swallowing, a speech therapist can help. A speech therapist can help the child learn to speak more clearly. They can help use communication devices, such as voice generation software on an iPad.
Orthopaedic surgery. Sometimes orthopaedic surgery is the best option to help reduce pain and prevent harmful changes in the shape or alignment of a bone or joint. It may help your child sit, walk or move their arms more easily. This type of surgery is first considered around ages 6 to 8.
A few examples of orthopaedic surgery for cerebral palsy are:
When possible, the orthopaedic surgeon does multiple procedures at once, rather than spreading them out over many years. This is called “single-event, multilevel surgery” (SEMLS). This helps to have fewer surgeries total.
Neurosurgery. Pediatric neurosurgeons offer two types of surgeries for children with cerebral palsy:
Most people with cerebral palsy live into late adulthood. They can enjoy fulfilling lives.
A child with a mild form of cerebral palsy will have an average life span. Children with severe motor and swallowing impairments or other health problems may not live as long. They need support from a caregiver to do the activities of daily life.
Children who get high-quality care from a multidisciplinary team tend to have a better quality of life and reach a higher level of independence than those who don’t.
Last Updated 09/2022
Reviewed By Jilda N. Vargus-Adams, MD, MSc
The Cerebral Palsy Program at Cincinnati Children's provides innovative treatment, support and services that are tailored to a child's specific goals and abilities.
