Cerebral palsy is a group of disorders that affect movement and muscle tone or posture. It's caused by damage that occurs to the immature brain as it develops, most often before birth.
People with cerebral palsy can have problems swallowing and commonly have eye muscle imbalance, in which the eyes don't focus on the same object. They also might have reduced range of motion at various joints of their bodies due to muscle stiffness.
Signs and symptoms can vary greatly. Movement and coordination problems associated with cerebral palsy include:
- Variations in muscle tone, such as being either too stiff or too floppy
- Stiff muscles and exaggerated reflexes (spasticity)
- Stiff muscles with normal reflexes (rigidity)
- Lack of balance and muscle coordination (ataxia)
- Tremors or involuntary movements
- Slow, writhing movements
- Delays in reaching motor skills milestones, such as pushing up on arms, sitting up or crawling
- Favoring one side of the body, such as reaching with one hand or dragging a leg while crawling
- Difficulty walking, such as walking on toes, a crouched gait, a scissors-like gait with knees crossing,
a wide gait or an asymmetrical gait
- Excessive drooling or problems with swallowing
- Difficulty with sucking or eating
- Delays in speech development or difficulty speaking
- Learning difficulties
- Difficulty with fine motor skills, such as buttoning clothes or picking up utensils
Cerebral palsy can affect the whole body, or it might be limited primarily to one limb or one side of the body. The brain disorder causing cerebral palsy doesn't change with time, so the symptoms usually don't worsen with age.
However, as the child gets older, some symptoms might become more or less apparent. And muscle shortening and muscle rigidity can worsen if not treated aggressively. Brain abnormalities associated with cerebral palsy might also contribute to other neurological problems, including:
- Difficulty seeing and hearing
- Intellectual disabilities
- Abnormal touch or pain perceptions
- Oral diseases
- Mental health conditions
- Urinary incontinence
- Physical therapy and rehabilitation. A child with cerebral palsy usually starts these therapies in the first few years of life or soon after being diagnosed. Physical therapy is one of the most important parts of treatment. It involves exercises and activities that can maintain or improve muscle strength, balance, and movement. A physical therapist helps the child learn skills such as sitting, walking, or using a wheelchair. Other types of therapy include:
- Orthotic devices. Braces, splints, and casts can be placed on the affected limbs and can improve movement and balance. Other devices that can help with movement and posture include wheelchairs, rolling walkers, and powered scooters.
- Assistive devices and technologies. These include special computer-based communication machines, Velcro-fastened shoes, or crutches, which can help make daily life easier.
- Medication. Certain medications can relax stiff or overactive muscles and reduce abnormal movement. They may be taken by mouth, injected into affected muscles, or infused into the fluid surrounding the spinal cord through a pump implanted near the spinal cord. For children who have cerebral palsy and epilepsy (seizures), standard epileptic medications should be considered, but these medications may also have negative effects on the developing brain.
- Surgery. A child may need surgery if symptoms are severe. For instance, surgery can lengthen stiff, tightly contracted muscles. A surgeon can also place arms or legs in better positions or correct or improve an abnormally curved spine. Sometimes, if other treatments have not worked, a surgeon can cut certain nerves to treat abnormal, spastic movements. Before conducting surgery, it is important for a health care provider to assess the procedure’s benefits by carefully analyzing biomechanics of the joints and muscles.