What is cerebral palsy?
Cerebral palsy (CP) is a disability that affects a child’s ability to control his muscles. It’s caused by damage to the brain while the brain is developing.
Children with cerebral palsy can have problems like muscle weakness, stiffness, awkwardness, slowness and shakiness. They might also have difficulty with balance.
Cerebral palsy is the most common childhood physical disability in Australia.
Causes of cerebral palsy
Cerebral palsy can happen when there is brain damage or there are problems with brain development in the parts of the brain that control muscle movements.
Damage or problems with brain development can happen when:
- a child’s brain doesn’t develop properly during pregnancy
- a baby is born prematurely and the brain isn’t fully developed
- a mother is exposed to certain viruses during pregnancy
- a baby doesn’t get enough oxygen during birth
- a baby has a stroke during pregnancy or after birth
- a baby gets a severe brain infection shortly after birth
- a child experiences certain kinds of injuries during the early years of life – for example, a serious motor vehicle accident.
Types of cerebral palsy
There are three different types of cerebral palsy.
Spastic cerebral palsy
If a child has this type of cerebral palsy, her muscles stiffen up or become tight automatically. This happens because messages from her brain to her muscles can’t get through clearly.
Dyskinetic cerebral palsy
In this type of cerebral palsy, when a child tries to move he might make twisting, repetitive movements with his arms, hands, legs and feet, and around his mouth. These movements might make it very difficult for him to sit, stand, reach or grasp. Dystonia and athetosis are two types of these movement problems.
Ataxic cerebral palsy
If a child has this type of cerebral palsy, she’ll have shaky and unsteady movements or tremors. She’ll also have problems with balance and might walk with her feet wide apart to help her balance.
Most people with cerebral palsy actually have a combination of two or more of these types of cerebral palsy.
Symptoms and effects of cerebral palsy
Every child with cerebral palsy has a different combination of symptoms.
The severity of cerebral palsy symptoms also varies from child to child.
Some children have quite mild symptoms, and can walk well and communicate effectively. Children with severe cerebral palsy might have difficulty making everyday movements and doing everyday things. About one-third of children with cerebral palsy will need extra help to get around, and one-quarter won’t be able to talk.
The effects of cerebral palsy can be different in different children. One child might be affected mainly on one side of the body (like a stroke in an adult), and another child might be affected in both legs. And yet another child might have effects in legs, arms and body. Many children feel the effects of cerebral palsy in the muscles of their face, mouth and throat. This can affect communication, eating and drinking.
Babies with cerebral palsy might have:
- problems with feeding
- slow or delayed development – for example, they might be slower than other babies to hold their heads up or sit up
- unequal movements across their bodies – for example, they might take no notice of one hand
- poor muscle control
- low muscle tone
- muscle spasms or stiffness when you try to move their joints.
Some babies with cerebral palsy might have been sick or premature when they were newborns. But about half of all babies later diagnosed with cerebral palsy were full term and well at the time of birth.
Sometimes these signs might not be obvious in your baby, but you might have the feeling that something isn’t right. You know your baby best, so trust your instincts and keep talking to your child and family health nurse, GP or paediatrician about your concerns.
The most common problems for children with cerebral palsy are feeding, pain, sleep and communication.
Other problems can include:
Other health issues
Many children with cerebral palsy also experience other health issues including gastro-esophageal reflux, constipation, epilepsy, orthopaedic problems and recurrent chest infections.
Your child with cerebral palsy will have a team of health professionals to look after him. You can work with them to find the best strategies for caring for your child’s health.
If your baby has cerebral palsy, her brain damage won’t get worse. But it can get harder for her body to manage extra challenges as she grows up – for example, it might be hard to keep walking once she gets tall during growth spurts in the teenage years. Diagnosing cerebral palsy early and managing it well will give your child the best chance. And even if your child wasn’t diagnosed early, it’s never too late for intervention.
Diagnosis and tests for cerebral palsy
Because cerebral palsy is a complex disability with many different symptoms, getting a clear diagnosis before 12 months isn’t always easy.
All babies develop at different rates and do things at their own pace. But if your baby hasn’t reached his developmental milestones or you’re worried that your baby is learning to move, sit or use his hands slower than you expect, it’s always worth talking to your GP, child and family health nurse or paediatrician.
A doctor can diagnose cerebral palsy after taking a complete medical history and thoroughly examining your child. The doctor will look at your child’s voluntary movements and muscle tone, checking carefully for floppy muscles or stiff and tight muscles. The doctor will also check whether your child holds herself in an unusual way or uses one side of her body more than the other.
The doctor might order tests to rule out other rarer conditions that get worse over time.
Some doctors might order an MRI (magnetic resonance imaging) scan, which can take pictures of your child’s brain. But about 10% of children with cerebral palsy will have a normal MRI.
Getting a confirmed diagnosis can take a long time because your child might have to see a few different specialists and go through a range of tests. Although the wait can be hard, it’s important for the doctors to rule out other movement conditions or other causes of movement delay. This is because the treatments for different conditions and delays can be different.