Cerebral palsy is a neurological condition that develops in the growing brain and can affect movement control, posture, and coordination. It may also impact speech and chewing, and in some cases, it can be associated with intellectual disability.
Cerebral palsy can be caused by a lack of oxygen during birth, brain hemorrhages, infections during pregnancy, or genetic changes.
Treatment for cerebral palsy should be prescribed by a pediatrician or neurologist and varies according to the affected brain area. It may include medications, physical therapy, speech therapy, and occupational therapy, among others.
Common symptoms
The main symptoms of cerebral palsy include:
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Developmental delays
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Motor problems, such as poor strength, coordination issues, and involuntary movements
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Seizures
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Difficulty chewing, eating, and swallowing
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Excess saliva
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Delayed speech or speech problems
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Intellectual or learning difficulties
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Vision problems, blindness, or abnormal eye movements
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Breathing difficulties
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Increased sensitivity to touch or pain
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Bladder or bowel problems, such as urinary incontinence or constipation
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Behavioral disorders
Symptoms of cerebral palsy usually appear in the first 2 to 3 years of life. They can range from mild to severe, change over time, and vary depending on the affected brain area.
It is important to see a pediatrician if a child shows any symptoms of cerebral palsy so that diagnosis can be made and the most appropriate treatment started.
Confirming a diagnosis
The diagnosis of cerebral palsy is made by a pediatrician based on medical history, physical examination, observed symptoms, and a full neurological assessment.
To confirm the diagnosis, the doctor may request an MRI scan to help identify possible brain abnormalities.
In some cases, a cranial ultrasound, electroencephalogram, blood tests, or genetic evaluation may be ordered to rule out other conditions with similar symptoms.
The pediatrician may also refer the child to other specialists, such as an ophthalmologist, otolaryngologist, or neurologist, to check for conditions associated with cerebral palsy.
Types of cerebral palsy
There are different types of cerebral palsy, classified according to the symptoms and how they affect muscle control, coordination, and movement.
1. Spastic cerebral palsy
Spastic cerebral palsy is the most common type, characterized by stiff muscles, strong reflexes, and difficulty controlling movements like walking, crossing the legs, or holding objects. In most cases, intelligence is preserved.
2. Dyskinetic cerebral palsy
In dyskinetic cerebral palsy, motor coordination is affected by involuntary movements that can be slow, rapid, jerky, or twisting in the arms, legs, and hands. This can make it harder to sit, walk, speak, and swallow.
In some cases, the face and tongue are also affected, impacting speech and eating, and hearing problems may occur. Intelligence is often affected.
3. Ataxic cerebral palsy
Ataxic cerebral palsy is the least common type. It causes tremors, uncoordinated movements, and problems with balance and motor coordination, affecting walking. Children with this type often walk with their legs apart.
This form also makes it harder to perform fine motor tasks such as grasping objects or writing.
4. Mixed cerebral palsy
Mixed cerebral palsy occurs when symptoms of more than one type are present, most commonly a combination of spastic and dyskinetic types.
In these cases, some muscles may be tight while others are more relaxed, resulting in a mix of muscle stiffness and involuntary movements.
Possible causes
The main causes of cerebral palsy include:
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Brain malformation
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Genetic factors
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Infections during pregnancy, such as rubella, herpes, syphilis, toxoplasmosis, or Zika virus
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Intracranial hemorrhage before or after birth
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Fetal stroke
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Premature birth
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Lack of oxygen during delivery
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Neonatal hypoglycemia
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Severe jaundice
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Neonatal infections such as meningitis, sepsis, vasculitis, or encephalitis
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Head injury during childhood
Risk factors for cerebral palsy include low birth weight, multiple pregnancies, and restricted growth in the womb.
Drug use during pregnancy, preeclampsia, placental problems, meconium aspiration, and delivery complications can also contribute to the development of cerebral palsy.
Treatment options
Treatment for cerebral palsy aims to improve mobility, independence, and quality of life, and is tailored to each person’s symptoms and needs.
1. Medications
Medications for cerebral palsy are prescribed by a neurologist to help reduce muscle stiffness and spasms. These may include oral muscle relaxants or botulinum toxin (Botox) injections into the muscle or nerve.
Botulinum toxin can also be injected into the salivary glands to reduce excessive saliva production.
2. Physical therapy
Physical therapy uses exercises recommended by a physical therapist to strengthen muscles, improve strength, flexibility, balance, and coordination, and support better breathing.
Some exercises can be done at home as guided by the therapist.
3. Occupational therapy
Occupational therapy helps improve quality of life and promote independence in daily activities at home or school, such as eating or walking.
During sessions, the therapist may teach the child to use adaptive equipment, such as special utensils, walkers, or wheelchairs.
4. Speech therapy
Speech therapy can help improve speaking and communication skills, including the use of sign language, and address difficulties with eating or swallowing.
5. Orthopedic surgery
Orthopedic surgery may be recommended to correct bone or joint deformities caused by muscle stiffness.
Surgery can also help relieve pain and improve movement in the affected area.
6. Assistive devices and technologies
People with cerebral palsy may benefit from assistive devices and technologies that promote independence, make movement easier, and improve daily communication.
These can include orthoses such as orthopedic boots and braces to correctly position the arms, legs, or spine, as well as communication devices, eye-tracking systems, and adapted keyboards.
Does cerebral palsy have a cure?
Cerebral palsy has no cure, as it is caused by a permanent brain injury. However, the damage does not worsen over time, and starting treatment early increases the chances of improving quality of life and independence.