Cerebral palsy in children: Overview
Cerebral palsy is the name for a group of nerve problems that make it hard for a child to control movement.
Cerebral palsy is caused by damage to the brain. In most cases, this damage happens before birth.
The way your child is affected may be different than how other children are affected. For some children, cerebral palsy causes only a slight limp. Others have little or no control over their arms and legs or other parts of the body. To find out more about how the disease affects your child, your doctor may do more tests.
You and your doctor can work together to create a treatment plan for your child. This plan can help manage symptoms. It can also help your child be as independent as possible. The plan will probably include physical therapy. It may also include medicines and other therapies.
Learning that your child has cerebral palsy isn’t easy. And raising a child who has it can be hard. It may help to join a support group or talk with other parents who have a child with special needs, so you don’t feel alone. You may also want to try counseling. It could help you understand and deal with all the emotions you may feel.
What are the symptoms of cerebral palsy?
When cerebral palsy (CP) is severe, signs are often noticed at birth or shortly after birth. But some early signs of severe CP vary, depending on the specific type of CP.
Symptoms shortly after birth
Common signs of severe CP that may be noticed shortly after birth include:
- Problems sucking and swallowing.
- A weak or shrill cry.
- Unusual positions. Often the baby's body is either very relaxed and floppy, or it's very stiff.
Even when a baby has CP at birth, the signs may not be noticed until a child is 1 to 3 years old. Doctors and parents may not see that a baby's movements are unusual until the movements become more obvious as the baby grows.
Symptoms over time
Some problems related to CP get more clear over time. Or they may develop as a child grows. These may include:
- Smaller muscles in the affected arms or legs.
Nervous system problems prevent movement in the affected arms and legs. Not being active affects how the muscles grow.
- Abnormal sensations.
Some people who have CP feel pain when touched lightly. Even everyday activities, such as brushing teeth, may hurt. Abnormal sensations can also make it hard to identify common objects by touch.
- Skin irritation.
Drooling is common when muscles of the face and throat are affected. Drooling irritates the skin, particularly around the mouth, chin, and chest.
- Dental problems.
Children who have trouble brushing their teeth have a greater risk of getting cavities and gum disease (gingivitis). Seizure medicines may also lead to gum disease.
Falls and other accidents are a risk, depending on muscle control, joint stiffness, and general physical strength. And CP-related seizures can cause injuries.
How is cerebral palsy diagnosed?
A doctor diagnoses cerebral palsy (CP) based on:
- Questions about the child's past health. This includes details about the mother's pregnancy.
- Developmental questionnaires and other screening tests.
- A physical exam to look for signs of CP. The doctor will look to see if the child retains newborn reflexes longer than normal. This can be a sign of CP. Postures and basic muscle function, hearing, and vision are usually checked.
- MRI of the head. This test can find brain abnormalities.
If the diagnosis is unclear, more tests may be done. Sometimes these tests can help find out how severe CP is.
Sometimes symptoms may not appear until the nervous system matures. It can take up to a few years before doctors can tell if a baby with body movement and posture (motor) problems has CP.
Developmental delays are often reported by parents or noticed by a doctor during routine well-baby checks.
Evaluating and monitoring cerebral palsy
A doctor may closely monitor a newborn or child for signs of CP if the child has known risk factors. These factors may be related to problems during pregnancy or birth, being born early (premature birth), or problems that occur within the first 2 or 3 years of life.
After CP is diagnosed, a child will also be checked for other medical conditions that can occur with cerebral palsy. These include:
- Other developmental delays along with ones already found. Developmental abilities will be checked to find out if new symptoms, such as speech and language delay, appear as a child's nervous system matures.
- Intellectual disability. This can be found by intelligence testing.
- Seizures. An electroencephalography (EEG) is used to check for abnormal activity in the brain if a child has a history of seizures.
- Problems with feeding and swallowing.
- Vision or hearing problems.
- Behavioral problems.
Most of the time, a doctor can predict many of the long-term physical effects of CP when a child is 1 to 3 years old. But sometimes such predictions aren't possible until a child reaches school age. That's when learning, communication skills, and other abilities can be checked.
Some children need repeated testing that may include:
- X-rays, to check for loose or dislocated hips. Children with CP are usually X-rayed several times during ages 2 to 5. Spinal X-rays also are done to look for curves in the child's spine (scoliosis).
- Gait analysis. This helps identify problems and guide treatment decisions.
Other tests may be needed, depending on a child's symptoms, other conditions, or medicines the child takes.
How is cerebral palsy treated?
Even though cerebral palsy (CP) can't be cured, treatment can help people make the most of their abilities and physical strength.
Treatment varies by the person and changes as needed. In general, treatment focuses on ways to maintain or improve a person's quality of life and overall health.
Treatment for CP includes:
- Physical therapy.
This can help your child get around as much as possible. It often continues throughout your child's life. It may help prevent the need for surgery.
They can help control some of the symptoms of CP and prevent complications.
It may sometimes be used for a child with severe problems.
- Devices and equipment.
These include braces, casts, and splints. The type of devices used will depend on a child's needs.
- Pain management.
This helps your child with short- and long-term pain.
Regular visits with your child's doctors are important for monitoring your child's condition.
Copyrighted material adapted with permission from Healthwise, Incorporated. This information does not replace the advice of a doctor.