Answers to questions families often have about caring for their child with cerebral palsy

Cerebral palsy, also referred to as CP, is a term used to describe a group of chronic conditions affecting body movement and muscle coordination. It is caused by damage to one or more specific areas of the brain, usually occurring during fetal development; before, during, or shortly after birth; or during infancy. Thus, these disorders are not caused by problems in the muscles or nerves. Instead, faulty development or damage to motor areas in the brain disrupts the brain's ability to adequately control movement and posture. "Cerebral" refers to the brain and "palsy" to muscle weakness/poor control. Cerebral palsy itself is not progressive (i.e. brain damage does not get worse); however, secondary conditions, such as muscle spasticity, can develop which may get better over time, get worse, or remain the same. Cerebral palsy is not communicable. It is not a disease and should not be referred to as such. Although cerebral palsy is not "curable" in the accepted sense, training and therapy can help improve muscle function and coordination. At this time, there is no cure for the developmental brain damage that causes cerebral palsy. Studies have found that children who receive early intervention services such as physical and occupational therapy and other support services are more likely to lead a more typical and improved quality of life.

A person with cerebral palsy may exhibit one or more of the following effects:

• Muscle tightness or spasticity
• Disturbance in gait or mobility
• Involuntary movement
• Difficulty in swallowing and problems with speech

A person with cerebral palsy may also exhibit:

• Difficulty in feeding
• Impairment of sight, hearing or speech
• Abnormal sensation and perception
• Seizures
• Difficulty with bladder and bowel control
• Intellectual disability
• Learning disabilities
• Problems with breathing due to postural difficulties
• Skin disorders due to pressure sores

There are several types of cerebral palsy. These include:

• Spastic cerebral palsy characterized by muscle stiffness and permanent contractions
  • Spastic diplegia characterized by more significant impairment in the lower extremities
  • Spastic hemiplegia characterized by one side of the body affected much more than the other, and usually the arm more than the leg
  • Spastic quadriplegia characterized by whole body involvement
• Athetoid or dyskinetic cerebral palsy characterized by uncontrolled, slow, writhing movements
• Ataxic cerebral palsy characterized by poor coordination and balance
• Mixed cerebral palsy characterized by features from more than one type

Cerebral palsy is diagnosed clinically in a child with non-progressive problems that has a physical exam consistent with the diagnosis. The child’s history, either prenatal, birth, or after birth, should also be consistent with the diagnosis of cerebral palsy. In some circumstances, your child’s primary care clinician may wish to perform testing to rule out other possible diagnoses.

The answer to this question depends on the type of cerebral palsy your child has and any related complications. Generally, children with more involved CP such as spastic quadriparesis may have shortened life expectancies, as children who are nonmobile and have difficulty eating by mouth by themselves are subject to illnesses such as pneumonia, although many live far into mid and late adulthood. Children with mild CP might be expected to have normal life-spans. Because the answer to this question is specific to the child, ask your primary care clinician. There are many resources for parents of children with serious illness. See Partnership for Parents.

The answer to this question is complicated and depends entirely on why your first child has cerebral palsy. Genetic conditions that may cause cerebral palsy may be inherited and lead to an increased risk for CP in subsequent children whereas environmental causes for CP are often very unlikely to happen again. Ask your provider who may refer you to a specialist such as a neurologist or geneticist for answers to this question. Also, it might be appropriate to consult with a perinatologist or high risk obstetrician prior to your next pregnancy.

Early Intervention and therapies are known to be helpful in optimizing abilities in children and adults with CP. Medications are available to help children with spasticity. For more information, see the Cerebral Palsy Diagnosis Module found in the Diagnoses & Conditions Section. See Cerebral Palsy.

This will depend on the severity of the child’s CP. Children with mild CP may function in a typical or near typical manner. Children with severe CP may require total care. You can discuss this question with your health care primary care clinician who should be able to give you some idea of your child’s prognosis.

Although certain symptoms of cerebral palsy such as contractures and stiffness tend to worsen over time, the brain lesion responsible for these symptoms does not progress. Children with cerebral palsy are able to make developmental improvements over time, although in very involved children these improvements may be very slow. If you think that your child is regressing in his abilities, this is important information for your primary care clinician to know as it is possible that the diagnosis of cerebral palsy is not correct.

There are many alternative therapies without proven medical benefit by controlled scientific studies that are offered to families of children with disabilities. As these therapies are often quite expensive, families should research potential benefits and discuss these therapies with their primary care clinician before embarking on any unproven and in some cases, potentially harmful, therapies. Also see UCP study on hyperbaric oxygen and US Dept Health & Human Services report on efficacy of hyperbaric oxygen therapy. [Pérez-Gaxiola: 2013]