Overview
Cerebral palsy is a group of conditions that affect movement, balance and posture. It's caused by damage that occurs to a baby's brain, most often before birth.
Symptoms appear during infancy or preschool years. Children may have exaggerated reflexes, or their arms, legs and trunk may appear floppy. Cerebral palsy can cause stiff muscles, known as spasticity. Symptoms also can include changes in posture and movements, such as not having a steady walk. Cerebral palsy can make it hard to swallow or focus the eyes. Some children have a combination of these symptoms.
The effects on function can vary. Some people with cerebral palsy can walk, while others need assistance. Some have intellectual disabilities, but others do not. Some may have epilepsy, blindness or deafness. There is no cure, but treatments can help improve function. The condition generally stays the same over time.
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Symptoms
Symptoms of cerebral palsy can vary greatly. In some people, cerebral palsy affects the whole body. In other people, symptoms might only affect one or two limbs or one side of the body. General symptoms include trouble with movement and coordination, speech and eating, and development.
Movement and coordination
Movement symptoms may include:
- Stiff muscles and exaggerated reflexes, known as spasticity. This is the most common movement condition related to cerebral palsy.
- Changes in muscle tone, such as being either too stiff or too floppy.
- Stiff muscles, known as rigidity.
- Lack of balance and muscle coordination, known as ataxia.
- Jerky movements that can't be controlled, known as tremors.
- Slow, writhing movements.
- Favoring one side of the body, such as only reaching with one hand or dragging a leg while crawling.
- Trouble walking. People with cerebral palsy may walk on their toes or crouch down when they walk. They also may have a scissorslike walk with their knees crossing. Or they may walk with their legs wide or not be steady.
- Trouble with fine motor skills, such as buttoning clothes or picking up utensils.
Speech and eating
Cerebral palsy can cause symptoms related to speech and eating, such as:
- Delays in speech development.
- Trouble speaking.
- Trouble with sucking, chewing or eating.
- Drooling or trouble with swallowing.
Development
Some children with cerebral palsy have these symptoms related to development:
- Delays in reaching motor skills milestones, such as sitting up or crawling.
- Learning disabilities.
- Intellectual disabilities.
- Delayed growth, resulting in smaller size for the child's age.
Other symptoms
Damage to the brain can contribute to other symptoms, such as:
- Seizures, which are symptoms of epilepsy. Some children with cerebral palsy are diagnosed with epilepsy.
- Trouble hearing.
- Trouble with vision and changes in eye movements.
- Pain or trouble feeling sensations such as touch.
- Bladder and bowel issues, including constipation and urinary incontinence.
- Mental health conditions, such as emotional conditions and behavior issues.
The brain condition causing cerebral palsy doesn't change with time. Symptoms usually don't worsen with age. However, as the child gets older, some symptoms may become easier to notice. Muscle shortening and muscle rigidity can worsen if not treated aggressively.
When to see a doctor
Contact your child's healthcare professional and get a prompt diagnosis if your child has symptoms of a movement condition. Also see a healthcare professional if your child has delays in development.
If you have concerns about episodes of loss of awareness or changes in body movements or posture, make an appointment with your child's healthcare professional. It's also important to contact a healthcare professional if your child has trouble swallowing, poor coordination, changes in eye muscle balance or other developmental issues.
Causes
Cerebral palsy is caused by brain development that is not usual. It's also caused by damage to the developing brain. This usually happens before a child is born, but it can occur at birth or in early infancy. Often the cause isn't known. Many factors can lead to changes in brain development. Some include:
- Gene changes that result in genetic conditions or differences in brain development.
- Maternal infections that affect an unborn baby, also called a fetus.
- Stroke, which interrupts blood supply to the developing brain.
- Bleeding into the brain in the womb or as a newborn.
- Infant infections that cause swelling in or around the brain.
- Traumatic head injury to an infant, such as from a motor vehicle accident, fall or physical trauma.
- Lack of oxygen to the brain related to hard labor or delivery, although this cause is less common than previously thought.
Risk factors
Several factors are linked to a higher risk of cerebral palsy.
Health during pregnancy
Certain infections or toxic exposures during pregnancy can greatly raise the risk of cerebral palsy in a baby. Inflammation triggered by infection or fever can damage a baby's developing brain.
- Cytomegalovirus. This common virus causes flu-like symptoms. If a pregnant person has a first active cytomegalovirus infection during pregnancy, it can lead to birth defects.
- German measles, known as rubella. This viral infection can be prevented with a vaccine.
- Herpes. The herpes virus can be passed from a pregnant person to an unborn baby, affecting the womb and placenta.
- Syphilis. This is a bacterial infection that's usually spread by sexual contact.
- Toxoplasmosis. This infection is caused by a parasite found in contaminated food, soil and the stool of infected cats.
- Zika virus infection. Zika virus is spread through mosquito bites and can affect the brain of a baby before birth.
- Intrauterine infections. These include infections of the placenta or fetal membranes.
- Exposure to toxins. One example is exposure to methyl mercury.
- Other conditions. Other conditions affecting a pregnant person can slightly raise the risk of cerebral palsy in the child. These include thyroid conditions, preeclampsia and seizures.
Infant illness
Illnesses in a newborn baby that can raise the risk of cerebral palsy include:
- Bacterial meningitis. This bacterial infection causes swelling in the membranes surrounding the brain and spinal cord.
- Viral encephalitis. This viral infection also causes swelling in the membranes surrounding the brain and spinal cord.
- Jaundice that is serious or isn't treated. Jaundice appears as a yellowing of the skin and eyes. The condition occurs when certain byproducts of "used" blood cells aren't filtered from the bloodstream.
- Bleeding into the brain. This condition is commonly caused by the baby having a stroke in the womb or during early infancy.
Pregnancy and birth circumstances
Some factors of pregnancy and birth may raise the risk of cerebral palsy, although the potential contribution from each is limited:
- Low birth weight. Babies who weigh less than 5.5 pounds (2.5 kilograms) are at higher risk of cerebral palsy. This risk goes up as birth weight drops.
- Premature birth. Babies born prematurely are at higher risk of cerebral palsy. The earlier a baby is born, the greater the cerebral palsy risk.
- Multiple babies. Cerebral palsy risk rises with the number of babies sharing the uterus. The risk may be related to premature birth and low birth weight. If one or more of the babies die, the survivors' risk of cerebral palsy goes up.
- Delivery complications. Events during labor and delivery may raise the risk of cerebral palsy.
Complications
Muscle weakness, muscle spasticity and trouble with coordination can contribute to complications in childhood or in adulthood, including:
- Contracture. Contracture happens when the muscles are shortened and tight. This can be the result of spasticity. Contracture can slow bone growth, cause bones to bend, and result in joint changes, dislocation or partial dislocation. This can include a dislocated hip, a curved spine or other bone changes.
- Malnutrition. Trouble with swallowing and feeding can make it hard to get enough nutrition, particularly for an infant. This can affect growth and weaken bones. Some children or adults need a feeding tube to get enough nutrition.
- Mental health conditions. People with cerebral palsy might have mental health conditions, such as depression. Social isolation and the challenges of coping with disabilities can contribute to depression. Behavior issues also can occur.
- Heart and lung disease. People with cerebral palsy may have heart disease, lung disease or breathing conditions. Trouble swallowing can result in respiratory issues, such as aspiration pneumonia. Aspiration pneumonia happens when a child gets food, drink, saliva or vomit in the lungs.
- Osteoarthritis. Pressure on joints or misalignment of joints from muscle spasticity may lead to this type of arthritis.
- Osteoporosis. Fractures due to low bone density can result from lack of mobility, poor nutrition and antiseizure medicines.
- Other complications. These can include sleep conditions, chronic pain, skin breakdown, intestinal issues and issues with oral health.
Prevention
Cerebral palsy often can't be prevented, but you can reduce risks. If you're pregnant or planning to become pregnant, take these steps to minimize pregnancy complications:
- Make sure you're vaccinated. Getting vaccinated against diseases such as rubella might prevent an infection. It's best to make sure you're fully vaccinated before getting pregnant.
- Take care of yourself. The healthier you are before you get pregnant, the less likely you'll be to develop an infection that could result in cerebral palsy.
- Seek early and continuous prenatal care. See your healthcare professional regularly during pregnancy. Proper prenatal care can reduce health risks to you and your baby, including premature birth, low birth weight and infections.
- Avoid alcohol, tobacco and illegal drugs. These have been linked to cerebral palsy risk.
Rarely, cerebral palsy can be caused by brain damage that occurs in childhood. Practice good general safety. Prevent head injuries by providing your child with a car seat, a bicycle helmet, safety rails on the bed and appropriate supervision.