Cerebral palsy

Cerebral palsy is a condition caused by damage to the brain, or by the brain not developing normally. This damage usually happens before birth or during a child's early development. Cerebral palsy is not normally progressive in nature.

It usually causes abnormal muscle tone and movement. The main types of abnormal muscle tone are:

This is the most common type of abnormal muscle tone. Someone with spastic cerebral palsy is likely to have tightening of the muscles throughout the body. The tightening can be persistent or it can come and go. How stiff the muscles get varies from person to person.

People with this type of muscle tone may have dystonia or, more rarely, athetosis.

This describes a type of abnormal muscle control where the muscles can shift from tight to floppy without warning, resulting in involuntary movements.

This is the least common type. You can recognise it by shaky movement and poor balance. Someone with ataxic cerebral palsy may struggle with fine motor movements and coordination, like writing or using cutlery. They may have a tremor that gets worse with activity, and they may struggle with balance, which can make standing or sitting upright difficult.

Someone with mixed cerebral palsy may show signs of more than one type of abnormal muscle tone at the same time.

Cerebral palsy affects each person differently, and the symptoms depend on the type of brain injury or abnormality behind it. Someone with cerebral palsy may:

• struggle with movement and balance, and may be unable to walk
• struggle to speak, and possibly need to use electronic aids
• have difficulties with eating, drinking and swallowing
• have problems with their vision
• experience pain symptoms
• experience fatigue (tiredness)
• have problems with their sleep
• have epilepsy
• have a learning disability
• display behavioural problems
• have bladder control problems
• have problems with their digestive system (constipation)
• struggle to control their saliva
• struggle to process information from their senses

A person with cerebral palsy may also have secondary symptoms. These come from the impact of the condition on the body, not directly from cerebral palsy itself. They can include:

• tightness in joints and muscles
• dislocations
• a change in their physical abilities
• changes in the amount of pain they experience
• increased fatigue

Cerebral palsy is caused by damage to the brain during pregnancy, birth or early development.

Some things can raise the risk of a child developing cerebral palsy. These include:

• premature birth (being born early)
• neonatal encephalopathy (caused by lack of oxygen to the brain in pregnancy or around the time of birth)
• stroke or bleeding in the baby's brain during pregnancy or after birth
• infection during pregnancy or after birth
• meningitis
• head injuries

It's not always possible to tell why a child has developed cerebral palsy. A child can have the condition even when the parents have done everything right during pregnancy and childbirth. The parents of a child with cerebral palsy are not to blame.

No single test can diagnose cerebral palsy. Your doctor will need to watch how your child develops over time before making a diagnosis. They may also use tests such as brain scans to confirm it.

Waiting for a diagnosis can be very stressful for parents. It's natural to feel anxious when your child is unwell.

Most children are diagnosed by two years old. Some are diagnosed earlier if they've spent time in medical settings, for example children who were born premature.

To diagnose cerebral palsy, the doctor will look at your child's medical history, and at how well they can move, balance and react. They may also use scans like an MRI to check for any sign of damage or abnormal development of the brain.

Cerebral palsy doesn't normally get worse over time, so doctors call it a non-progressive condition. But that doesn't mean it stays exactly the same for life. The symptoms can change as a person grows older, even in adulthood.

Contact your doctor if you or your child:

• are experiencing a change in condition
• have symptoms that are getting worse

Cerebral palsy doesn't normally shorten life expectancy. People with the condition often go on to live long, rich and rewarding lives.

Treatments and resources are available to help both children and adults. Everyone with cerebral palsy has individual needs, and those needs may change over time. Your doctor will help you find treatments and resources that work for you or your child.

Targeted physiotherapy can help you or your child improve and maintain posture, coordination, strength and balance. Physiotherapists may recommend specialist mobility equipment and advise about using orthotic splints.

Occupational therapists help people who struggle with everyday tasks to find new ways of doing them. They can show you or your child how to break activities down into smaller movements, which helps build confidence. They also know a good deal about the medical aids and technologies that can help you or your child.

If you or your child is struggling to talk, a speech and language therapist can help. They have many techniques that can help people get better at talking, such as learning to shape a sound. Some speech therapists will recommend specialist communication aids.

If swallowing is a problem, a speech and language therapist can also help by doing an assessment and making recommendations.

An orthotic device is a piece of equipment that supports a part of the body. It can help you or your child move more easily and be more active.

Orthotics can help with many of the physical problems that cerebral palsy can cause. Some will only be used for a short time, while others may be used for your whole life or your child's whole life. The need for them can also change with time.

An orthotist will examine how well you or your child can move, and make recommendations based on your or your child's personal needs.

Finding out that your child has cerebral palsy can feel very overwhelming for parents. You may feel anxious about the future and cut off from other parents. If you're feeling isolated, an online support group might help you feel less alone.

Medicine cannot cure cerebral palsy, but some types may help ease some of the symptoms. Muscle relaxants, for example, may help people with spastic or dystonic cerebral palsy. Speak to your doctor for more information about medicine.

Surgery may be recommended to help with certain symptoms. Surgery on muscles, bones and nerves, for example, can help with movement. Speak to your doctor for more information on surgical options.