What does Cerebral Palsy Mean?
What causes Cerebral Palsy?
How frequently does Cerebral Palsy occur?
Are there different types of CP?
Are there other conditions that go along with Cerebral Palsy?
How is Cerebral Palsy diagnosed?
Can Cerebral Palsy be treated?
What happens as a person with CP gets older?
Is research being done?

What does Cerebral Palsy Mean?

Cerebral Palsy (CP) is the result of some type of trauma – or injury – to the brain before, during or shortly after birth. It is a permanent but not progressive disorder characterized by a disruption of motor skills. Severity varies widely, and no two people with CP will have an identical situation. Once cerebral palsy occurs, it does not get better or worse so it is properly referred to as a condition, not a disease.

What causes Cerebral Palsy?

There are many, many possible explanations for what might have caused the injury to the brain. Here are just a few:

When the brain injury occurs before birth -- it might have been caused by abnormal fetal brain development, an infection (the mother might not even have been aware of being sick), an accident in which the mother was injured, a medical condition such as high blood pressure or diabetes, or unknown biochemical or genetic factors. (80% of reported cases)

When the brain injury occurs during the birth process -- it is usually due to a deprivation of oxygen, often the result of a difficult delivery. (10% of reported cases)

When the injury occurs after birth -- it may be the result of prematurity, an infection, bleeding in the brain, or an accident in which the baby is injured. (10% of reported cases) When that portion of the brain which normally sends messages to the muscles in the body is injured, cerebral palsy is the result; children with CP have difficulty or an inability to control muscle coordination. They may have muscle tone that is too high (spasticity or hypertonicity), or too low (hypotonicity), or a combination of both.

How frequently does CP occur?

Approximately 1 in every 1,000 infants has some form of cerebral palsy. Twins are four times more likely to have CP than single births, and triplets are more likely still to develop CP. Despite medical advances, the incidence and severity of CP has actually increased slightly over time. This may be attributed to medical advances that help premature and low birth-weight babies to survive and/or the increased usage of artificial fertilization techniques and multiple births.

Are there different types of Cerebral Palsy?

There are three main types: spastic, ataxic, and athetoid.

• Spastic – If the muscle tone is too high (hypertonic) or too tight, the individual has stiff and jerky movements. They often have a hard time moving from one position to another. This is the most common type and occurs in approximately 70% of the CP population.
• Ataxic – Persons with ataxia have damage to their cerebellum which results in problems with balance, especially while walking. It is the rarest type, as it occurs in no more than 10% of all cases.
• Athetoid (or dyskinetic) – This type of CP describes individuals who have both low and high tone. They may experience difficulty holding themselves steady for sitting or walking and have involuntary body movements. It accounts in approximately 20% of all cases.

Individuals may have a mixture of these types of cerebral palsy. There are also classifications for the areas of the body that cerebral palsy affects. Common terms one might hear could be:

• Diplegia – the cerebral palsy affects the legs only. Walking or running may be difficult however the upper body is not affected. Spastic diplegia, is sometimes known as Little’s disease in the United Kingdom.
• Hemiplegia – this term refers to those individuals whose CP affects one side of their body – either the right arm and leg, or the left arm and leg, while the other side functions normally. People with hemiplegia are generally able to walk and run but may have a limp or awkwardness in their gait.
• Quadriplegia – This refers to the individual who is affected in all four limbs; they may have difficulty moving all of their body parts and oftentimes require a wheelchair for mobility. Due to the problems controlling the muscles of their face and upper body, they may have trouble speaking and eating.

Are there other conditions that go along with CP?

Depending upon precisely where the damage in the brain occurs and to what extent, some individuals may have abnormal sensation and perception; impaired sight, hearing or speech; seizures; mental retardation; feeding difficulties; learning disabilities; as well as bladder and bowel control. Because CP is caused by damage to the brain cells, the damage may have occurred in areas other than just the motor portion of the brain. Statistically, about 33% of individuals with CP have moderate or severe cognitive impairment, 33% are mildly intellectually impaired, but 33% are of normal intelligence. Approximately 50% of individuals with CP have experienced seizures.

How is Cerebral Palsy diagnosed?

Physicians diagnose cerebral palsy by looking at the child’s motor skills, medical history, and development. The physician will test reflexes and may look for an unusually early development of hand preference (babies younger than 12 months generally do not show hand preference). Many times, a CT scan or MRI may be ordered to identify possible problems in the brain’s structure; however, CP may be diagnosed by the clinical manifestations of the individual even if the scans do not indicate any brain anomalies. Often, the initial diagnosis is made by a neurologist but the child may not need to continue to see a neurologist unless seizures are also occurring. Individuals with cerebral palsy are often followed by an orthopedist or physiatrist who monitors the usage of their muscles and bones.

Can Cerebral Palsy be treated?

“Management” is a better word than “treatment.” Management consists of helping the child achieve maximum potential in growth and development. Intervention should begin as early as possible and include attention to the child’s movement, learning, speech, hearing, as well as social and emotional development. Certain medications, surgery, and braces may be utilized to improve nerve and muscle coordination and prevent dysfunction.

The importance of early therapy for children with cerebral palsy is what originally motivated UCP-OC to establish an Early Invention program to help infants from birth through 36 months.

What happens as a person with CP gets older?

Remember that CP is not progressive; the brain damage does not spread or worsen. However, evidence suggests that functional decline may occur in adulthood with persons having cerebral palsy. The decline may encompass a decrease in range of motion, decrease or loss of ambulation, and increased pain. It appears that adults with CP undergo an accelerated aging process compared to their non-disabled peers. Onset of arthritis and osteoporosis may occur much sooner in adults with CP.

As individuals mature, they may require support such as personal assistance services, continuing therapy, educational and vocational training, independent living services, counseling, transportation, recreation/leisure programs, and employment opportunities – all essential to the developing adult. People with cerebral palsy can go to school, be employed, get married, raise families, and live in homes of their own. Most of all, people with cerebral palsy need the opportunity for full inclusion in our society.

Is research being done?

Yes. Active national programs of research are being vigorously pursued to prevent cerebral palsy and to improve the quality of life for individuals with cerebral palsy. The two key organizations with major research programs are the Cerebral Palsy International Research Foundation. Research updates are available at www.cpirf.org.

Individuals may have a mixture of these types of cerebral palsy. There are also classifications for the areas of the body that cerebral palsy affects.