Cerebral Palsy

What is it?

The Campbell Foundation-led Center of Excellence for Cerebral Palsy Care and Research, in partnership with Le Bonheur Children’s Hospital, offers comprehensive multidisciplinary care to patients with CP and other neuromuscular conditions.

Learn more at the Lebonheur Cerebral Palsy Clinic

Cerebral palsy (CP) is a neuromuscular disorder that affects one’s ability to control muscle movement. Both the spinal cord and muscles are intact in cerebral palsy; however, there is either damage or abnormalities to the structure of the brain that coordinates muscle movement in order to cause this.

Cerebral palsy roughly affects every 2 of 1000 live births. Cases of CP differ in severity and can range from mild to severe based on the area of the brain affected and how much. Most doctors classify CP cases in three categories: physiologic, geographic, and functional.

Within the physiologic classification of CP, there are four sub-classifications:

  • Spastic: most common form, increased muscle tightness
  • Athetoid: muscle looseness, weakness, involuntary movement of entire body
  • Ataxic: rare form, poor balance and coordination, decreased depth perception
  • Mixed: a combination of spastic and athetoid symptoms

The geographic category of CP cases is based on the region of the body that is affected. For example,

  • Diplegic: affects both legs, legs turn inward and knees may cross (known as scissoring)
  • Hemiplegic: one side of the body is affected, arm often more so than the leg
  • Triplegic: both legs and one arm are affected
  • Quadriplegic: all four limbs and the trunk are affected

The functional category of CP is the most common category as it best describes how a child with CP will be able to function. There are five subcategories within the functional category, which are:

  • I. Ability to walk without restrictions and keep up with peers
  • II. Ability to walk but sometimes requires leg braces, difficulty keeping up with peers
  • III. Requires walking aids (i.e. walker or crutches) for short distances and a wheelchair for longer distances
  • IV. Nonambulatory, but can maneuver own wheelchair
  • V. Inability to independently support the trunk or move on one’s own

Not only does cerebral palsy affect the musculoskeletal system, other impairments may result, such as:

  • Learning or intellectual disability
  • Seizures
  • Limb deformity, including shorter limbs and spinal curvature
  • Vision problems
  • Dental problems
  • Hearing problems
  • Joint problems

What causes it?

The majority of cerebral palsy cases begin in utero prior to the baby’s birth. However, some cases may begin at birth or during the first few years of life.

The exact reason why the brain cannot communicate for muscle coordination is not currently understood. However, certain factors, such as drugs, alcohol, or environmental toxins are known to affect unborn babies in utero. After the baby is born, additional risk factors include low oxygen, head injury, or infection.

It is known that premature babies are at an elevated risk of developing cerebral palsy.

How is it diagnosed?

Before diagnosing your child with cerebral palsy, your doctor will want to rule out other conditions, such as genetic or muscle diseases, metabolism disorders, or tumors. Your doctor will perform a physical exam of your child assessing for muscle tightness or looseness, reflexes, and certain milestones that your child should have reached, such as crawling or standing.

Depending on the age of your child, a short observation period may be needed so that your doctor can assess your child’s movement abilities.

Unfortunately, there is no specific test that confirms the diagnosis of cerebral palsy. However, an MRI can show any damage or abnormality of the brain.

How is it treated?

Treatment for CP often comprises a variety of medical professionals, such as orthopaedic surgeons, physical therapists, occupational therapists, speech therapists, social workers, psychologists, behavioral therapists, to name a few.

The most common nonsurgical treatment for CP is physical therapy to help your child learn how to sit, stand, and walk with their condition. In addition, physical therapy can help improve muscle strength, balance and coordination.

Other nonsurgical treatments include the use of braces, splints or casts. Medications can help with muscle spasms associated with CP.

In some cases, surgery may be needed to lengthen muscles to improve mobility if muscle contracture is severe.

There currently is no cure for CP; however, the condition does not worsen over time.

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