CEREBRAL PALSY about this condition

WHAT is CEREBRAL PALSY?

CEREBRAL PALSY

Cerebral palsy is a lifelong condition that affects movement or coordination. It appears in early childhood and it can be associated with problems with muscle control and coordination, sensation, vision, hearing, swallowing or speaking.6,7 

Living with cerebral palsy poses difficult physical challenges. One of these challenges is often severe spasticity, which is where certain muscles are contracted continuously. This makes them tight and stiff, and can interfere with movement and posture.

Nearly one million people in Europe have cerebral palsy.4 Over 40% of people with cerebral palsy experience severe spasticity, which can get in the get in the way of daily activities and impact on quality of life.1-5 Fortunately, there are therapies that can minimise severe spasticity in some individuals.

WHAT CAUSES CEREBRAL PALSY?

Cerebral palsy is caused by a problem with the brain that takes place before, during or soon after birth.4,6,7

The most common cause of cerebral palsy is a problem affecting the development of the baby’s brain while it is in the womb. These problems include:6,7

  • Bleeding in the unborn baby’s brain
  • Reduced blood and oxygen supply to the unborn baby’s brain
  • An infection caught by the mother while pregnant
  • An injury to the head of the unborn baby

Though less common, cerebral palsy can also be caused by damage to a baby’s brain during or soon after birth. In such cases, it can be caused by:6,7

  • A difficult birth in which the baby’s brain temporarily does not receive enough oxygen
  • A serious head injury
  • Meningitis or another infection of the brain
  • Choking or nearly drowning, which results in the brain not getting sufficient oxygen
  • A very low blood sugar level

WHAT ARE THE RISK FACTORS FOR CEREBRAL PALSY?

There are a number of risk factors that can increase the likelihood of cerebral palsy. However, it’s important to know that these risk factors will not necessarily result in the disease. These risk factors are usually present during foetal development before, during or shortly after birth, or during infancy.

The risk factors for cerebral palsy include:6

  • Infection of the mother with German measles or other viral diseases in early pregnancy
  • Bacterial infection of the mother, foetus or infant that directly or indirectly attacks the infant’s central nervous system
  • Prolonged loss of oxygen before or during birth
  • Severe jaundice shortly after birth 
  • Premature birth
  • Low birth weight
MAN PUSHING BOY IN WHEEL CHAIR

WHAT ARE THE SYMPTOMS OF CEREBRAL PALSY?

GUY WALKING

Cerebral palsy is associated with a wide range of signs and symptoms related to movement and coordination problems. They signs of cerebral palsy may include:6,8

In a baby from 3 to 6 months of age:

  • Unable to hold up his/her own head when picked up or while lying on back
  • Variations in muscle tone, such as being either too stiff or too floppy
  • Seems to overextend back and neck when cradled in someone’s arms
  • Legs get stiff and cross or scissor when picked up

In a baby older than 6 months of age:

  • Delays in reaching motor skills milestones, such as 
    • not independently rolling over in either direction
    • not bringing hands together
    • bringing hands to mouth with difficulty
  • Favouring one side of the body, such as reaching with one hand while keeping the other fisted

In a baby older than 10 months of age:

  • Prefers to use one side of their body, such as crawling in a lopsided manner, pushing off with one hand and leg while dragging the opposite hand and leg
  • Delayed development, such as 
    • can’t sit up 
    • scoots around on buttocks or hops on knees, but does not crawl on all fours
  • Difficulty with fine motor skills, such as buttoning clothes or picking up utensils

The disability caused by cerebral palsy could be limited mainly to one limb or one side of the body, or it could affect the whole body. The brain injury caused by cerebral palsy remains unchanged and the symptoms tends not to get worse as children develop. However, muscle shortening and muscle rigidity could worsen if not treated.6

HOW IS CEREBRAL PALSY DIAGNOSED?

Cerebral palsy is usually diagnosed early in life. If you or your doctor is concerned that your child has cerebral palsy, he or she will review your medical and family history and perform a physical evaluation. 

In addition to checking for the typical symptoms, the doctor may perform specialised tests to help diagnose the condition. Your doctor will help to distinguish if your child has cerebral palsy or whether he or she is developing normally.

WHAT IS SPASTIC CEREBRAL PALSY?

Cerebral palsy can injure the part of the brain that controls movement and muscle tone. Because the brain cannot control the flexibility of the muscles, they become tense and can experience spasms. This is known as spasticity.

Spastic cerebral palsy can make movement, posture and balance difficult. It may affect your ability to move one or more of your limbs, or to move one side of your body. Sometimes spasticity is so severe that it gets in the way of daily activities, sleep patterns and caregiving. 

However, there are a range of treatment options for people who experience spasticity due to cerebral palsy. These can reduce the impact of spasticity and improve quality of life for some individuals with cerebral palsy.

cerebral palsy

Close to 1million people in Europe have cerebral palsy.4

Over 40%of these people
are living with severe spasticity1-5

    spa-ci

One of the most common symptoms of cerebral palsy is spasticity, which is a movement disorder where muscles become tight, stiff and difficult to control.3

A comparison of 28 cerebral palsy registry studies from 8 geographic regions, reports that 90% of patients with cerebral palsy have a spastic motor disorder.3

One study on functional status (using the definition for motor function suggested by the Surveillance of cerebral palsy in Europe, which may be a proxy for severe spasticity) reports that 42.3% of patients have severe disability caused by the underlying issue.4,5

cerebral palsy is the most common cause of spasticity in children and young adults1,2

Patients with spastic motor disorder
Patients with severe spasticity
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Treating
severe
spasticity
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1

Albright AL. Spasticity and movement disorders in cerebral palsy. J. Child Neurol. 1996;11 Suppl 1(Suppl 1):S1-4.

2

Hutchinson R, Graham HK. Management of spasticity in children. In: Barnes MP, Johnson GR, eds. Upper Motor Neurone Syndrome and Spasticity: Clinical Management and Neurophysiology. 2 ed. Cambridge, UK: Cambridge University Press; 2008:214-239.

3

Reid SM, Carlin JB, Reddihough DS. Distribution of motor types in cerebral palsy: how do registry data compare? Dev. Med. Child Neurol. 2011;53(3):233-238.

4

Surveillance of Cerebral Palsy in Europe. Prevalence and characteristics of children with cerebral palsy in Europe. Dev Med Child Neural. 2002; Sept; 44:633-40.

5

Kirby RS, Wingate MS, Van Naarden Braun Ket al. Prevalence and functioning of children with CP in 4 areas of the US in 2006: a report from the Autism and Developmental Disabilities Monitoring Network. Res in Dev Disabilities. 2011 ;32(2):462-469.

6

Mayo Clinic. Cerebral Palsy. Available at: www.mayoclinic.com. Accessed March 2020.

7

https://www.nhs.uk/conditions/cerebral-palsy/ Accessed March 2020.

8

Patel DR, Neelakantan M, Pandher K, Merrick J. Cerebral palsy in children: a clinical overview. Transl Pediatr 2020;9(Suppl 1):S125-S135