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What is Cerebral Palsy?

Justin Morgan, MD, FAAP, Board Certified Pediatrician
January 3, 2019 . 15 min read

What is Cerebral palsy?

Cerebral palsy (CP) is a disorder affecting a person’s ability to move and maintain balance and posture. Cerebral refers to the brain, and palsy refers to a weakness or problem using the muscles. CP is caused by damage to the brain’s outer layer (called the cerebral cortex) before, during, or after birth. Depending on which areas of the brain are affected, one or more of the following movement disorders can occur:

Stiff muscles (spasticity)

Uncontrollable movements (dyskinesia)

Poor balance and coordination (ataxia)

Three other common descriptions of CP, based on which limbs are affected, include the following:

Hemiplegic: one side (often an upper extremity) is more affected than the other.

Diplegic: lower extremities are affected more than upper extremities.

Quadriplegic: upper and lower extremities are affected to the same degree.

The incidence of CP is approximately 1.5-4 per 1,000 live births. Ten thousand babies born in the United States develop CP each year. About 1 in 323 children has the disorder.

How is CP diagnosed? 

CP is usually diagnosed by a pediatrician, neurologist, or a developmental specialist after an infant or toddler fails to meet developmental milestones over the first two years of life. The diagnosis is based on a careful history and physical examination, not on laboratory or other diagnostic tests. Genetic diseases, brain malformations, infections, and anoxic injury (severe lack of oxygen to the brain) are a few of the many causes of CP. Finding the cause of a child’s CP can greatly influence treatment options, prognosis, and ongoing medical management of associated conditions.

CP ranges in severity from isolated, mild spasticity of the legs alone to four-limb involvement (quadriplegia) associated with intellectual disability, epilepsy (seizures), and complete reliance on others for activities of daily living. Associated conditions with CP include epilepsy, mental retardation, speech and language disorders, and vision and hearing impairments.

For those affected by CP, a pediatrician should be able to help identify and access interventions that are most likely to optimize the health and well-being of the patient. Children with CP typically receive care from multiple medical providers including a neurologist, orthopedist, and physical, occupational, and speech-language therapist. The pediatrician is usually the team leader of the treatment team, helping the family by providing insight and care coordination. Children with CP usually receive services through Early Intervention (i.e. First Steps) and school-based programs.

Sources:

  • Ashwal S, Russman BS, Blasco PA et al
  • (2004)
  • “Practice Parameter: Diagnostic assessment of the child with cerebral palsy: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society”
  • Neurology
  • 62 (6): 851–63.
    Centers for Disease Control and Prevention
  • Cerebral Palsy.
    Liptak GS, Murphy NA; Council on Children with Disabilities (2011)
  • “Providing a Primary Care Medical Home for Children and Youth With Cerebral Palsy.” Pediatrics
  • 128: e1321.
    “Cerebral Palsy: Hope Through Research”
  • National Institute of Neurological Disorders and Stroke (U.S.)
  • NIH Publication No
  • 06-159
  • July 2006.

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