Cerebral palsy Dr Trisha Macnair Dr Rob Hicks Cerebral palsy isn't a particular disease or illness. The term means a physical condition that affects movement as a result of an injury to the brain. Every person with cerebral palsy is affected in a different way.

In this article

What is it? What are the symptoms?

What causes it? What's the treatment?

There are several different types of cerebral palsy. While some people are severely affected, others have only minor disruption, depending on which parts of the brain have been damaged.

The main types of cerebral palsy are:

• Spastic cerebral palsy - some of the muscles in the body are tight, stiff and weak, making control of movement difficult
• Athetoid (dyskinetic) cerebral palsy - control of muscles is disrupted by spontaneous and unwanted movements. Control of posture is also disrupted
• Ataxic cerebral palsy - problems include difficulty with balance, shaky movements of hands or feet, and difficulty with speech
• Mixed cerebral palsy - a combination of two or more of the above

The symptoms of CP may take some months to become apparent and depend on the type.

There may be abnormal tone (stiffness or floppiness) of the limbs and odd postures.

In spastic cerebral palsy (70 per cent of cases), the limbs become stiff and may be drawn in. In athetoid cerebral palsy (10 per cent of cases), the child develops involuntary irregular writhing movements.

There may be incoordination of the muscles of the mouth, causing feeding problems such as slow feeding, gagging and vomiting, delayed motor milestones, such as crawling and walking, weakness or paralysis of the limbs, an abnormal gait and slowness in developing speech and social skills.

As many as one in three children and adolescents with cerebral palsy also has epilepsy.

Other common problems include:

• Difficulty with walking, writing, eating, talking, dressing
• Problems with balance and coordination
• Difficulty controlling and maintaining posture (they may need help to sit upright)
• Visual difficulties
• Hearing problems

A common misconception is that people with cerebral palsy inevitably have learning difficulties. This may have arisen because people with the condition can have problems controlling their facial movements and speech, and it can be difficult to understand them at first. Some people with cerebral palsy do indeed have moderate or even severe learning difficulties, but just as in the rest of the population, there's a range of intelligence.

It's easiest to think of cerebral palsy as a condition in which part of the brain hasn't developed properly. This might be because of a variery of events occurring before, during or after birth.

Most people think of cerebral palsy as a condition caused by problems during labour and birth. However, it's now generally accepted that complications at this time are an important factor in a only minority of cases, around one in ten.

The most common cause of cerebral palsy is something that damages the brain while the baby is growing in the womb. These antenatal factors can be found in 80 per cent of those affected and include genetic problems, malformations of the brain and maternal infection (rubella, toxoplasmosis).

Better maternity care has meant fewer babies are born with cerebral palsy due to birth trauma, but this has been offset by the improved survival of premature and low birthweight babies, who may be up to 50 times more at risk of cerebral palsy.

Infections when a baby is young (especially encephalitis or meningitis) can also lead to cerebral palsy.

In a number of cases, it's difficult to pin down the exact cause with any certainty.

There's no cure for cerebral palsy. However, there are plenty of treatments and therapies that can reduce the impact of the condition by easing symptoms such as spasticity, improving communication skills and finding other ways to do things.

Physiotherapy, occupational therapy and speech therapy can all play an important part. Find out more from Scope, a charity that focuses on cerebral palsy.

Children with cerebral palsy do best when they get special help from an early age. Because the brain changes a lot during the first few years of life, it can be difficult to assess the extent of cerebral palsy at first, but most experts suggest babies should be first assessed at about nine to 12 months.

Many children with cerebral palsy benefit from an approach known as conductive education, which helps them to overcome movement problems and gain some control through special education and rehabilitation. Adults can get a lot from it, too.

Speech and language therapy helps with speech development and also with eating, drinking, and swallowing.

Surgery is sometimes needed to correct any deformities that develop as a result of abnormal muscle development or function.

Medication can reduce muscle hyperactivity and spasticity, but physiotherapy is the bedrock of cerebral palsy management and can helps with posture and movement. It also tries to prevent progression of disability.

Occupational therapy helps children overcome difficulties performing everyday tasks, encouraging them to lead independent lives.

With help, most people with cerebral palsy are able to live much the same sort of lives as everyone else. They may have to work a bit harder to overcome practical problems, but most things are possible.

This article was last medically reviewed by Dr Trisha Macnair in April 2009.