Cerebral Palsy

What is cerebral palsy (CP)?

From: MedlinePlus, National Library of Medicine

Cerebral palsy (CP) is a group of neurologic disorders that cause problems with movement, balance, and posture. The first part of the name, cerebral, means having to do with the brain. The second part, palsy, means weakness or problems with using the muscles.

CP can range from mild to severe. The brain damage and the disabilities it causes are permanent. But treatments can improve the lives of people who have the condition. For example, treatments can help to improve their motor skills and ability to communicate.

What are the types of cerebral palsy (CP)?

From: MedlinePlus, National Library of Medicine

There are different types of CP:

• Spastic cerebral palsy, which is the most common type. It causes increased muscle tone, stiff muscles, and awkward movements. Sometimes it only affects one part of the body. In other cases, it can affect both arms and legs, the trunk, and the face.
• Dyskinetic cerebral palsy, which causes problems controlling the movement of the hands, arms, feet, and legs. This can make it hard to sit and walk.
• Ataxic cerebral palsy, which causes problems with balance and coordination.
• Mixed cerebral palsy, which means that you have symptoms of more than one type.

What causes cerebral palsy (CP)?

From: MedlinePlus, National Library of Medicine

CP is caused by abnormal development or damage to the developing brain. When this development or damage happens before birth, it is called congenital CP. Most CP is congenital, and its causes may include:

CP can also happen during or after birth. CP that happens more than 28 days after birth is called acquired CP. Its causes can include:

In some cases, the cause of congenital or acquired CP is unknown.

• Gene changes (variants)
• Brain malformations
• Infections or fevers in the pregnant parent
• An injury to the developing baby
• Brain damage in the first few months or years of life
• Infections, such as meningitis or encephalitis
• Problems with blood flow to the brain, for example from a stroke or abnormal blood vessels
• Head injuries, for example from a car accident, a fall, or child abuse

Who is more likely to develop cerebral palsy (CP)?

From: MedlinePlus, National Library of Medicine

Certain medical conditions or events that can happen during pregnancy and delivery may increase a baby's risk of congenital cerebral palsy. These may include:

• Being born too small
• Being born too early
• Being born a twin or other multiple birth
• Being conceived by in vitro fertilization (IVF) or other assisted reproductive technology (ART)
• Infections
• Health problems in the pregnant parent, such as thyroid problems and seizures
• Severe newborn jaundice
• Having complications during birth
• Rh incompatibility
• Exposure to toxic chemicals during pregnancy

What are the signs of cerebral palsy (CP)?

From: MedlinePlus, National Library of Medicine

There are many different types and levels of disability with CP. So the signs can be different in each child. These signs usually appear in the early months of life. They may include:

• Developmental delays. Your child may be slow to reach developmental milestones such as learning to roll over, sit, crawl, or walk.
• Abnormal muscle tone. Your child may seem floppy, or they may be stiff or rigid.
• An unusual posture or favoring one side of the body when reaching, crawling, or moving.
• Stiff or tight muscles and exaggerated reflexes (spasticity).
• Shaking (tremor) of arms, legs, hands, or feet.
• Sudden, uncontrolled movements.

It's important to know that children without CP can also have these signs. Contact your child's health care provider if your child has any of these signs, so you can get a correct diagnosis.

How is cerebral palsy (CP) diagnosed?

From: MedlinePlus, National Library of Medicine

Diagnosing CP involves several steps:

• Developmental monitoring (or surveillance) means tracking a child's growth and development over time. If there are any concerns about your child's development, they should have a developmental screening test as soon as possible.
• Developmental screening involves giving your child a short test to check for motor, movement, or other developmental delays. If the screenings are not normal, the provider will recommend more evaluations.
• Developmental and medical evaluations are done to diagnose which disorder your child has. To make the diagnosis, your provider: Will check your child's motor skills, muscle tone, reflexes, and posture Will ask about their medical history May order lab tests, genetic tests, and/or imaging tests

What are the treatments for cerebral palsy (CP)?

From: MedlinePlus, National Library of Medicine

There is no cure for CP, but treatment can improve the lives of those who have it. It is important to begin a treatment program as early as possible.

A team of health professionals will work with you and your child to develop a treatment plan. Common treatments include:

• Medicines
• Surgery
• Assistive devices such as braces and walkers
• Physical, occupational, recreational, and speech therapy

Can cerebral palsy (CP) be prevented?

From: MedlinePlus, National Library of Medicine

You cannot prevent the genetic problems that can cause CP. But it may be possible to manage or avoid some of the risk factors for CP. For example:

• If you are pregnant, make sure that you are vaccinated against infections that could cause CP in your developing baby.
• Get regular prenatal care, which can reduce the risk of preterm birth or having a low birthweight baby. It can also help you manage any health conditions that could raise the risk of CP.
• Use car seats for your baby to prevent head injuries that could cause CP.

Which doctor should you see?

The suggested department for discussing Cerebral Palsy is Neurology, with a neurologist as the relevant type of clinician. General physician / Family Medicine; paediatrician for children. Referral depends on symptoms.

This is an editorial referral starting point. The appropriate clinic depends on the person’s age, symptoms, previous diagnosis and local services. The first clinician can decide whether another specialty or a team is needed; a department label does not confirm the diagnosis.

How to prepare for an assessment

Bring a short timeline of the main symptoms: when they first appeared, whether they are constant or episodic, what seems to change them, and how they affect daily activities. Include previous reports, discharge summaries, current medicines and supplements, allergies, and any relevant family history. A dated record is more useful than trying to match every feature in an online article.

Ask the clinician what is already established and what remains uncertain. If a test is suggested, ask what question it answers, what its limitations are and how the result would change the next step. The information here is not an instruction to arrange every possible test. In children, bring growth, developmental and school information if it is relevant to the concern.

• Which nervous-system findings help explain the symptoms?
• Would an assessment of walking, communication or daily function be helpful?
• Are rehabilitation or other specialist services relevant?

Treatment discussions and follow-up

Where the source describes treatments, these are an overview of possible care, not a prescription for an individual. Ask which option applies to the confirmed diagnosis, what benefit is expected, what adverse effects to watch for and how progress will be assessed. Availability, approvals and local practice can differ from the country described in the source.

Before leaving the appointment, clarify the next review date, who will communicate results, and whom to contact if the situation changes. Discuss difficulties with sleep, work, school, mobility, eating or emotional wellbeing when these are relevant. Practical support may require coordination between the treating clinician and other services.

When to seek emergency help

Severe breathing difficulty, collapse, new stroke-like symptoms, a seizure that is prolonged or repeated without recovery, uncontrolled major bleeding, or an immediate risk of self-harm require emergency help. In India, call 112 or reach the nearest emergency department. This is a general, non-exhaustive warning list; it is not a condition-specific triage tool.