Cerebral palsy (seh-reh-brul pauls-ee) is a term used to describe a condition where a person has difficulties with making and/or controlling their body movements. This difficulty is the result of damage to the brain areas that control movements. This damage occurs early in life,
including before birth. Cerebral palsy is often called 'CP' for short.
CP is the most common physical disability in childhood and occurs in one in 500 births.
The type of movement difficulty that children with CP experience can vary greatly. The movement difficulties can include problems with stiff muscles, involuntary movements (extra movements that the person did not intend to make), weakness, reduced coordination, balance and tremors
(shaking movements).
These movement difficulties may affect the whole body in some children, but only some parts of the body (e.g. one or two limbs) in others. In more severe cases, the movements that produce speech and swallowing movements are often affected.
The severity of the condition can range from children only experiencing limitation in challenging physical activities (e.g. sports), while other children may have significant challenges performing any voluntary movement (e.g. walking).
Signs and symptoms of cerebral palsy
The first sign of CP in an infant or child may be a difference or delay in the expected development of movement skills. This is often noticed as a difference in movement between the right and left sides of the body, or being slow to reach the milestones of sitting up, standing and
walking independently.
In some cases, the movement problems are found because the child is being monitored by health professionals due to being in a risk group for CP (such as children born prematurely).
When to see a doctor
If you have concerns about your child's movement or gross/fine motor development, see your GP. They may refer you to a paediatrician, paediatric neurologist or physiotherapist.
Different types of cerebral palsy
CP is classified according to severity, the type of movement difficulty, and how much of the body is affected.
Severity
This refers to how much movement difficulty the child has. A physiotherapist or paediatrician will grade the severity of your child’s CP according to the Gross Motor Function Classification System (GMFCS).
The type of movement difficulty
There are three main types of movement difficulty:
- Spastic: the most common type, where the muscles are stiff and difficult to stretch.
- Dyskinetic (also called either dystonic or choreoathetoid): where there are uncontrolled, involuntary movements.
- Ataxic: where there is poor coordination of movement, unsteadiness and shakiness.
Some children have only one type of movement problem and others have a mix of these movement problems.
How much of the body is affected
The terms commonly used to describe how much of the body is affected in someone with CP are:
- unilateral: one side of the body
- bilateral: both sides of the body.
Sometimes, older terms that describe the number of limbs affected are also still used to classify the type of CP. These include such as monoplegia (one limb), hemiplegia (one arm and one leg on the same side of the body), diplegia (both legs), quadriplegia (all four limbs affected).
What causes cerebral palsy?
CP is caused by damage to the brain or a difference in development affecting the areas of the brain that control movement. This damage or development difference can occur before birth, around the time of birth or in infancy.
There are several possible causes of the brain problem that results in CP and it is important that the cause of each person’s condition is investigated. Often an MRI scan of the brain is the first test that is performed to investigate possible CP.
There are many possible causes of CP. Some of the more common causes are:
- premature birth, which is a risk factor as some of the brain’s movement control areas are vulnerable to damage in the early weeks of life in a premature baby
- stroke in childhood
- certain infections during pregnancy or during infancy
- a difference in how the brain formed during its growth before birth, which in some cases may be due to a genetic condition.
A lack of oxygen during the birth process can cause CP, but research has shown that this is a less common cause than was previously thought. Lack of oxygen is now believed to cause less than one in 10 cases of CP.
Complications associated with cerebral palsy
In some children with CP, movement problems are the only difficulty. In other children however, additional areas of the brain are also damaged, which can cause other brain-related conditions. For example, some children with CP also have intellectual disability, epilepsy, or problems with
hearing and/or vision.
Children with CP can also have problems with feeding, swallowing and saliva control. Medical problems such as gastro-oesophageal reflux, constipation and repeated chest infections occur more frequently in children with CP, particularly if the CP is severe.
Treatment for cerebral palsy
Currently there is no cure for CP. Care for children with CP is aimed at ensuring a good quality of life by:
- maximising independence in activities of daily living
- preventing additional problems with body structure (e.g. curvature of the spine due to prolonged wheelchair use)
- maximising participation in family, school and community life
- managing any pain or other medical conditions that your child may have.
Your child may be cared for by a team of professionals, including doctors, physiotherapists, occupational therapists, speech therapists, psychologists, social workers and specialised educators. This management begins as soon as your child is diagnosed.
Key points to remember
- Cerebral palsy (CP) describes a condition where a person has difficulties with making and/or controlling their body movements.
- The type of movement difficulty that children with CP experience and the severity of the condition can vary greatly.
- CP is caused by damage to the brain or a difference in development affecting the areas of the brain that control movement.
- Your child may be cared for by a team that involves doctors, therapists, social workers, educators and family members.
For more information
Common questions our doctors are asked
Is CP a genetic disease?
In a few cases, cerebral palsy results from a genetic condition, but in most cases, there are other causes. It is important for doctors to identify the cause of CP, and if it is genetic they can discuss with you whether any further pregnancies you are planning may be affected. When the
time comes, your child can also seek medical advice about the likelihood of any of their future pregnancies being affected.
Does CP get better or worse over time?
Cerebral palsy affects children throughout their lifetime. It is not a progressive condition, in that the underlying movement control problem does not get worse. However, in many cases problems develop over time with the body's structure, such as with the muscles or bones. These problems
can include muscle contractures (shortenings), hip dysplasia (poor growth of the hip joints), bony torsions (bones growing in a shape that makes movements more difficult) and scoliosis (curvature of the spine).
What kind of support can I access for my child?
Support is available from different professionals and through many organisations that focus on different aspects of the child’s and parents' needs. Some children are eligible for support through the NDIS (National Disability Insurance Scheme). A healthcare professional (such as your
GP, paediatrician or a therapist) familiar with the services available can help guide you with seeking support for your child.
Cerebral Palsy – an information guide for parents and families provides more information about support.
How will having CP affect my child's life expectancy?
The life expectancy of a person with cerebral palsy varies, depending on the severity of the condition and whether the person has medical problems (such as frequent chest infections). In people with mild cerebral palsy and with no additional medical problems, life expectancy is similar to
the typical population.
Developed by The Royal Children's Hospital Neurodevelopment and Disability department. We acknowledge the input of RCH consumers and carers.
Reviewed September 2018.
This information is awaiting routine review. Please always seek the most recent advice from a registered and practising clinician.
Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit
www.rchfoundation.org.au.