• About
• Fact sheets
• Medicines
• Find a family doctor
• Resources
• Contact us
• Mailing list
• Contribute

Cerebral Palsy - an overview

Cerebral palsy is a disorder of muscle control. It is caused by damage to, or lack of development in a part of the brain that controls movement. Cerebral palsy is the most common physical disability in childhood occurring in one in every 500 live born babies. Cerebral palsy is often called 'CP' for short.

Cerebral palsy causes problems with motor control and co-ordination, for example weakness, stiffness, awkwardness, slowness, shakiness and difficulties with balance.

A child with cerebral palsy may have slight clumsiness in one arm or leg (monoplegia), one side of the body may be affected (hemiplegia), there may be involvement of predominantly the lower limbs (diplegia), or involvement of both arms and legs and the trunk (quadriplegia).

Other difficulties can include problems with speech, hearing or vision, epilepsy, intellectual or learning difficulties, perceptual difficulties such as judging the size and shape of objects, gastro-oesophageal reflux (heartburn), orthopaedic problems (with bones), constipation, feeding difficulties, saliva control problems or repeated chest infections.

There is a wide range of intellectual ability in children with cerebral palsy. Children with a very severe physical disability can have completely normal intelligence.

Types of cerebral palsy

• Spastic cerebral palsy is the most common type. Spasticity means stiff or tight muscles. The muscles are stiff because the messages to the muscles are relayed incorrectly from the damaged parts of the brain.

• Athetoid cerebral palsy is characterised by uncontrolled movements. This lack of control is often most obvious when the child starts to move - for example, when the child tries to grasp a toy or a spoon. Also, children with athetoid cerebral palsy often have very weak muscles or feel floppy when carried.

• Ataxic cerebral palsy (or ataxia) is the least common type. Children with ataxia have unsteady shaky movements or tremor and problems with balance.

• Some children also have dystonia. This means that they have involuntary muscle contractions (which they cannot control) causing abnormal movements and/or postures.

• Many children do not have just one type of cerebral palsy, but a mixture of several of these movement patterns.

Causes of cerebral palsy

There are many different causes. A problem with the brain can occur:

• If the brain does not form or grow properly during pregnancy.

• During labour - for example, if the baby does not receive enough oxygen.

• In the first few days or weeks of life - for example, when an infant develops a severe infection, such as meningitis or there is a bleed into part of the brain.

• In children having accidents in the first five years of life, which cause permanent brain injury.

• Children born extremely prematurely are particularly at risk.

In some children, despite a careful review and various tests, the cause of cerebral palsy remains unknown. With new technologies such as MRI brain scans and sophisticated blood tests, more causes are slowly being identified.

Management of cerebral palsy

Management of cerebral palsy is focused on the problems of muscle control and movement, and treatment of the additional health issues. Encouragement and education of families is the most important aspect of care.

• Physiotherapy and occupational therapy to encourage motor development.
  
  
• Orthoses also known as braces to support the lower limbs.
  
  
• Upper limb splints to help grasp small objects.
  
  
• Plaster casts: sometimes called inhibitary casts to help with positioning.
  
  
• Botulinum toxin A (Botox): to relax tight muscles. Given by injection, requiring light anaesthesia.
  
  
• Oral medications including Diazepam and Baclofen.
  
  
• Intrathecal Baclofen: medication is given into the space around the spinal cord.
  
  
• Orthopaedic surgery: such as soft tissue surgery for the hip, or hamstring surgery for the knee.
  
  
• Plastic surgery: tendon transfers and releases to improve arm use.
  

You'll find much more detailed information in 'Cerebral Palsy - an information guide for parents' published by the RCH CPBooklet.pdf (40 pages).

Key points to remember

• Early intervention is the key to the best outcome for children with cerebral palsy.
  
• Access to services including therapy and integration assistance are essential to optimise the child's progress in all areas of development.
  
• Management requires a team approach with the parents, therapists, doctors, nurses and teachers all contributing to ensure optimal progress is made.

For more information

• www.rch.org.au/devmed  
  Royal Children's Hospital Department of Developmental Medicine.
• www.acd.org.au / tel (03) 9818 2000  or 1800 654 013 (rural callers)
  Association for Children with a Disability - information, support and advocacy for families of children with a disability.  It is designed to meet international standards for disability access to the Internet.
• www.scopevic.org.au/
  Scope is a not-for-profit organisation providing disability services throughout Victoria to children and adults with physical and multiple disabilities.
• CP Australia
  CP Australia works towards enhancing the lives of people with cerebral palsy and other similar disabilities by providing a national focus and leadership.
• http://www.yooralla.com.au/
  Yooralla is a community service helping Victorian children and adults who are born with or who have acquired disabilities.
• CP Register.pdf
  is one of the largest single cerebral palsy registers contributing to what is known about cerebral palsy worldwide.