Cerebral Palsy

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 Dr. Krupa Torne due to being in a risk group for CP (such as children born prematurely).

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. Dr. Krupa Torne 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.

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.
  • 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.

Treatment for cerebral palsy

  • Only 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.