Cerebral palsy

What is cerebral palsy?

Cerebral palsy (CP) is a term used to describe disorders that affect a child's movements and posture. CP is the result of a brain injury suffered in utero, while a baby is developing in the womb. Premature babies, especially those born before 28 weeks, are at a higher risk of being diagnosed with this disorder. CP can also result from an injury in a near drowning or car accident.

In general, CP does not get worse over time. There is no cure for the condition. Therapy can help your child.

As many as five in 1,000 babies born in North America have CP.

Signs and symptoms of cerebral palsy

Poor gross or fine motor (movement) skills are the most common signs that your child may have CP. If your child is not rolling, sitting or walking by the expected time, it may be a sign that they have CP. Other signs may include:

• floppy or stiff muscles
• unusual muscle movements
• seizures

The symptoms of CP may be more or less severe, depending on the type of CP and the area of the brain that has been injured.

Some children with CP have normal intellect. Other children have severe brain damage or poor hearing and vision. Any of these conditions can make it harder for the child to communicate.

Different types of CP cause different symptoms:

Spastic

This is the most common form of CP. Symptoms include:

• tight muscles and exaggerated reflexes
• difficulty moving
• a few muscles or the whole body may be affected

Athetoid

This type of CP is marked by involuntary movements. Other symptoms include:

• squirming
• looking as if the child is constantly moving

Atonic

The atonic child is weak, floppy and lacks normal muscle tone. Symptoms of this type of CP include:

• poor balance
• poor depth perception
• an unsteady walk
• poor coordination

Mixed

This type of CP occurs when the child has a combination of spastic, athetoid or atonic CP symptoms.

CP can affect different parts of the body. There are terms to describe the part of the body affected:

• monoplegia: one arm or one leg is affected
• hemiplegia: the arm and leg on the same side are affected
• paraplegia: only the legs are affected
• diplegia: paralysis of similar parts on both sides of the body
• quadriplegia: both arms and both legs are affected

Causes of cerebral palsy

CP is caused by an injury to the brain during pregnancy, delivery or following birth. It can also occur later in childhood. There are many causes of CP. Some causes include:

Before birth and during delivery

• abnormal development of the brain
• infections
• genetic problems
• complications of prematurity
• decreased oxygen to the brain

After birth

• severe jaundice
• meningitis
• head injury

What a doctor can do to help your child

Some babies with CP will show signs at birth. In other cases, it may be hard to make a diagnosis. Usually, CP is determined by age one or two years.

If you are concerned about your child, tell your child's doctor. The doctor will do a physical examination and ask you about your child's medical history.

A diagnosis can take months. There is not one single test that will determine the presence of CP. Some tests may be ordered, including:

• a CT scan or an MRI to look for abnormalities in your child's brain
• an EEG to look for evidence of seizures
• hearing and vision tests
• blood tests

Treatment of cerebral palsy

Your child's doctor will determine the best line of treatment for your child. Treatment will depend on the severity of the condition.

• Physical therapy will likely be a big part of the treatment program. Physical therapy will work on muscle strength, flexibility, balance and mobility.
• Occupational therapy will work on hand and hand-eye coordination. The therapist may also help your child with equipment like wheelchairs, braces or talking devices.
• Speech therapy can help your child to communicate better.
• Some children need medicine to improve motor control and reduce spasticity.

What you can do to help your child with cerebral palsy

Seek support

As a parent of a child with CP, you may be overwhelmed by emotion. Feelings like fear of the future or guilt are common. There is help out there. Support groups, friends, family, therapists, places of faith or community centers can serve to strengthen your abilities as a parent. Ask your doctor for resources.

Encourage your child to be social

It can be difficult for children to cope with having CP. Encourage your child to express their feelings and help them work through them. Encourage your child to join in group activities with other children their age. Such interaction will help your child reach their fullest potential.

​Virtual care services for children

Boomerang Health was opened by SickKids to provide communities in Ontario with greater access to community-based services for children and adolescents. For more information on virtual care services in Ontario to support cerebral palsy, visit Boomerang Health powered by SickKids.