What is Cerebral Palsy?
Cerebral palsy (CP) describes a group of disorders that affect a child’s ability to move and maintain balance and posture. Cerebral palsy is caused by brain injury or atypical brain development that happens around the time of birth or early in life. One in 320 children in the United States has cerebral palsy, making it the most common motor disability in childhood.
In some cases, symptoms of cerebral palsy in infants are evident soon after birth. In others, the diagnosis comes in later infancy or toddlerhood. Cerebral palsy is a permanent condition, meaning the injury to the brain doesn’t change; rather, the effects of cerebral palsy often progress, as people get older.
The disability in cerebral palsy can be mild, moderate, or severe. Some children can walk by themselves. Others need help from braces, crutches, walkers, or wheelchairs.
Developing fetuses and infants up to age 1 can develop cerebral palsy if they experience brain injury or disruptions in brain development caused by:
- Bleeding in the brain before, during, or after birth.
- Infections of the brain, including meningitis or encephalitis.
- Shock—a state in which organs and tissues don’t receive adequate blood flow.
- Traumatic brain injuries.
- Seizures at birth or in the first month following birth.
- Certain genetic conditions.
In some cases, healthcare providers are unable to determine the precise cause of a child’s cerebral palsy.
Older children can develop symptoms that present similar to those of cerebral palsy if they sustain traumatic brain injuries, experience a lack of oxygen, or contract an infection such as meningitis. Children whose injuries occur when they are older receive a diagnosis of brain injury rather than cerebral palsy.
Symptoms of Cerebral Palsy
Children with cerebral palsy may be slow to meet developmental targets such as rolling over, sitting up, crawling, and walking. Cerebral palsy may also affect body systems other than motor skills.
For example:
- Seizures.
- Vision or hearing difficulties.
- Problems with teeth or swallowing.
- Constipation.
- Curvature of the spine (scoliosis).
- Joint stiffness or hip dislocations.
- Developmental delays, including learning disabilities or speech problems.
Keep in mind that having CP doesn’t mean your child will have cognitive impairment. Only 30 to 50 percent of children who have cerebral palsy have some level of cognitive impairment, ranging from mild to severe.
Your doctors will look at your child’s muscle tone and reflexes, and check the range of motion of the joints. They will also watch to see what your child can do, such as sitting, crawling, and using their hands. Watching your child walk is also an important part of the evaluation. Many times, no other tests are needed to evaluate for cerebral palsy. Your doctor may request help with the evaluation and diagnosis from a pediatric neurologist (a doctor who specializes in children’s brains and nerves).
Treatments for Cerebral Palsy
Before the age of three, treatment for cerebral palsy involves helping the child to reach milestones such as walking. Early intervention programs offer physical therapy (PT), occupational therapy (OT), and speech therapy (ST). As the child reaches school age, treatment for cerebral palsy becomes centered on maintaining function. For example, PT helps keep the joints moving and improves strength, while braces and assistive devices (crutches, walkers or wheelchairs) help the child join in with classmates. When your child is older, treatment options may include surgery.
Treating Cerebral Palsy with Braces
Braces can help keep your child’s feet flat on the ground. This can help the child to feel more stable and can help prevent foot problems. Braces also can help keep the muscles stretched out, which sometimes may help avoid the need for surgery.
Treating Cerebral Palsy with Medications
We have four offices in northern NJ — in Cedar Knolls, Springfield, Jersey City, and Wayne — staffed with eight pediatric orthopedists and a pediatric foot and ankle specialist. From hip disorders to spinal and limb deformities to the many sports injuries student-athletes suffer, we’re here to treat your child with award-winning care. Call or fill out the form for an appointment on our website.
Operative Treatments for Cerebral Palsy
Operative treatments can be another option. Keep in mind that cerebral palsy is a term that includes many kinds of patients with different problems. Every child with cerebral palsy is different and it is difficult to guess if your child will need surgery. This is rarely performed before 6 years of age. When appropriate, most pediatric orthopedic surgeons agree that an ideal time to perform surgery is between 7 and 12 years old. Procedures can include tendon lengthening, moving tendons from one muscle to another, or cutting the bone to re-align it. Some patients benefit from a pump that delivers medicine to the fluid around the spine. This medicine, known as baclofen, relaxes muscles. Cutting selective nerves in the lower spinal cord may also help to relax the muscles. This is known as a dorsal rhizotomy.
Your child—and your child’s cerebral palsy — is unique, so you will need to discuss your child with your doctors. There are still some common, expected facts about your child’s growth and development. Most children with cerebral palsy will have delayed milestones — walking later than other children, for example — but will continue to show improvement until about 6 years of age. Your child’s function may remain the same in the early school years. When your child enters the teenage years and starts to grow taller and heavier, the muscles may have a harder time functioning due to the increased forces required. Because of this, your child may seem to have worse function.
Every child who has cerebral palsy is affected differently and has a unique combination of strengths and challenges. No one can predict where your child will fall within this diagnosis, but most people who have cerebral palsy live long, fulfilling, and active lives. Early intervention and appropriate treatment can help your child improve their abilities and ease cerebral palsy symptoms.
The Pediatric Orthopedic Center is the premier NJ hub for pediatric orthopedics, with four offices throughout northern NJ. Having been the leader in pediatric orthopedics in this area for over 25 years, we are the largest and most award-winning pediatric orthopedic practice in the tri-state area.
