Cerebral palsy

What is cerebral palsy?

Cerebral palsy is a condition that affects your body movements. It’s the result of a brain injury. The injury can happen before, during or after birth. Cerebral palsy doesn’t get worse over time.

The brain damage affects how your body moves. It also can affect the way you stand. This is called your ‘posture’.

Cerebral palsy can show up as floppy or stiff muscles. You may have muscle movements that you can’t control.

Cerebral palsy can affect:

• movement
• coordination
• muscle tone
• posture

People with cerebral palsy sometimes have problems with their sight (eyes) or hearing (ears). They might have trouble speaking clearly, eating and learning.

Sometimes cerebral palsy can affect the whole body. Other times only one part of the body is affected.

The damage to the brain is permanent. There is no cure.

Most people with mild cerebral palsy live for the same length of time as other people.

What are the types of cerebral palsy?

There are 4 main types of cerebral palsy.

• Spastic — in which the muscles are weak and stiff. This makes movements difficult or awkward. One or both arms or legs may be affected. This could affect:
  • all the muscles on one side of your body
  • just your arms
  • just your legs
  • every muscle in your body
• Dyskinetic (athetoid) — when you can’t control your muscles. You might not be able to sit upright. If the muscles of your face and tongue are affected, talking and eating is difficult. This can cause drooling.
• Ataxic — when your movements seem jerky and clumsy. This is due to problems with balance and coordination. It can lead to unsteady walking and difficulty moving quickly. You may also have shaking of the hands that you can’t control.
• Mixed — when you show a range of the above characteristics.

What are the symptoms of cerebral palsy?

Cerebral palsy causes a range of symptoms. The most common ones are:

• being stiff or floppy
• having exaggerated reflexes or jerking movements that are bigger or stronger than expected
• muscle weakness
• lack of muscle coordination
• uncontrolled body movements
• problems with balance and coordination
• problems with swallowing, sucking or eating
• using only one side of the body to reach for things

These symptoms can be mild or severe. They usually appear in a child’s first 2 years of life.

People with cerebral palsy may or may not have other conditions. These conditions can include:

• intellectual disability
• epilepsy
• delayed growth
• spinal deformities
• trouble with seeing, hearing and speaking

What causes cerebral palsy?

Cerebral palsy occurs when there’s damage to the developing brain. The part of the brain that is affected is the area that controls muscle tone (called the motor cortex). The damage happens when the baby is a fetus — it’s still growing in the womb.

An injury to the fetus is can be caused by:

• low oxygen levels
• poor circulation of the baby’s blood
• an infection or trauma
• the baby’s brain simply doesn’t develop properly in the womb

There’s usually no obvious reason why a baby develops cerebral palsy. Some babies have a higher risk of developing cerebral palsy. They are babies who:

• are born prematurely or with small birth weight
• have had an infection in the womb
• have a birth defect
• had a lack of oxygen
• have severe jaundice

There are also some genetic conditions that are linked to cerebral palsy.

Sometimes cerebral palsy can occur after an accident. This might happen because of a near-drowning or other brain injury in early childhood.

Depending on the damage, cerebral palsy affects people in different ways and to different extents.

When should I see my doctor?

Children with cerebral palsy tend to miss developmental milestones. Examples of these milestones are crawling, walking and talking.

You may be worried about cerebral palsy if your child:

• is slow to develop physical skills, such as sitting or standing on their own
• has not started talking at an age when you might expect them to be talking
• has tight or floppy muscles or an unusual posture

If you think your child has symptoms of cerebral palsy, talk to your early childhood nurse or doctor.

How is cerebral palsy diagnosed?

Your doctor will look at your child’s symptoms and do an examination of the child’s body. They will talk to you and your child, and run tests.

Tests might include:

• hearing tests
• vision tests
• blood tests
• imaging — ultrasound, CT scan, or MRI

These tests help to tell the doctor if your child has cerebral palsy. The tests can also show if there is another reason for their signs and symptoms.

They may refer you to a paediatrician, a specialist doctor for children.

It can take time to find out if your baby has cerebral palsy. You might have several doctor visits and tests done.

In mild cases, it may take months or even years. Although this can be very frustrating, the time is needed. It’s important to get the diagnosis right.

How is cerebral palsy managed?

Even though cerebral palsy can’t be cured, a lot can be done to manage the condition. Children can benefit from the services of a team of health professionals to help with:

• mobility
• speaking, seeing and hearing
• eating and drinking
• pain
• learning
• control of bladder (wee) and bowel (poo)
• emotional wellbeing

Physiotherapists and occupational therapists can help with everyday tasks like:

• sitting
• walking
• dressing
• using the toilet

They may suggest casts, splints or orthotics. They can also give the child exercises to help strengthen their muscles. Special equipment such as walking frames, wheelchairs and modified shoes can be arranged.

There are special braces and mechanical aids to help with muscle imbalance and movement. Doctors can also operate to help with other movement issues.

People with cerebral palsy sometimes need extra help in other areas. There are experts who can help with learning, communication and emotional issues.

Medicines may be needed for:

• epilepsy
• pain
• sleep
• eating problems due to the cerebral palsy
• relax stiff or overactive muscles to improve movement

Medicines may be given as tablets or injections. Sometimes medicine pumps are placed in the child’s body to give constant doses of medicine.

For more information on the different treatments for cerebral palsy, visit the Cerebral Palsy Alliance website.

Particular issues for adults

Adults with cerebral palsy who work may need to adapt their working conditions. you may need to arrange:

• flexible hours
• more rest time
• changes to your physical work environment

This can help enable you to work with the same conditions as other workers.

Mobility can be an issue. This can include when moving from one place to another, such as from your bed to sitting up. An assessment of your environment can be done by an occupational therapist.

Sexual function can also be an issue. Find out more about sex and disability.

Can cerebral palsy be prevented?

There is still no way to prevent or cure cerebral palsy. However, the rate of cerebral palsy in Australia is getting lower. This is because there are now medical treatments to reduce the risk or severity of cerebral palsy.

Also, improved safety laws, such as using car seatbelts and pool fencing, have been successful in reducing the number of accidents. In the past these accidents in early childhood could cause brain damage, and cerebral palsy.

Rubella vaccination has also helped lower the number of children born with brain damage.