What is Cerebral Palsy?

Cerebral palsy is a term used to describe a group of chronic disorders impairing control of movement that appear in the first few years of life and generally do not worsen over time. The disorders are caused by faulty development of or damage to motor areas in the brain that disrupts the brain's ability to control movement and posture. This damage can occur when there is trauma to the infant's head during the birth process.

Symptoms of cerebral palsy include difficulty with fine motor tasks (such as writing or using scissors), difficulty maintaining balance or walking, involuntary movements. The symptoms differ from person to person and may change over time. Some people with cerebral palsy are also affected by other medical disorders, including seizures or mental impairment, but cerebral palsy does not always cause profound handicap. Early signs of cerebral palsy usually appear before 3 years of age. Infants with cerebral palsy are frequently slow to reach developmental milestones such as learning to roll over, sit, crawl, smile, or walk. Cerebral palsy may be congenital or acquired after birth. Several of the causes of cerebral palsy that have been identified through research are preventable or treatable: head injury during labor or delivery, jaundice, Rh incompatibility, and rubella (German measles). Doctors diagnose cerebral palsy by testing motor skills and reflexes, looking into medical history, and employing a variety of specialized tests. Although its symptoms may change over time, cerebral palsy by definition is not progressive, so if a patient shows increased impairment, the problem may be something other than cerebral palsy.

Is there any treatment?

There is no standard therapy that works for all patients. Drugs can be used to control seizures and muscle spasms, special braces can compensate for muscle imbalance. Surgery, mechanical aids to help overcome impairments, counseling for emotional and psychological needs, and physical, occupational, speech, and behavioral therapy may be employed.

What is the prognosis?

At this time, cerebral palsy cannot be cured, but due to medical research, many patients can enjoy near-normal lives if their neurological problems are properly managed.

What research is being done?

Research suggests that cerebral palsy results from incorrect cell development early in pregnancy. For example, a group of researchers has recently observed that more than one-third of children with cerebral palsy also have missing enamel on certain teeth. Scientists are also examining other eventsÑsuch as bleeding in the brain, seizures, and breathing and circulation problemsÑthat threaten the brain of a newborn baby. Some investigators are conducting studies to learn whether certain drugs can help prevent neonatal stroke, and other investigators are examining the causes of low birth-weight. Other scientists are exploring how brain insults (like brain damage from a shortage of oxygen or blood flow, bleeding in the brain, and seizures) can cause the abnormal release of brain chemicals and trigger brain disease.

Select this link to view a list of all studies currently seeking patients.

Newborns at Risk for Cerebral Palsy - Many children with cerebral palsy have a congenital malformation of the brain, meaning that the malformation existed at birth and was not caused by factors occurring during the birthing process. Prematurity and a low birth weight have been shown to be related to an increased incidence of specific disorders. Premature infants are at a much higher risk for developing cerebral palsy than full-term babies, and the risk increases as the birth weight decreases. Between 5 and 8 percent of infants weighing less than 1500 grams (3 pounds) at birth develop cerebral palsy, and infants weighing less than 1500 grams are 25 times more likely to develop cerebral palsy than infants who are born at full term weighing more than 2500 grams.

Many premature infants suffer bleeding within the brain, called intraventricular hemorrhages, intracranial hemorrhages. Again, the highest frequency of hemorrhages is found in the babies with the lowest weight: the problem is rare in babies who weigh more than 2000 grams (4 pounds). This bleeding may damage the part of the brain that controls

CEREBRAL PALSY FROM THE BIRTHING PROCESS

The birthing process can be traumatic for the newborn, and injuries occurring during birth can cause cerebral palsy. Newborns who suffer severe asphyxia or blunt trauma during birth have a far greater risk (about 250 times) of developing cerebral palsy.

THE DIFFERENT TYPES OF CEREBRAL PALSY

Cerebral palsy may be classified by the type of movement problem (such as spastic or athetoid cerebral palsy) or by the body parts involved (hemiplegia, diplegia, and quadriplegia). Spasticity refers to the inability of a muscle to relax, while athetosis refers to an inability to control the movement of a muscle. Infants who at first are hypotonic wherein their limbs are very floppy may later develop spasticity. Hemiplegia is cerebral palsy that involves one arm and one leg on the same side of the body, whereas with diplegia the primary involvement is both legs. Quadriplegia refers to a pattern involving all four extremities as well as trunk and neck muscles. Another frequently used classification is ataxia, which refers to balance and coordination problems. Most professionals who care for children with cerebral palsy understand these diagnoses and use them to communicate about a child's condition.

PROGNOSIS FOR THE CHILD WITH CEREBRAL PALSY

The first questions usually asked by parents after they are told their child has cerebral palsy are "What will my child be like?" and "Will he walk?" Predicting what a young child with cerebral palsy will be like or what he will or will not do (called the prognosis) is very difficult. Any predictions for an infant under six months of age are little better than guesses, and even for children younger than one year it is often very difficult to predict the pattern of involvement. By the time the child is two years old, however, the physician can determine whether the child has hemiplegia, diplegia, or quadriplegia. Based on this involvement pattern, some predictions can be made. It is worth saying again that children with cerebral palsy do not stop doing activities once they have begun to do them. Such a loss of skills, called regression, is not characteristic of cerebral palsy. If regression occurs, it is necessary to look for a different cause of the child's problems. In order for a child to be able to walk, some major events in motor control have to occur. A child must be able to hold up his head before he can sit up on his own, and he must be able to sit independently before he can walk on his own. It is generally assumed that if a child is not sitting up by himself by age 4 or walking by age 8, he will never be an independent walker. But a child who starts to walk at age 3 will certainly continue to walk and will be walking when he is 13 years old unless he has a disorder other than CP.

It is even more difficult to make early predictions of speaking ability or mental ability than it is to predict motor function. Here, too, evaluation is much more reliable after age 2, although a motor disability can make the evaluation of intellectual function quite difficult. Sometimes "motor-free" tests which can assess intellectual ability without, the person being tested, needing to use his hands are administered by psychologists who have expertise in their use. Overall, the intellectual ability of the person, far more than their physical disability, will determine the person's prognosis. In other words, mental retardation is far more likely than cerebral palsy to impair a child's ability to function.

Read press releases from the National Institute of Neurological Disorders and Stroke of easy-to-understand  summarizing recent studies in cerebral palsy.

Negligence

Negligence by a doctor or other health care provider during the birthing and newborn time is a possibility.

Negligence is a possible cause of a child's injuries.

Legal Consultation 

If a family member has suffered a serious, permanent injury related to childbirth, you may want to talk to a lawyer. We provide free consultations to help determine if you have a valid medical negligence case that should be pursued. If you have already consulted with another lawyer or are in the process of doing so, we can offer information about how to evaluate whether you have obtained the right lawyer for your case.

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