Cerebral Palsy: What Is It?

Cerebral palsy (CP) is the most common physical disability affecting people throughout their lifespan. There are approximately 18 million people in the world who have CP, and one million of those live in the United States.

CP affects how the brain controls muscle movements. Muscles may be tight (hypertonia) or loose (hypotonia) or may alternate between the two. In all cases, there are differences in coordination, body posture and movement. Many people with CP experience movements of their muscles which they cannot control.

What Causes CP?

CP results from abnormal development of or injury to the brain early in life, either before birth or soon thereafter.  There are many possible things that may affect the brain’s structure or function and cause CP, such as:

• A stroke or bleed (hemorrhage)
• Certain types of infection
• Differences in how the brain develops before birth
• Genetic conditions

What Are the Symptoms of CP?

People with CP have a wide variety of symptoms that may affect how they move, walk or speak.  Examples of common early symptoms that parents may notice in their infant are a delay in learning motor skills such as sitting and walking, moving one side of the body less than the other side, stiffness or unusual postures in the arms or legs, or walking on tiptoes. Some people only have symptoms on one side of their body, and some people are affected on both sides. Symptoms may be mild and cause only a very slight change in how a person moves, or they may be severe and cause more impairment.

In addition to challenges with movement, people with CP can have other medical conditions. Some of the most common include:

• Learning difficulties or intellectual disability
• Seizures
• Hearing or vision impairment
• Difficulty with chewing or swallowing

How Is CP Treated?

Most treatments for CP target muscle tone and joint alignment. In general, treatment starts with therapies and medications. Over time, when necessary, treatment may involve procedures. Treatments include:

• Therapy – Most people with CP benefit from regular stretching to make movement easier, and activities to build strength and improve balance, stamina and coordination. This is the focus of physical therapy. Other treatments may include occupational or speech therapy.
• Medicines –A number of medications are available to reduce muscle stiffness and involuntary movements. Some people with CP benefit from taking medication all their lives.
• Injections – Botulinum toxin injections can help relax specific muscle groups. Injections generally need to be repeated every few months.
• Surgery – There are many surgeries available to people with CP. Some surgeries involve releasing tight muscles, others involve the bones themselves, some interrupt the connections of the nerves that cause tightness in the legs, and others help to correct severe spinal curvature (scoliosis).

What Kinds of Equipment Do People with CP Use?

• Braces provide support for joints to be positioned in the best way possible to reduce pain and wear and tear, and to encourage function. One common type of brace is called an AFO (ankle foot orthosis) which can be worn inside a shoe and usually extends up the calf.
• Other types of equipment help people with CP to stand with support, such as a stander, or to move independently, such as canes, a walker or gait trainer. Some people with CP use wheelchairs.
• Augmentative and alternative communication (AAC) systems can help children who have difficulty with speech to express themselves. AAC devices come in all shapes and sizes and can include communication boards, picture books, tablets, eye gaze technology and speech generation.

People with CP can live long and happy lives. By receiving comprehensive medical care and participating in therapies, people with CP can continuously work to build skills and participate actively at school and in the community.