What is cerebral palsy?

Doctor reviewing and pointing at brain scan imaging on lightbox

What is cerebral palsy?


Cerebral palsy (CP) refers to a group of enduring neurological disorders stemming from non-progressive disruptions during brain development. These disruptions affect an individual's control over movement and posture. It is crucial to understand that CP is not a disease or an illness but rather a term encompassing the consequences of brain disturbances on the control of specific muscles, particularly those involved in movement and posture.

CP often co-occurs with sensory, perceptual, cognitive, communicative, behavioural, epileptic, and orthopedic complications.


What is the meaning of "cerebral palsy"? 

The term "Cerebral" pertains to the brain, and "Palsy" denotes any condition that hampers control of bodily movements.

There exists a wide spectrum of CP types, causes, and degrees of impairment, with some overlap among them.

What causes CP?

CP can arise when an infant's developing brain sustains injuries before, during, or shortly after birth while the brain is still forming. Globally, CP occurs in approximately 1 out of every 400 births. Numerous contributing factors, either independently or in combination, can lead to brain damage resulting in CP.


Some of these factors include:


  • Conditions during fetal development, encompassing brain malformations or inherited biochemical genetic disorders.
  • Placental damage that affects fetal nutrition.
  • Prenatal exposure to harmful substances like nicotine, alcohol, or certain drugs.
  • Maternal infections during pregnancy, such as German Measles, leading to fetal central nervous system damage.
  • Low birth weight due to premature birth or multiple births.
  • Brain hemorrhage, especially in very premature infants or due to non-accidental trauma.
  • Disrupted oxygen supply to the brain during a challenging birth or within the first three years of life, resulting from head trauma, poisoning, or near-drowning incidents.


Types of CP

It is important to note that these terms categorize patterns of physical challenges and do not define the individual. Each person with CP is unique and experiences CP differently, influenced by the type and extent of CP, as well as their access to support and resources within their family, community, and education or vocational settings.



There are three primary types of CP, each associated with specific muscle function impairments:

Descriptive illustration showing the 3 primary types of Cerebral PalsyP

Spastic CP

  • The most prevalent form, causing muscle tightness and stiffness, particularly during exertion, resulting in jerky and challenging movements. The degree of spasticity may vary over time and is attributed to damage in the brain's motor cortex, which disrupts communication between the brain and muscles.

Dyskinetic CP

  • Characterized by involuntary, uncontrolled movements, making it difficult to maintain posture and perform precise movements.

Ataxic CP

  • Affects coordination and balance, leading to unsteady movements and difficulties with precise motor skills.

Management of CP

While individuals with CP face various challenges, significant progress has been made in treatments and assistive technologies to enhance functionality. The modern approach focuses on promoting functioning rather than striving for "normalcy." It involves a multidisciplinary and multidimensional strategy, adapting both the environment and tasks to the individual's needs.


Management options include:


Physical Therapy

Physical therapy helps individuals achieve their potential for physical independence and mobility. Orthotics, casts and splits are made to supplement physical therapy programs.


Occupational Therapy

Aims to enhance independence in daily activities using adaptive equipment.


Speech-­Language Therapy

Improves communication, including alternative communication methods.


Medications

Such as botulinum toxin (Botox), can help in the control of muscle spasticity.


Orthopaedic and soft tissue surgery

Can help to counter the distorting effects of spasticity on the spine, hips and legs. 


Family Engagement and Family Goal-setting

Contemporary approaches prioritize family-centered care, acknowledging the profound impact of family well-being on the child's development. Health professionals recognize parents as experts on their child's condition and actively involve them in setting intervention goals and decision-making processes.