Introduction to cerebral palsy
Cerebral palsy is a condition in which impairment to the immature brain affects movement, posture and co-ordination. The condition can occur before, during or after birth, but depending upon severity may not become obvious until early childhood. Cerebral palsy is a wide-ranging condition and can affect people in many different ways.
Cerebral palsy is more common than generally realised. Currently, it is believed that about one in every 400 children is affected by the condition, that’s about 1,800 babies who are diagnosed with cerebral palsy in Great Britain each year. Cerebral palsy can affect people from all social backgrounds and ethnic groups.
It is often not possible for doctors to give an exact reason why part of a baby’s brain has been injured or failed to develop, as there may be no obvious single reason why a child has cerebral palsy. Causes of cerebral palsy can be multiple and complex. Known possible causes include:
- Infection in the early part of pregnancy.
- Oxygen starvation to the brain
- Difficult or premature birth.
- A cerebral (brain) bleed.
- Premature or multiple birth.
- Abnormal brain development.
- A genetic link (though this is quite rare).
Cerebral palsy affects the messages sent between the brain and the muscles. It is often difficult for a doctor to predict accurately how a young child with cerebral palsy will be affected later in life. Cerebral palsy is not progressive - the condition itself does not become more severe as the child gets older, although some of the effects on the body may become more noticeable and function may deteriorate.
There is no cure for cerebral palsy. If children are positioned well from an early age and encouraged to move in a way that helps them to improve their posture and muscle control, they can be supported to develop and achieve more independence for themselves. There are also a number of therapies, which may be beneficial for some individuals.
There are three types of cerebral palsy: spastic, dyskinetic (also known as athetoid or dystonic) and ataxic and these generally relate to which part of the brain has been affected. The effects of cerebral palsy vary enormously from one person to another, with some people having a combination of two or more types.
Spastic cerebral palsy
‘Spastic’ means ‘stiff’ and this form of cerebral palsy causes the muscles to stiffen and decreases the range of movement in the joints. It is the most common form of cerebral palsy and can affect different areas of the body. Generally someone with spastic cerebral palsy will have impaired mobility. If the person is only affected on one side of their body the term used to describe this is ‘hemiplegia’. If their legs are affected but their arms are unaffected or only slightly affected this is known as ‘diplegia’. If both arms and both legs are equally affected, then the term used is ‘quadriplegia’.
Dyskinetic (also dystonic or athetoid) cerebral palsy
Dyskinetic means difficulty with movement. People with dyskinetic cerebral palsy make involuntary movements, because their muscle tone changes rapidly from floppy and loose to tense and still, in a way they cannot control. Speech can be hard to understand as there may be difficulty controlling the tongue, breathing and vocal cords. Hearing problems are also common.
Dystonic cerebral palsy affects the movement of the body and presents as slow, rhythmic twisting movements of the trunk, or an arm or leg. It can also include irregular postures.
Ataxic cerebral palsy
People with ataxic cerebral palsy find it very difficult to balance. They may also have poor spatial awareness, which means it is difficult for them to judge their body position relative to other things around them. Ataxia affects the whole body. Most people with ataxic cerebral palsy can walk but they will probably be unsteady. They may also have shaky hand movements and irregular speech.
It can be difficult to state what type of cerebral palsy a person has as it is common to have a combination of two or more types. It is important to bear in mind that no two people with cerebral palsy are affected in the same way. Some have cerebral palsy so mildly that its effects are barely noticeable. Others may be profoundly affected and require help with many or all aspects of daily life.
Other associated difficulties
Other difficulties and medical conditions may occur more commonly in people with cerebral palsy but just because a person has cerebral palsy does not mean that they will also have other difficulties. However it may help you to be aware of some of them:
- Children with cerebral palsy may have problems with constipation, spasms or sleeping. The doctor or health visitor should be able to offer advice about this.
- People with cerebral palsy may have problems with speech and associated difficulties in chewing and swallowing. They may also have problems understanding the spoken word. A speech and language therapist may be able to offer advice.
- Some people with cerebral palsy may also have epilepsy. Often medication can help to manage this.
- Some people with cerebral palsy may have difficulty distinguishing and comparing shapes. This is to do with visual or spatial perception, which is about a person’s ability to interpret what they have seen and not a problem with their eyesight.
- People with cerebral palsy may also have some form of learning difficulties, making them slow to learn. The difficulties can be mild, moderate or severe. There may be a ‘specific learning difficulty’ or problems with a particular activity such as reading, drawing or arithmetic because a specific area of the brain is affected.
- It is important to remember that even someone severely physically affected by cerebral palsy may have average or above average intelligence.