Cerebral palsy (CP) is a group of permanent movement disorders appearing in early childhood.

• Varies between Pt's
• Often includes:
  • Poor coordination
  • Spasticity (stiff muscles)
  • Weak muscles
  • Trouble swallowing or speaking
  • Tremors
• Also:
  • Problems with sensation
  • Vision
  • Hearing
  • Difficulty with cognition
  • Seizures
• Babies: do not roll over, sit crawl, or walk as ealry as other kids their age

Patient information

You say the "brain" - WOW !! So not just "movements". Isn't that going to affect a heck of a lot of things given the brain controls, well... everything?!
Yes. Which is exactly why in addition to things related to motor (tone, power, reflex, coordination) and sensation - you also have issues with other things. Vision. Hearing. Cognition. They're just some of the other things that can happen

• Caused by abnormal development or damage to the parts of the brain that control movement, balance, and posture, specifically, the corticospinal pathway or extrapyramidal regions
• Cause is often unknown
• Inherited genetic cause in 2%

Risk factors include:

• During pregnancy:
  • Certain infections during pregnancy (e.g. toxoplasmosis, or rubella)
  • Exposure to methylmercury during pregnancy
  • Being a twin
• During childbirth:
  • Premature birth, a major risk factor (45% of CP Pt's were born prematurely)
• Shortly after birth:
  • Head trauma during the first few years of life

• Based on motor impairment of the limbs or organs, and by restrictions to the activities an affected person may perform, and therefore also reflect the areas of the brain that are damaged:
  • Spastic CP, have stiff muscles
  • Ataxic CP, with poor coordination
  • Athetoid CP (aka dyskinetic CP), with writhing movements
  • Mixed, which is a combination of the other types
• Based on severity, assessed via the Gross Motor Function Classification System, or the International Classification of Functioning, Disability and Health

• Based on the child's development over time
• Blood tests and medical imaging, used to rule out other possible causes

• Prevention, through:
  • Immunization of the mother
  • In those at risk of premature birth (<34 weeks), magnesium sulfate appears to decrease risk of CP. It is unclear if it assists those born at term
  • Cooling high risk fully term babies shortly after birth, may reduce disability
  • Efforts to protect head injuries in children
• No cure
• Physiotherapy
• Speech therapy
• Medications may help relax stiff muscles, including diazepam, baclofen, and botulinum toxin
• Surgery, including lengthening muscles, and cutting overly active nerves
• External braces, and other assistive technology

• Sx may get more noticeable over the first few years of life
• Underlying problems do not worsen over time
• Some children have near normal adult lives with appropriate Tx

• Most common movement disorder in children
• Occurs in 0.21% of live births

• Spastic CP
• Ataxic CP
• Athetoid CP