Condition: Cerebral palsy (CP) is caused by abnormal development or injury to a baby’s brain before they are born or during infancy. CP affects posture and muscles, which can make it hard to control movement.
Background: CP occurs in up to 4 out of every 1,000 births and is more common in babies who are born early. It is the most common motor disability of childhood. It can be caused by stroke, lack of oxygen, traumatic injury, infection, genetic syndrome, or brain malformation. In some cases, the cause is not known.
Risk Factors: CP is more common in boys and African Americans and babies that are born prematurely, have low birth weight, or are part of a twin pregnancy. Sometimes, genetic syndromes or strokes can run in families.
History and Symptoms: Children with CP may have trouble meeting milestones on time. They may have muscle spasms, weakness, or abnormal movements. They may seem either “floppy” or very stiff. CP does not get worse over time but can lead to problems with thinking, speech, swallowing and mobility. Children with CP may also have seizures, orthopedic problems, pain, and difficulties with vision and hearing. There are many types of CP, with some children having few symptoms and others needing total care.
Physical Exam: The physical medicine and rehabilitation (PM&R) physician will check strength, posture, reflexes, joint flexibility, muscle tightness, and how the baby or child moves. Based on the exam, the PM&R physician will determine the type of movement pattern and parts of the body affected.
Diagnostic Process: Depending on the child’s age, head/brain ultrasound, CT, or MRI will help diagnose CP. Genetic testing, other blood tests, and tests of hearing and vision may be considered as well to aid in diagnosis. These results, along with the history and exam, help the PM&R physician diagnose the type of CP.
Rehab Management: A PM&R physician has special training in diagnosing and treating children with CP. Babies and children with CP need help moving and meeting milestones. They may need help with eating, communicating, and going to the bathroom. PM&R physicians help coordinate a large team of specialists to treat CP. This team includes orthopedists, neurologists, therapists, social workers, nurses, parents, and teachers.
The PM&R physician may prescribe physical, occupational, or speech therapy to help the child’s development. They may also prescribe medication to help with muscle tightness or abnormal movement. Equipment, such as braces, walkers, and wheelchairs, is used to help the child make progress and be independent. Regular check-ups are important to avoid complications, like joint contractures and hip or spine issues. Adaptions to school and social activities are also important to help the child with CP live a full life.
Other Resources for Patients and Families: The PM&R physician focuses on function and quality of life. They can help families find resources for their child. There are laws that require early intervention and other services for children with CP. A social worker or the local school system can help with these services as well. Additional resources may be found at www.aacpdm.org, www.cdc.gov/ncbddd/cp, and www.ucp.org.