Cerebral palsy | |
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A child with cerebral palsy being assessed by a physician | |
Specialty | |
Symptoms | |
Complications | |
Usual onset | Prenatal to early childhood[1] |
Duration | Lifelong[1] |
Causes | Often unknown[1] or brain injury |
Risk factors |
|
Diagnostic method | Based on child's development[1] |
Treatment | |
Medication | |
Frequency | 2.1 per 1,000[2] |
Cerebral palsy (CP) is a group of movement disorders that appear in early childhood.[1] Signs and symptoms vary among people and over time,[1][3] but include poor coordination, stiff muscles, weak muscles, and tremors.[1] There may be problems with sensation, vision, hearing, and speech.[1] Often, babies with cerebral palsy do not roll over, sit, crawl or walk as early as other children.[1] Other symptoms may include seizures and problems with thinking or reasoning. While symptoms may get more noticeable over the first years of life, underlying problems do not worsen over time.[1]
Cerebral palsy is caused by abnormal development or damage to the parts of the brain that control movement, balance, and posture.[1][4] Most often, the problems occur during pregnancy, but may occur during childbirth or shortly afterwards.[1] Often, the cause is unknown.[1] Risk factors include preterm birth, being a twin, certain infections or exposure to methylmercury during pregnancy, a difficult delivery, and head trauma during the first few years of life.[1] About 2% of cases are believed to be due to an inherited genetic cause.[5]
Sub-types are classified, based on the specific problems present.[1] For example, those with stiff muscles have spastic cerebral palsy, poor coordination in locomotion have ataxic cerebral palsy, and writhing movements have dyskinetic cerebral palsy.[6] Diagnosis is based on the child's development.[1] Blood tests and medical imaging may be used to rule out other possible causes.[1]
Some causes of CP are preventable through immunization of the mother, and efforts to prevent head injuries in children such as improved safety. There is no known cure for CP, but supportive treatments, medication and surgery may help individuals.[1] This may include physical therapy, occupational therapy and speech therapy.[1] Mouse NGF has been shown to improve outcomes[7][8] and has been available in China since 2003.[8] Medications such as diazepam, baclofen and botulinum toxin may help relax stiff muscles.[1][9][10] Surgery may include lengthening muscles and cutting overly active nerves.[1] Often, external braces and Lycra splints and other assistive technology are helpful with mobility.[11][1] Some affected children can achieve near normal adult lives with appropriate treatment.[1] While alternative medicines are frequently used, there is no evidence to support their use.[1] Potential treatments are being examined, including stem cell therapy.[1] However, more research is required to determine if it is effective and safe.[1]
Cerebral palsy is the most common movement disorder in children,[12] occurring in about 2.1 per 1,000 live births.[2] It has been documented throughout history, with the first known descriptions occurring in the work of Hippocrates in the 5th century BCE.[13] Extensive study began in the 19th century by William John Little, after whom spastic diplegia was called "Little's disease".[13] William Osler first named it "cerebral palsy" from the German zerebrale Kinderlähmung (cerebral child-paralysis).[14]
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