In general, early signs of cerebral palsy include 1 , 2 : Developmental delays. The child is slow to reach milestones such as rolling over, sitting, crawling, and walking. Developmental delays are the main clues that a child might have cerebral palsy. And muscle shortening and muscle rigidity can worsen if not treated aggressively. It's important to get a prompt diagnosis for a movement disorder or delays in your child's development. See your child's doctor if you have concerns about episodes of loss of awareness of surroundings or of unusual bodily movements or muscle tone, impaired coordination, swallowing difficulties, eye muscle imbalance, or other developmental issues.
Cerebral palsy is caused by abnormal brain development or damage to the developing brain. This usually happens before a child is born, but it can occur at birth or in early infancy. In many cases, the cause isn't known. Many factors can lead to problems with brain development. Some include:. Certain infections or toxic exposures during pregnancy can significantly increase cerebral palsy risk to the baby.
Inflammation triggered by infection or fever can damage the unborn baby's developing brain. While the potential contribution from each is limited, additional pregnancy or birth factors associated with increased cerebral palsy risk include:. Muscle weakness, muscle spasticity and coordination problems can contribute to a number of complications either during childhood or in adulthood, including:.
Most cases of cerebral palsy can't be prevented, but you can reduce risks. If you're pregnant or planning to become pregnant, you can take these steps to keep healthy and minimize pregnancy complications:. Rarely, cerebral palsy can be caused by brain damage that occurs in childhood. Practice good general safety. Prevent head injuries by providing your child with a car seat, bicycle helmet, safety rails on the bed and appropriate supervision.
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However, General Movements Assessment cannot predict the severity of cerebral palsy. One of the frustrations for parents is that sometimes a diagnosis can take a long time, with repeated tests and visits to specialists.
This may be because the child has a mild form of cerebral palsy, but it could also be because the doctor needs to make sure it is not another type of movement disorder that may be progressive get worse over time. For a better experience on our website, enable JavaScript in your browser.
High contrast. Depending on the level of severity of cerebral palsy, toddlers and children may experience difficulties with physical development such as: not walking by months not speaking simple sentences by 24 months If your child is not reaching these milestones or they display some of the signs of cerebral palsy, you may need to speak to your early childhood nurse, general practitioner or paediatrician.
When is cerebral palsy diagnosed? The time varies when parents are given an official diagnosis that their child has cerebral palsy. Common signs of severe CP that may be noticed shortly after birth include: Problems sucking and swallowing. A weak or shrill cry. Unusual positions. Often the baby's body is either very relaxed and floppy or very stiff. Signs that occur over time Some problems related to CP become more clear over time.
These may include: Smaller muscles in the affected arms or legs. Nervous system problems prevent movement in the affected arms and legs. Not being active affects how the muscles grow. Abnormal sensations. Some people who have CP feel pain when touched lightly.
Even everyday activities, such as brushing teeth, may hurt. Abnormal sensations can also make it hard to identify common objects by touch. Skin irritation. Drooling is common when facial and throat muscles are affected.
Drooling irritates the skin, particularly around the mouth, chin, and chest. Dental problems. Children who have trouble brushing their teeth have a greater risk of getting cavities and gum disease gingivitis. Seizure medicines may also lead to gum disease.
Falls and other injuries are a risk, depending on muscle control, joint stiffness, and general physical strength. And CP-related seizures can cause injuries. What Happens All people who have cerebral palsy CP have some problems with body movement and posture. How CP may affect your child How much a child is able to move around and do things depends on the type of CP the child has and how much of his or her body is affected.
Living with CP Just like people who have normal physical development, people who have CP have social and emotional concerns throughout their lives. What Increases Your Risk Risk factors before birth Babies born to teen mothers or to mothers age 35 and older have a higher risk for cerebral palsy CP.
These problems may include: Infections, such as rubella , cytomegalovirus infection CMV , chorioamnionitis, and toxoplasmosis. Exposure to certain medicines, such as thyroid hormones, estrogen, or methotrexate. Use of alcohol or illegal drugs. Other problems, such as bleeding in the uterus during the sixth to ninth month of pregnancy, large amounts of protein in the urine proteinuria , or high blood sugar levels.
Premature birth and low birth weight About half of all children who have cerebral palsy CP are born prematurely. Risk factors for cerebral palsy at birth In rare cases, some babies develop CP as a result of complications during the mother's pregnancy or at birth.
Risk factors include: Premature birth. Premature babies are more likely to have bleeding in the brain intraventricular hemorrhage, or IVH or a brain injury called periventricular leukomalacia PVL. Either of these problems may cause CP. Difficult or prolonged labour. Brain infection or physical trauma can increase a baby's risk of getting CP. A lack of oxygen also increases a baby's risk. This isn't common. CP can itself cause a baby to have a difficult birth because of body movement and posture problems related to the condition.
Abruptio placenta. The placenta usually separates from the wall of the uterus several minutes after the birth of the baby. But if it separates before the baby is born, the baby loses the blood and oxygen supply from the mother. Infections in the mother's uterus or vagina, such as strep infections , that transfer to the baby during birth.
Risk factors after birth Risk factors for developing CP just after birth or within the first 2 or 3 years of life are related to brain damage. They include: A serious illness, such as severe jaundice , meningitis , or lead poisoning very rare. A serious head injury from an injury or fall. This includes injury to a baby from shaking, throwing, or other force shaken baby syndrome.
Lack of oxygen to brain tissues, such as the result of a brain tumour or a near-drowning incident. Having some kinds of blood-clotting or genetic problems.
When should you call your doctor? Call or other emergency services if your child with cerebral palsy CP : Is having problems breathing. Chokes during feeding and you are not able to dislodge the food. Call a doctor right away if: Your child has a seizure for the first time.
If you have a child diagnosed with CP, call your doctor if your child has: A seizure if it is the first time, call your doctor or seek care right away. Constipation that isn't relieved by home treatment. Skin irritation that isn't getting better, starts to bleed or weep fluid, or causes pain. Feeding problems that aren't relieved by home treatment, such as: A pattern of coughing and choking during feeding.
If food is inhaled into the lungs, it increases the risk of pneumonia. Trouble chewing, along with weight loss or complaints of being hungry. Frequent injuries that threaten your child's safety.
Other signs of complications. These may include bladder control problems, bleeding gums, or an increase in joint stiffness. Who to see A team of health care providers will be involved in your child's care. You may also be referred to specialists, such as: Pediatricians some pediatricians specialize in developmental disabilities.
Neurological surgeons. Physiatrists , physical medicine and rehabilitative physicians, and other doctors who specialize in therapeutic and long-term treatment issues. Other specialists who may be involved in the care of people who have CP include: Gastroenterologists. Orthopedic surgeons.
Respirologists pulmonologists. Ear, nose, and throat specialists otolaryngologists. Psychiatrists , psychologists , social workers , and psychiatric nurses.
Other health professionals who may be involved in the care of people who have CP include: Occupational therapists. Dentists or orthodontists.
Hearing specialists audiologists. Speech therapists speech-language pathologists. Registered dietitians. Examinations and Tests Diagnosing cerebral palsy Developmental delays are often reported by parents or observed by a doctor during routine well-baby checks. A doctor diagnoses CP based on: Questions about the child's medical history, including details about the mother's pregnancy.
A physical examination to look for signs of CP. The doctor will look to see if the child retains newborn reflexes longer than normal.
This can be a sign of CP. Postures and basic muscle function, hearing, and vision are usually checked. Screening tests. Developmental questionnaires and other tests may be done. MRI of the head. This test can find brain abnormalities. Evaluating and monitoring cerebral palsy After CP is diagnosed, a child will also be checked for other medical conditions that can occur with cerebral palsy, such as: Other developmental delays in addition to ones already found.
Developmental abilities will be checked to find out if new symptoms, such as speech and language delay, appear as a child's nervous system matures. Intellectual disability.
This can be checked by intelligence testing. An electroencephalography EEG is used to check for abnormal activity in the brain if a child has a history of seizures. Problems with feeding and swallowing. Vision or hearing problems. Behavioural problems. Some children need repeated testing that may include: X-rays , to check for loose or dislocated hips. Children with CP are usually X-rayed several times during ages 2 to 5.
Spinal X-rays also are done to look for curves in the child's spine scoliosis. Gait analysis. This helps identify problems and guide treatment decisions. Treatment Overview Even though CP can't be cured, a variety of treatments can help people who have CP to make the most of their abilities and physical strength, prevent complications, and improve their quality of life. Treatment for CP includes: Physiotherapy, which can help your child become as mobile as possible.
Medicines, which can help control some of the symptoms of CP and prevent complications. For more information, see Medications. Certain kinds of surgery, which may sometimes be used for a child with severe problems. For more information, see Surgery. Devices and equipment, such as braces, casts, and splints. Pain management.
For more information, see the topics Pain Management and Chronic Pain. Physiotherapy Physiotherapy is an important treatment that begins soon after a child is diagnosed. Devices and equipment Many people who have CP benefit from using something to maintain or improve joint mobility, help strengthen muscles and relax overactive spastic muscles, and assist with daily activities. Other treatments Other therapies may also be needed, depending on specific needs. Occupational therapy helps teens and adults adapt to their limitations and live as independently as possible.
Speech therapy helps control the mouth muscles. This therapy can be of great help to children with speech or eating problems. Speech therapy often starts before the child begins school and continues throughout the school years. A registered dietitian can provide nutritional counselling when a child has problems eating or is not gaining weight.
Both massage therapy and hatha yoga are designed to help relax tense muscles, strengthen muscles, and keep joints flexible. Hatha yoga breathing exercises are sometimes used to try to prevent lung infections. More research is needed to find out the health benefits of these therapies for people who have CP. Therapies to stimulate learning and sensory development may benefit babies and young children.
Some also help people of other ages. These therapies cannot repair damaged parts of the brain. But they may be able to stimulate undamaged parts of the brain. Behavioural therapy may help some school-age children with CP learn better ways to communicate with others.
Biofeedback may be useful as part of physiotherapy or on its own. Although it doesn't help everyone with CP, some people who use the technique learn how to control their affected muscles or reduce muscle tension. Preparing for independent living Many adults with CP get jobs if they have good support from their family and community. Prevention The cause of cerebral palsy CP sometimes isn't known. Before and during pregnancy Doing all you can before and during pregnancy can help lower the risk that a brain injury will occur in a developing baby.
Eat nutritious foods.
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