Cerebral Palsy (CP) is the most common cause of motor/movement disability in children and also affects a large adult population. Cerebral palsy is caused by a disturbance or injury in the infant brain that interferes with the areas responsible for controlling movement. While in many cases the specific causes may be unknown, changes in blood flow to the baby inside the womb or around the time of birth, infections and genes all may play a part. As a result, a person who has CP cannot move in a typical way. These alterations in body control, coordination and movement have names like spasticity (stiffness), hypotonia (low tone), dystonia (simultaneous activity of two or more muscle groups), athetosis and chorea (extra, abnormal movements). These problems can create lifelong and progressive changes for a person with CP even though the initial brain injury or disturbance that led to these symptoms is not progressive.
Causes of CP
The brain injury or disturbance in brain development that leads to CP can be caused by a number of different events or conditions. Some of these conditions that are associated with an increased risk for cerebral palsy include maternal or infant infection, infant stroke, multiple births, premature birth, genetic abnormalities, and other problems affecting how blood and oxygen move throughout the developing brain.
Even though doctors have a good understanding of the risk factors for CP, there is still much we have to learn about why some babies develop CP and others do not. There are many babies who share similar risk factors and injuries but develop very differently. The reasons for this are not entirely clear.
People with CP are affected differently
The differences in how CP affects people is partially due to where and how the injury/disturbance in brain development occurred. Whereas one person may have trouble with movement on one side of the body including their hand, arm and leg, another may have difficulty sitting up, maintaining balance, and using all four limbs. For these reasons, it is important to discuss early intervention with the infant or child’s medical team as soon as possible.
As people age abnormal wear and tear on the muscles, tendons and bones, may cause new problems especially during growth spurts or where there is prolonged immobility.
It is important to keep in mind that the muscle/movement difficulties related to CP are not limited to the obvious large muscles and muscle groups. Muscles all over the body may be affected including tiny muscles, like, for example, those controlling and coordinating eye movements.
Most people who have CP have a typical lifespan. However, there are some individuals, especially those with more severe forms of CP, who may have conditions such as epilepsy or problems with aspiration and pneumonia that may make them more vulnerable to a shorter than average life.
Conditions that may be seen in people who have CP
There are a variety of conditions that are seen in people who have CP. Some result from problems related to how the muscles and tendons respond to improper signaling from the brain (too tight, too loose, etc.) Other conditions are the result of various parts of the brain being affected that are outside of motor function. While some people with CP may develop many of these conditions, others may only experience a couple of these conditions or be minimally impacted by them.
Examples of some conditions affecting the muscles and bones:
- Hip dysplasia-when the hip ball and socket become misaligned
- Contractures-when the muscles become very rigid and extremely difficult to move
- Scoliosis-curvature of the spine
- Early Osteoporosis
Other conditions seen with CP:
- Sleep disorders-resulting from discomfort/pain or difficulty positioning oneself, constipation or reflux
- Problems with continence
- Constipation–due to motility problems in the intestines
- Difficulty swallowing/drinking—related to muscle coordination problems that control these functions
- Speech impairments
- Ocular impairments-disorders of the eye
- Visual processing disorders like CVI which relate to how the visual centers of the brain interpret incoming visual information
- Intellectual disability
- Learning difficulties
- Hearing impairments