Cerebral Palsy (CP) | Diagnosis & Treatment

How is cerebral palsy diagnosed?

Clinicians typically diagnose cerebral palsy (CP) when a child is 6 to 24 months old, since this is the time when they start missing developmental milestones like walking and controlling hand and head movements.

The process of diagnosing CP begins with a thorough history and physical examination. During the initial exam, a neurologist or pediatrician obtains a complete history of the mother's pregnancy and the child's birth and infancy.

Next, your child may have a variety of diagnostic or ancillary tests, including:

What are the treatment options for CP?

Because CP affects different children in different ways, your child's treatment plan will depend on several factors, including:

  • their age, overall health and medical history
  • the type of CP they have
  • the extent of symptoms
  • their tolerance for specific medications, procedures or therapies
  • the expected course of their CP
  • you and your family's preferences for treatment

CP is a lifelong condition that is not correctable, so managing the disorder is focused on:

  • preventing or minimizing physical deformities
  • improving and enhancing mobility and motion to the greatest possible extent
  • optimizing health
  • maximizing your child's capabilities to succeed at home, at school and in the community

Medications to help manage CP

While medication can't treat or cure CP itself, it can be helpful in managing certain symptoms of CP. Medications used to treat CP include:

  • antispasmodics to reduce muscle spasms and relax tightness in the muscles
  • anticonvulsants to treat seizures in children who experience them as a side effect of CP
  • anticholingerics to help children who experience dystonia (rigidity) and uncontrollable drooling
  • botulinum toxin injections to help reduce muscle tightness

Your clinician will determine whether medication is safe and advisable for your child -and, if so, which drugs and dosages are recommended.

CP therapy options

Physical therapy. Either alone or in combination with orthotic devices like a brace or splint, physical therapy can be extremely beneficial in preventing muscle contractures by stretching your child's spastic muscles. Many children receive regular physical therapy to take part in stretches, strengthening exercises and play activities that can help them improve their flexibility, endurance and mobility.

Occupational therapy. This approach is very helpful in giving children with CP independence, confidence and essential life skills. The occupational therapist will use exercises, games and training to help your child develop better fine motor skills, improve hand-eye coordination and master basic skills, such as getting dressed or bathing.

Speech therapy. A speech therapist can work with your child to address concerns about communication, swallowing and feeding. There are many opportunities for intervention, ranging from augmentative communication (using a computer system to help with communication) to feeding skill development, depending on the issue.

Nonsurgical options for CP

Management of CP usually includes several nonsurgical aids, such as:

Seating and positioning aids. These are used to help your child sit, lie or stand and include wheelchairs, walkers and ergonomic chairs that promote correct posture.

Orthotics. Orthotics are used to prevent deformity and to provide support or protection for the limbs and torso. These devices can include braces and splints.

Special eating or writing utensils. Forks, spoons, knives, pens and pencils can be designed for kids with fine motor skill difficulties.

Communication aids. Communication aids are used to help children who may be hard to hear or understand, or who have difficulty communicating with others. These can special picture books and posters, alphabet boards that can be used to spell out messages and computers with adaptive programs and functions such as speech-recognition software.

Surgical options for CP

In some cases, surgery can be a helpful option for managing symptoms of CP.

Orthopedic surgery. Orthopedic surgeons treat CP symptoms that affect the skeleton and muscles - namely, spasticity and muscle contractures. While not always necessary, surgery may be recommended if your child's muscle spasms are severe enough to cause problems with movement, balance and coordination. Likewise, surgery can help reduce spasticity in the legs by elongating or releasing the contracted muscles and tendons that are too short. Surgical procedures are also used to treat scoliosis, hip dislocations and ankle and foot deformities.

Neurosurgery. Some children with CP have pain and spasms severe enough to warrant neurosurgical intervention. Neurosurgeons perform procedures that can help control both the pain and the spasms caused by CP, including implantation of a baclofen pump, a device that administers precise dosages of the muscle relaxant baclofen into your child's spinal canal. Neurosurgeons may also perform selective dorsal rhizotomy, an operation that cuts certain nerves in the spine to reduce spasticity and improve your child's movement and posture.