Cerebral Palsy and Spasticity Center | What is Cerebral Palsy?

Cerebral Palsy (CP) is a chronic, lifelong condition that:

  • is caused by a non-progressive injury or disruption to the developing brain
  • affects communication between the brain and the muscles
  • causes uncoordinated movements and postures

Cerebral palsy is the most common motor disability in children in the United States and the world. Although it can’t be reversed, children with CP can lead rich, fulfilling lives with the appropriate medical and surgical management, as well as family support and specialized therapies.


What Causes Cerebral Palsy?

The cause of cerebral palsy is a brain injury or brain malformation that occurs while the brain is developing—at any time from conception to approximately two to three years of life. As a result, a child’s muscle control, muscle coordination, muscle tone, reflex, posture and balance can be affected and cause abnormal tone, uncoordinated movements and postures.

In many cases, however, no exact cause can be found.

Although CP often emerges without a specific cause, certain risk factors have been linked to the disorder. They include:

  • premature birth (approximately 25 percent of CP is due to prematurity)
  • very low birth weight (especially in babies weighing less than 1,000 grams, or 2.2 lbs.)
  • brain hemorrhages (bleeding within the brain) and brain trauma
  • some viruses and infections affecting the mother during pregnancy, including cytomegalovirus (CMV), rubella (German measles), toxoplasmosis and urinary tract infections or kidney infections 
  • genetic abnormalities
  • chemical/substance abuse by the mother during pregnancy

Common Types of Cerebral Palsy

There are many ways to classify cerebral palsy. The most commonly defined types are spastic, dyskinetic and mixed cerebral palsy.

  • Spastic cerebral palsy is characterized by increased muscle tone. That means that muscles are unusually tight and stiff, which affects movement and growth. Spastic cerebral palsy can affect one limb, both legs, one or both sides of the body or the entire body.
  • Dyskinetic cerebral palsy is characterized by involuntary movements, such as dystonia and difficulty making coordinated movements.
  • Mixed cerebral palsy describes people who experience features of both spastic and dyskinetic cerebral palsy.
  • Ataxic cerebral palsy (the least common type) is characterized by difficulty balancing and movements that may appear disorganized or jerky.

Signs and Symptoms of Cerebral Palsy

The signs of cerebral palsy differ from child to child and may change over time. Signs of the condition may include:

  • weakness in one or more limbs (arms or legs)
  • standing and walking on tiptoe
  • difficulty with fine motor tasks (such as writing or using scissors)
  • difficulty maintaining balance
  • walking abnormally, with one foot/both feet or leg dragging
  • involuntary, uncontrolled and purposeless movements
  • rigidity and/or high tone throughout the muscles
  • poor head control

Babies with CP are often slow to reach developmental milestones, such as learning to roll over, sit, crawl or walk.

Children with CP may also have additional problems, including:

  • hip displacement or curvature of the spine (Scoliosis)
  • bone abnormalities, such as osteopenia, fractures that occur too easily because of bone fragility, and rotational deformities
  • seizures
  • vision loss or impairment
  • hearing loss or impairment
  • speech impairment
  • learning disabilities
  • feeding difficulties
  • behavioral problems
  • developmental delays
  • intellectual disability
  • respiratory problems, such as asthma and aspiration
  • bowel and bladder control problems
  • constipation
  • gastroesophageal reflux (GERD)
  • poor weight gain
  • excessive drooling

Our care team will consult with you and your child’s pediatrician and make referrals to any number of subspecialists at Boston Children’s Hospital that the team identifies as being potentially helpful to your child.

How is Cerebral Palsy Diagnosed?

If your child has symptoms of CP, it is critical to get a diagnosis early in childhood. Most often, children receive a cerebral palsy diagnosis between ages two and three. Cerebral palsy evaluation at Boston Children’s provides accurate, objective information that enables doctors to anticipate complications before they develop. Addressing symptoms of CP in early childhood, before development peaks, can have a tremendous impact on your child’s treatment outcomes.

Tests to diagnose cerebral palsy may include:

  • neurologic examination to evaluate your child’s reflexes and motor function
  • magnetic resonance imaging (MRI), which uses a combination of large magnets, radiofrequency waves and a special computer to create detailed pictures of organs and structures within the body
  • laboratory studies (blood and urine tests)

Other tests that may be performed to better understand your child’s condition include:

  • gait analysis, a review of your child’s walking patterns
  • electroencephalogram (EEG), a non-invasive procedure that records the brain's continuous electrical activity through electrodes attached to the scalp
  • computerized tomography (CT) scans, which use X-rays and computer technology to produce cross-sectional images of parts of the body (including bones, muscles and organs)

Patients with complex motor skills issues may be referred to the state-of-the-art Gait Laboratory at nearby Spaulding Rehabilitation Hospital.

Learn more about cerebral palsy evaluation at Boston Children’s Hospital.

Advanced Cerebral Palsy Treatment at Boston Children’s Hospital

Cerebral palsy is a lifelong condition that requires ongoing management that often changes as your child grows older. Our goal is to help your child achieve the most function, independence and comfort possible. Treatment is focused on managing the disorder, specifically:

  • Preventing or minimizing physical deformities and discomfort
  • Improving and enhancing mobility and motion to the greatest possible extent
  • Maximizing your child's capabilities to be as independent as possible at school and in the community and into adulthood
  • Enhancing your child’s overall health

Boston Children’s Hospital’s dedicated team of cerebral palsy physicians understands that no two children with the condition are alike. Our team provides individualized and comprehensive cerebral palsy treatment plans that are as unique as your child. Meet our cerebral palsy team.

Addressing symptoms of CP in early childhood is extremely important to maximizing muscle control, independence and comfort as your child continues to develop. Our team of experts, working in many specialties, will create an integrated care plan, tailored to your child’s needs. As your child changes and grows, the treatment plan will change, too.

Your child’s treatment plan may include medical (non-surgical) therapies, such as medicines, muscle injections, casting and physical therapy. Some of our patients benefit from surgical procedures to improve their mobility and comfort. Orthopedic surgeons, neurologists, neurosurgeons, complex care physicians, physiatrists and other specialists will consult with you to make collaborative decisions about your child’s care.

Your child’s treatment plan may include:

Learn more about cerebral palsy treatment at Boston Children’s.

Make an Appointment

For an appointment, more information or to obtain a second opinion for your child, please call us at 617-355-6021 or request an appointment online.

International Patients

For families residing outside of the United States, please call Boston Children's International Health Services at +1-617-355-5209.