Cerebral Palsy

What is cerebral palsy (CP)?

Cerebral palsy (CP) is the most common motor disability of childhood. CP is a group of disorders that affect muscle tone, posture, and movement as a result of damage to an infant's developing brain. Though the damage doesn't progress, the symptoms change over time with growth and development.

Children with CP often have one or more associated conditions, including learning disabilities, developmental delays, epilepsy, problems with vision or hearing, and challenges with speech and communication. They can also have other medical concerns, such as feeding and nutritional difficulties and respiratory issues.

What are the different types of cerebral palsy?

There are several types of cerebral palsy. They are classified by the kind of motor function issues the child has:

  • spastic diplegia: spastic movements of the legs
  • spastic quadriplegia: spastic movements in all four limbs (both arms and legs)
  • spastic hemiplegia: spasticity that affects one half, or one side, of the body (such as the right arm and right leg)
  • athetoid: involuntary, uncontrolled, and purposeless movements
  • dystonia: sustained or repetitive muscle contractions that do not relax, causing twisted or fixed postures

It is sometimes helpful to think of dystonia as an "overflow" of movements due to abnormal signals from the brain's movement system. This differs from spasticity, which describes increased muscle tone, due to exaggerated stretch reflexes. Reflexes are normally suppressed by signals from the brain and spinal cord that allow us to move properly, and an inability to properly suppress reflexes results in spasticity.

It is not uncommon to have both spasticity and dystonia with CP, and it is often difficult to tell them apart because they both result in too much muscle tone.

What are the symptoms of cerebral palsy?

Cerebral palsy symptoms can vary from child to child. Symptoms range from muscle weakness and poor motor control to muscle tightness (spasticity), to movement disorders (dyskinesias).

Children with CP may also have other symptoms including:

Infants with CP are often slow to reach developmental milestones, such as learning to roll over, sit, crawl, or walk. They may also have certain reflexes past the time these reflexes normally disappear (primitive reflexes). While CP doesn't progress or worsen over time, your child's symptoms may change with age.

What are the causes of cerebral palsy?

There are many causes of CP, but all occur either during pregnancy, birth, or shortly after birth. Common causes include brain malformations, infection, or stroke. In a small number of cases, oxygen deprivation is the cause. In many cases, the cause is unknown.

Sometimes, CP occurs as a complication of another condition, like premature birth, low birth weight, or neurological trauma.

How we care for cerebral palsy

Because cerebral palsy can refer to several different types of brain injury, it's important to seek treatment from experts from many different disciplines who understand:

  • a child's symptoms of cerebral palsy might not match any given "textbook" example
  • cerebral palsy may affect many parts of a child's body
  • how and why other medical conditions can occur alongside cerebral palsy
  • the vital role of orthopedic support

The team of specialists in the Cerebral Palsy and Spasticity Center at Boston Children's Hospital provides evaluation and treatment for children with cerebral palsy and other neuromuscular conditions. We combine expertise in orthopedic surgery, complex care, neurology, and neurosurgery, among several other specialties, to improve the functional capabilities of more than 2,000 patients of all ages every year.