Cerebral palsy

Cerebral palsy (CP) is a group of movement disorders that appear in early childhood.[1] Signs and symptoms vary among people and over time,[1][3] but include poor coordination, stiff muscles, weak muscles, and tremors.[1] There may be problems with sensation, vision, hearing, and speaking.[1] Often, babies with cerebral palsy do not roll over, sit, crawl or walk as early as other children of their age.[1] Other symptoms include seizures and problems with thinking or reasoning, each of which occur in about one-third of people with CP.[1] While symptoms may get more noticeable over the first few years of life, underlying problems do not worsen over time.[1]

Quick facts: Cerebral palsy, Specialty, Symptoms, Complica... ▼

Cerebral palsy
A child with cerebral palsy being assessed by a physician
Specialty	Pediatrics Neurology Physiatry
Symptoms	Poor coordination Stiff or loose muscles Weak muscles Tremors[1]
Complications	Epilepsy Intellectual disability[1] Learning disability
Usual onset	Prenatal to early childhood[1]
Duration	Lifelong[1]
Causes	Often unknown[1] or brain injury
Risk factors	Brain damage during infancy Preterm birth Being a twin Certain infections during pregnancy Difficult delivery[1]
Diagnostic method	Based on child's development[1]
Treatment	Physical therapy Occupational therapy Speech therapy Conductive education External braces Orthopedic surgery[1]
Medication	Diazepam Baclofen Botulinum toxin[1]
Frequency	2.1 per 1,000[2]

Cerebral palsy is caused by abnormal development or damage to the parts of the brain that control movement, balance, and posture.[1][4] Most often, the problems occur during pregnancy, but they may also occur during childbirth or shortly after birth.[1] Often, the cause is unknown.[1] Risk factors include preterm birth, being a twin, certain infections during pregnancy, such as toxoplasmosis or rubella, exposure to methylmercury during pregnancy, a difficult delivery, and head trauma during the first few years of life, among others.[1] About 2% of cases are believed to be due to an inherited genetic cause.[5] A number of sub-types are classified, based on the specific problems present.[1] For example, those with stiff muscles have spastic cerebral palsy, those with poor coordination in locomotion have ataxic cerebral palsy, and those with writhing movements have dyskinetic cerebral palsy.[6] Diagnosis is based on the child's development over time.[1] Blood tests and medical imaging may be used to rule out other possible causes.[1]

Some of the causes of CP are preventable through immunization of the mother, and through efforts to prevent head injuries in children such as through improved safety.[1] There is no known cure for CP, but supportive treatments, medication and surgery may help many individuals.[1] This may include physical therapy, occupational therapy and speech therapy.[1] Medications such as diazepam, baclofen and botulinum toxin may help relax stiff muscles.[1][7][8] Surgery may include lengthening muscles and cutting overly active nerves.[1] Often, external braces and Lycra splints and other assistive technology are helpful with mobility.[9][1] Some affected children can achieve near normal adult lives with appropriate treatment.[1] While alternative medicines are frequently used, there is no evidence to support their use.[1]

Cerebral palsy is the most common movement disorder in children.[10] It occurs in about 2.1 per 1,000 live births.[2] Cerebral palsy has been documented throughout history, with the first known descriptions occurring in the work of Hippocrates in the 5th century BCE.[11] Extensive study of the condition began in the 19th century by William John Little, after whom spastic diplegia was called "Little's disease".[11] William Osler first named it "cerebral palsy" from the German zerebrale Kinderlähmung (cerebral child-paralysis).[12] A number of potential treatments are being examined, including stem cell therapy.[1] However, more research is required to determine if it is effective and safe.[1]