What is cerebral palsy (Cerebral Palsy)?

From the Guidelines

Cerebral palsy (CP) is a group of permanent disorders of the development of movement and posture, causing activity limitations that are attributed to nonprogressive disturbances that occurred in the developing fetal or infant brain.

Key Characteristics of Cerebral Palsy

• CP is the most common major disabling motor disorder of childhood, with an estimated prevalence of 2 to 3 cases per 1000 births 1
• It is characterized by alterations in muscle tone, posture, and/or movement, which are noted in the first years of life as a consequence of altered brain development 1
• The condition often coexists with other neurodevelopmental disorders (NDDs), such as intellectual disability (ID) in 27% to 45%, epilepsy in 38%, speech disorders in 33% to 82%, and autism spectrum disorder (ASD) in 3% to 9% of cases 1

Diagnosis and Classification

• CP is a clinical diagnosis based on a combination of clinical and neurological signs, with diagnosis typically occurring between age 12 and 24 months 1
• There are four motor types of CP: spasticity (85%−91%), dyskinesia (4%−7%), ataxia (4%−6%), and hypotonia (2%) 1
• The condition can be classified topographically as unilateral (hemiplegia) or bilateral, including diplegia and quadriplegia 1

Importance of Early Diagnosis and Intervention

• Early diagnosis and intervention are crucial to optimize infant neuroplasticity, prevent complications, and enhance parent and caregiver well-being 1
• A combination of standardized tools, such as the Prechtl Qualitative Assessment of General Movements and the Hammersmith Infant Neurological Examination, can be used to predict risk and detect CP in infants 1

From the Research

Definition of Cerebral Palsy

• Cerebral palsy is a clinical description of children who share features of a non-progressive brain injury or lesion acquired during the antenatal, perinatal, or early postnatal period 2
• It is defined as motor impairment that limits activity, and is attributed to non-progressive disturbances during brain development in fetuses or infants 3
• Cerebral palsy is a broad range of static, nonprogressive motor disabilities that present from birth or early childhood as a result of injury to neuromotor components of the central nervous system 4
• It is a neurodevelopmental disorder characterized by abnormalities of muscle tone, movement, and motor skills, and is attributed to injury to the developing brain 5

Characteristics of Cerebral Palsy

• The clinical manifestations of cerebral palsy vary greatly in the type of movement disorder, the degree of functional ability and limitation, and the affected parts of the body 2
• The motor disorders of cerebral palsy are frequently accompanied by impaired cognition, communication, and sensory perception, behavioral abnormalities, seizure disorders, or a combination of these features 3
• Cerebral palsy has the potential to affect the overall development of a child by affecting the child's ability to explore, speak, learn, and become independent 6

Prevalence and Management of Cerebral Palsy

• Cerebral palsy affects about 1 in 500 neonates with an estimated prevalence of 17 million people worldwide 2
• It is thought to affect three to four individuals per 1000 of the general population 3
• Medical management of children and adults involves care from primary-care physicians with input from specialists in neurology, orthopedics, and rehabilitation medicine 3
• The management of cerebral palsy involves neurological rehabilitation, diagnosis, and management of co-morbidities, and is multidisciplinary involving a team of rehabilitation, orthopedic, psychologic, and social care providers 5