What is cerebral palsy (Cerebral Palsy)?

From the Guidelines

Cerebral palsy is a clinical diagnosis defined as 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. This condition is the most common major disabling motor disorder of childhood, with an estimated prevalence of 2 to 3 cases per 1000 births 1. The diagnosis of cerebral palsy is typically made based on a combination of clinical and neurological signs, and it can be categorized into different motor types, including spasticity, dyskinesia, ataxia, and hypotonia 1.

Key Characteristics of Cerebral Palsy

• It affects muscle tone, movement, and motor skills, making it difficult for a person to move in a coordinated and purposeful way.
• The condition varies widely in severity, with some individuals experiencing mild impairment while others have significant physical disabilities.
• Cerebral palsy can also be accompanied by other issues such as intellectual disabilities, seizures, vision or hearing problems, and difficulties with speech 1.
• The brain damage that causes cerebral palsy is permanent, but the resulting physical impairments can sometimes be improved with treatment.

Management and Treatment

• Management typically involves a multidisciplinary approach including physical therapy, occupational therapy, speech therapy, medications like baclofen or botulinum toxin to reduce muscle stiffness, and sometimes surgery to correct physical abnormalities.
• Early intervention is crucial for maximizing a child's capabilities and potential, and it should aim to optimize motor, cognition, and communication outcomes, prevent secondary impairments, and promote parent or caregiver coping and mental health 1.
• Task-specific, motor training-based early intervention, such as Goals-Activity-Motor Enrichment (GAME) and constraint-induced movement therapy (CIMT), are recommended as the new paradigm of care for cerebral palsy, as they induce neuroplasticity and produce functional gains.

While there is no cure for cerebral palsy, many people with the condition lead fulfilling, independent lives with appropriate support and accommodations. It is essential to prioritize early diagnosis and intervention to maximize the child's potential and improve their quality of life 1.

From the Research

Definition of Cerebral Palsy

• Cerebral palsy (CP) is a group of permanent neurologic disorders of movement and posture commonly seen in early childhood, caused by abnormal brain development early in life 2.
• It is characterized by abnormalities of muscle tone, movement, and motor skills, attributed to injury to the developing brain 3.
• CP is a clinical diagnosis, and clinicians must have a strong understanding of the clinical presentation to ensure early diagnosis and improved outcomes for patients 2.

Clinical Presentation and Diagnosis

• The clinical features of CP evolve over time, and the specific CP syndrome may be recognizable only after 3-5 years of age 3.
• Early diagnosis is possible based on a combination of clinical history, use of standardized neuromotor assessment, and findings on magnetic resonance imaging (MRI) 4.
• MRI scan is indicated to delineate the extent of brain lesions and to identify congenital brain malformations 4.

Types and Prevalence of Cerebral Palsy

• The prevalence of CP is about 1/500 births, and it is the most prevalent cause of persisting motor function impairment 5.
• The incidence of CP is 2-3 per 1,000 live births 4.
• There are different types of CP, including spastic, dyskinetic, and ataxic cerebral palsy 5.

Management and Treatment

• The management of CP involves neurological rehabilitation, addressing muscle tonal abnormalities, and devising physical and occupational therapies 3.
• It also involves diagnosis and management of co-morbidities, including epilepsy, impairment of cognition, vision, hearing, and disturbances of growth and gastrointestinal function 3.
• A multidisciplinary team approach is required for the management of CP, involving the treating physician working with a team of rehabilitation-, orthopedic-, psychologic-, and social care-providers 3.