Neurologic Care for Adults with Cerebral Palsy
Yes, adults with cerebral palsy should establish care with a neurologist, as they face increased risk of new neurologic conditions—including stroke, myelopathy, and premature motor decline—that require ongoing surveillance to distinguish from baseline motor impairments. 1
Why Neurologic Care Is Essential
Adults with CP are not simply "grown-up children" with a static condition. The neurologic injury itself is non-progressive, but adults with CP commonly develop new complications as they age 2:
- New neurologic conditions such as stroke and myelopathy require ongoing neurologic surveillance to distinguish them from baseline motor impairments 1
- Premature motor function decline, chronic pain, and chronic fatigue are commonly experienced and may have neurologic contributors 1
- Severe pain, chronic fatigue, and premature decline in mobility develop as musculoskeletal and neurological symptoms emerge with aging 2
The Gap in Adult Care
Most CP care and research efforts focus on children, yet most people with CP are adults 1. Young adults transitioning from pediatric to adult care face significant barriers 3:
- Perceived lack of provider expertise and comfort in adult care settings managing CP 3
- Feeling "rudderless" navigating the logistics of transition from established pediatric relationships 3
- Differences in pediatric versus adult models of care create uncertainty 3
What Neurologic Surveillance Should Include
Based on systematic review, adults with CP require 1:
- Monitoring for new neurologic conditions that present differently from baseline motor impairments
- Evaluation of motor function decline to determine if neurologic factors beyond musculoskeletal aging are contributing
- Assessment of chronic pain and fatigue for potential neurologic etiologies
- Screening for stroke risk, given the increased incidence in this population 1
Multidisciplinary Coordination
While neurologic care is essential, it should coordinate with other specialists 4:
- Primary care physicians provide overall medical management 4
- Rehabilitation medicine specialists address functional decline and spasticity management 5, 4
- Orthopedic specialists manage musculoskeletal complications 4
- Rehabilitation therapists implement neuroplasticity-based interventions 4
The focus has shifted toward neurological rehabilitation that capitalizes on the brain's capacity to change and adapt throughout the patient's life, not just in childhood 4.
Common Pitfalls to Avoid
- Do not assume CP is a static condition in adulthood—new neurologic complications require active surveillance 1
- Do not attribute all new symptoms to "expected aging" with CP—distinguish new neurologic conditions from baseline impairments 1
- Do not leave adults with CP without neurologic follow-up after pediatric transition—the perceived lack of adult provider expertise creates dangerous care gaps 3
- Do not focus solely on musculoskeletal management—neurologic factors contribute to pain, fatigue, and functional decline 1
The Bottom Line
As life expectancy for individuals with CP approaches that of the general population, therapies and surveillance strategies must address the needs of adults aging with disability 4. Establishing neurologic care is not optional—it is necessary to detect and manage the evolving neurologic risks that distinguish adults with CP from their pediatric counterparts 1.