Cerebral Palsy in Children

Dr. Parang Mehta, MD.

Cerebral palsy is a broad term.  It includes a group of disorders that affect muscle control.  Most cerebral palsy results from some damage to the developing brain.

Cerebral palsy is classified as an encephalopathy -- a disorder of the brain.  Though it is one term, cerebral palsy varies hugely from person to person.  While one child with cerebral palsy may have only some clumsiness, another may have rigidity or flaccidity of all the limbs, with a significantly limited life.

Many children with cerebral palsy have normal intelligence and perform well academically.

Many people equate cerebral palsy with mental retardation, but the two are different entities, and do not always coexist.  Some children with cerebral palsy have mental retardation.  However, many children with significant physical handicap due to cerebral palsy are intellectually normal, and excel in academics.

The Child With Cerebral Palsy

Cerebral palsy is a broad group of disorders, and the children affected vary in their manifestations.  Depending on the manifestations, cerebral palsy is classified into four types (see sidebar).  Even within these types, the degree of affection varies from barely noticeable to severe handicap.

The manifestations of cerebral palsy vary with the type and severity.  Children with the spastic type have stiff limbs, and often walk on their toes.  Diaper changing is difficult because of the stiff thighs, and when they crawl, they do so using only the hands -- the legs are simply dragged.  When held up by two hands at the armpits, the legs are held crossed over -- the well known "scissoring" sign.

Children with hemiplegia have weakness on one side of the body, and a marked preference for one hand very early in life.  Children with the hypotonic type of cerebral palsy are limp to hold.  The athetoid type of cerebral palsy comes to notice because of the abnormal movements and postures.

Many children with cerebral palsy have feeding difficulties in the early months, because of poor coordination of muscles of sucking and swallowing.  Speech is often slurred and unclear because of similar reasons.  About a quarter of children with cerebral palsy develop seizures (fits) in the first 2 years of life.  

Problems Associated With Cerebral Palsy

Cerebral palsy is often associated with other problems.  It is probable that the same factors that caused cerebral palsy also gave rise to these accompaniments.

Types of Cerebral Palsy

Spastic Cerebral Palsy: This is the most frequently occurring type.  The muscles are in spasm -- they are rigid.  Though the muscles are in contraction, the child has no strength in his limbs, because the control over the muscles is lost.
Diplegia:  affection of both lower limbs.
Quadriplegia:  affection of all four limbs.
Hemiplegia:  affection of an arm and a leg on the same side.  

Dyskinetic Cerebral Palsy/ Athetoid Cerebral Palsy: : These children have bizarre twisting motions of the limbs and trunk, with unusual posturing of the body.

Mixed Cerebral Palsy: This type is a combination of the spastic and dyskinetic types of cerebral palsy.

Hypotonic Cerebral Palsy: When first diagnosed, these children have limp/flaccid limbs.  Over some years, these children often develop spasticity or athetosis.  This type of cerebral palsy is most likely to be associated with mental retardation.

Causes of Cerebral Palsy

The developing brain can be damaged by many things. Some of them:

 

Last Revision: May 22, 2020