Cerebral Palsy from Birth Injury

Cerebral palsy (or CP for its medical abbreviation) is one of the most common disorders that affects children in the United States. Each year, between 8,000 and 10,000 people are diagnosed with some form of the disorder. That accounts for around 800,000 people. 

Cerebral palsy is a complicated group of disorders, each with various types and many signs and symptoms ranging from mild to severe.  

Although it is a common disorder, parents, understandably, don’t want their child to develop cerebral palsy.  If your child already has it, or you suspect they might, it’s important to understand what the disorder is. That includes knowing what causes it, the signs to look for, and ultimately, the best treatment options.

What is Cerebral Palsy?

Cerebral palsy is an abnormal development of the brain that causes motor deficiencies. 

Therefore, there is an area of the brain that’s dormant or paralyzed.  This leads to either partial or complete muscle paralysis.  Brain damage usually happens before, during, or shortly after birth. Sadly, it can end up being a lifetime disability for the child.

Cerebral palsy is the most common motor disorder affecting children in the United States.  While that certainly sounds significant, most people don’t really know just how common the disorder is. They also don’t know the impact it has on families. Babies especially face an uphill battle. This is a condition that affects infants, children, and adults across the world.

Risk Factors

There are many risk factors that may contribute to developing cerebral palsy. Some of these include the following:

• Premature birth
• Low birth weight (primarily infants weighing less than 1,500 grams)
• Multiple births (twins, triplets, etc.)
• Fertility treatments
• Chorioamnionitis
• Maternal infections
• Uterine blood flow problems/placental insufficiency
• Traumatic head injury
• Oxygen deprivation (lack of oxygen)
• Hypoxia
• Bleeding in the brain (intracranial hemorrhage)
• Hyperbilirubinemia (kernicterus)
• Periventricular leukomalacia (PVL)

There may be other risk factors not on this list. To learn more about possible risk factors, talk to your doctor.

Types of CP

Cerebral palsy can manifest in many different ways.  Some children have more trouble with seizures than spasticity. Some children have intellectual disabilities and others do not.  Sometimes cerebral palsy is a term that includes a number of different movement- and brain-related disabilities. 

Those falling under this umbrella term include: 

Spastic CP

Spastic cerebral palsy is often diagnosed earlier than other forms of the disorder. This is because the symptoms appear faster.  Babies born with the spastic type of disorder experience stiff, rigid muscles.  This leads to awkward movements, muscle spasms and random muscle contractions. Spastic cerebral palsy includes:

Hemiparetic or Hemiplegic

Often developing from a stroke. This type occurs when a child experiences muscle stiffness or spasticity on one side of the body.  The child may have problems with one leg, or with an arm and a hand. They may also experience speech problems.  Children with this form of disability are also more prone to seizures than children with other types.

Diplegic

This type of spastic cerebral palsy is the first form of the disorder that was ever scientifically diagnosed and named. It is also referred to as spastic diplegia and Little’s Disease. This type of CP is marked by the child experiencing tense muscles and muscle spasticity, mainly from the lower muscle groups. The upper body is less affected or not at all.  The child might have difficulty walking because tight hip and leg muscles cause their legs to pull together, turn inward and cross at the knees.

Spastic Quadriplegia

Also referred to as tetraplegic CP, this is a form of disorder where the child experiences paralysis in all four limbs.  Children with this form of the disorder experience more difficulties meeting developmental milestones.  Some cannot reach certain milestones, such as crawling or walking.  Some children also experience an incredible amount of pain. This precludes them from wanting to learn how to walk. They are more likely to have associated impairments such as:

• Severe intellectual disability
• Communication problems
• Visual impairment
• Epilepsy
• Feeding difficulties
• Pulmonary disease

Dyskinetic CP

Involuntary Movements define dyskinetic cerebral palsy. These are especially noticeable when the person tries to move around. Unlike patients with spastic cerebral palsy, those with purely dyskinetic syndromes usually do not develop contractures unless they are positional. Sometimes, dyskinetic cerebral palsy is a name given to a form of brain injury originating from bilirubin encephalopathy or hypoxic-ischemic encephalopathy. Different types of dyskinetic cerebral palsy include:

Athetoid

The second most common form. Abnormal postures and movements due to poor muscle tone, movement control and coordination characterize this type of cp. The child is typically intellectually aware and feels trapped inside their body.  The child often drools and has a lack of control of oral muscles.  Likewise, they may have a lack of control with muscles all over the body that differ in tone (flabby or tight). Muscles may often contract involuntarily.

Choreoathetoid

This type is defined by involuntary twitching, which can be called choreiform. Other indicators of this are slow, writhing movements of the distal extremities.  Choreiform movements are unintentional and may be repetitive or jerky.  Athetosis is most apparent during reaching, as the fingers extend and abduct. Stress, excitement or fever may make the condition worse.

Hypotonic

Babies with this form of CP suffer from limbs that are floppy. They are often described as a “rag doll”.  They put up little resistance to parents moving limbs. Also, they generally don’t sit up or lift muscle groups at all. When they do sit up, they have a very hard time holding up their head. This is in contrast to hypertonic muscles, which make the joints and limbs very stiff and difficult to move.

Ataxic CP

Considered the rarest form, ataxic cerebral palsy only affects fine motor skills.  The child may have poor balance and coordination issues related to the inner ear. Therefore, they may have a speech impediment.  Generally, a child with ataxic cerebral palsy has a hard time doing anything from tying shoelaces to buttoning a shirt or using a pencil.  As the child tries to focus more on the finite skill, they may have tremors as the muscles work. With ataxic cerebral palsy, speech, which is related to intellectual ability, typically is slow, jerky and explosive.

Mixed CP

Mixed cerebral palsy occurs when the child has damage to different parts of the brain. Therefore, they have a combination of symptoms. These symptoms may resemble those of spastic, dyskinetic cerebral palsy or ataxic cerebral palsy, or any combination thereof. Symptoms of mixed cerebral palsy will depend on where the brain damage is and how severe it is. Movement-related symptoms may be limited to a single area of the body, such as the legs (diplegia), just one side of the body (hemiplegia) or in all four limbs (quadriplegia).

Mixed cerebral palsy is the second most common type of the disorder. Around 10-15% of all cases are mixed. These cases develop after brain damage – most commonly in the motor cortex, the pyramidal tracts, the basal ganglia or the cerebellum. It is important to remember that mixed cerebral palsy symptoms may be unique compared to other types of the disorder. Spastic athetoid and spastic ataxic symptoms are common, but symptoms are not limited to these areas.

Children with mixed types are generally diagnosed after three years of age. This is due to the complexity of brain damage and symptoms. Their care requires a multidisciplinary team that can address the complex nature of mixed symptoms. The primary focus of treatment for mixed cerebral palsy includes pain management, therapies, medications and possibly surgery.

Cerebral Palsy from Birth Injury

There are many cases of cerebral palsy that are caused by a physician’s failure to properly identify medical issues or take the correct actions during birth to reduce risks.  The most common reasons that it occurs because of medical negligence include a doctor, nurse or hospital’s failure to:

• Properly monitor and assess the fetal heartbeat during and after delivery.
• Schedule and provide a timely C-section.
• Detect and treat maternal infections.
• Properly use birth-assisting tools, such as forceps or a vacuum extraction tool.
• Correct umbilical cord problems, such as a cord prolapse.
• Supply oxygen in a timely manner.
• Monitor treatments for respiratory function and lack of oxygen.

Estimates suggest that thousands of cases of cerebral palsy each year occur as a result of medical negligence.  You should know your rights related to cerebral palsy from birth injury. Parents may be eligible for compensation if their child’s CP was preventable and/or was caused by medical negligence. A cerebral palsy lawyer can help you find out if you are eligible.

Can Cerebral Palsy That Was Caused by Medical Negligence Be Compensated?

You may be eligible for compensation if your child’s cerebral palsy was caused by medical negligence.  Before you file a birth injury compensation claim, make sure the following pertains to your case:

• Doctor/Patient Relationship: A doctor/patient relationship must be in place.  A doctor/patient relationship means that there was an agreement that the doctor would care for you during your pregnancy, including before and after delivery.  
• The Doctor Must Have Been Negligent: There must be clear proof that the doctor was negligent in causing your baby’s injuries.  That means identifying the standard of care and showing that the doctor violated it.  
• The Negligence Caused Cerebral Palsy: Once it’s been established that the doctor was negligent, there must be proof that your infant’s injury or condition was caused by the negligence. Generally, once the negligence has been established the proof of injury follows.

How Much Compensation is Available?

The amount of compensation you are eligible for will depend on a variety of factors, including:

• How severe the medical negligence was
• What type of CP the infant has (some types of CP are more severe than others)
• The state you live in
• The needs of your child now, and in the future

The amount of compensation may also depend on the type of damages.  There are two types of damages in birth injury lawsuits:

• Economic damages are damages that are easily quantifiable.  These include medical expenses, lost income, medications, therapy and any other factors that cause an economic loss because of the injury.
• Non-economic damages are damages like pain and suffering, loss of enjoyment of life, stress, and anxiety caused by the injury. Also, any other negative outcome because of the injury.

In some states, there is a non-economic damage cap, which limits how much plaintiffs can receive in a birth injury case.  This means that only a certain amount of compensation is allowed. Find out more by speaking with one of our cerebral palsy lawyers.

Cerebral Palsy Causes

The causes of cerebral palsy can vary greatly.  In some instances, the cause is unknown.  In others, the cause is due to a brain injury caused by medical negligence, a congenital disorder or a birth injury.  The best way to help your child manage their condition as successfully as possible is to understand the cause of their disorder.

Congenital Causes

It is considered congenital cerebral palsy when an infant develops it before or during childbirth.  Many parents question if their child was born with cerebral palsy, which can be difficult to answer. Congenital forms of the disorder develop before birth.  Per the Centers for Disease Control and Prevention (CDC), congenital cerebral palsy is the most common form of the disorder.  The most common causes being:

Maternal Infections

Infections during pregnancy increase cytokine protein production in the mother’s body. These proteins then circulate in the blood and travel to the baby’s blood and brain. Cytokines cause inflammation, fever and other complications that can be dangerous for the baby. Infections such as cytomegalovirus (CMV), chickenpox and rubella may increase the likelihood of cerebral palsy. Bacterial infections in the pelvic area, fetal membranes or placenta can also cause problems.

Twins or Multiple Births

A pregnancy with more than one baby increases the chances of cerebral palsy.  This is due to, in most cases, the infants each weighing less or being born prematurely. The risk of conditions like cerebral palsy increase if one of the fetuses dies while in the womb.

Low Birth Weight

Infants weighing less than five-and-a-half pounds are considered to have a low birth weight. The less an infant weighs at birth, the greater the changes that they will suffer complications or have medical conditions. Baby’s weighing less than five pounds are at an increased risk for cerebral palsy and other disorders.  Infants under three pounds have the highest risk. 

Infertility Treatments

Since many infants born after infertility treatments tend to be born prematurely with low birth weight, the risk for cerebral palsy increases. This is especially a risk factor if there are multiple fetuses.

Jaundice

There is a common misconception that jaundice is a minor medical issue that won’t pose any long-term medical problems. Jaundice is very common among newborns, and often resolves without any issues. However, if left untreated, jaundice can cause a host of serious problems, including kernicterus. Kernicterus is a type of brain damage that occurs when bilirubin enters brain tissue and causes damage. This brain damage can cause cerebral palsy.

Birth Problems

Uterine rupture, placental problems and umbilical cord problems can all lead to an increased risk of the infant developing cerebral palsy due to loss of blood flow and oxygen to the baby.

Chorioamnionitis

Chorioamnionitis is inflammation of the fetal membranes and amniotic fluid caused by a bacterial infection.  A study performed by San Diego’s University of California revealed that chorioamnionitis present in the womb during pregnancy increases the risk of an infant developing cerebral palsy by up to four times.

Incompatible Blood

Incompatibility of blood types between a mother and infant can lead to Rh-factor diseases, increasing the risk of cerebral palsy.  To prevent this problem, a mother who is Rh(-) blood type would be given a Rho(D) immune globulin injection starting at around the 28^th week of pregnancy.

Acquired Causes

Acquired cerebral palsy occurs when an infant develops brain damage at least 28 days or more after birth.  This type of cerebral palsy affects around 20 percent of all people who develop the disorder.  The most common causes include:

• Low Birth Weight: Similar to congenital factors, this also increases the risk of acquired CP.
• Blood Flow Problems: Blood flow problems, particularly to the brain, heighten the risk of acquired CP.  Common blood flow problems to brain can occur because of blood clotting, unformed blood vessels, sickle cell diseases and/or heart defects.
• Traumatic Head Injuries: Traumatic head injuries can happen when an infant is dropped.  If brain damage occurs after a traumatic brain injury, acquired CP may follow.

Brain Damage

Brain damage before, during or after birth can lead to cerebral palsy.  In the past, many physicians believed that the disorder was related to brain damage that occurred during birth because of asphyxiation.  This is partially true. At least one out of every 10 infants develop cerebral palsy after asphyxiation.  However, recent research shows that brain damage that occurs before birth can also lead to some types of the disorder. Brain damage that causes cerebral palsy can include stroke, bleeding in the brain, blood clotting problems, heart defects or diseases like sickle cell disease.

Can CP Be Prevented, And How?

Because there are many causes of cerebral palsy, prevention strategies may seem somewhat general.  Your doctor should advise you to follow all instructions during pregnancy, such as:

• Attend all prenatal visits
• Take regular walks (if applicable)
• Eat nutritious food
• Keep your vaccinations up to date
• Abstain from drugs or alcohol

Cerebral palsy may be caused by factors outside your control, such as birth injuries due to poor medical care. The best thing you can do to reduce the risk of your child developing the disorder is to take care of yourself during your pregnancy.

Cerebral Palsy Symptoms

One of the most common questions that parents ask is “what are the symptoms of cerebral palsy?” Cerebral palsy is marked by spastic movements, a lack of muscle control and sometimes the inability to use muscles.  CP is often determined by abnormal, slow, writhing movements that the child cannot control.  Additionally, muscle tone varies between floppy (low muscle tone) and stiff (high muscle tone), which also could result in the use of some muscles over others.  Other signs that your child may have cerebral palsy include missing developmental milestones and/or intellectual disabilities.

According to the CDC, some of the clinical symptoms and signs of cerebral palsy include:

Muscle Tone-Related Symptoms

Cerebral palsy is a brain injury that affects mobility and muscle tone.  Some areas of the brain are dormant and cause an abnormal reaction in the muscles from the messages that the brain sends out.  As a result, there are countless muscle-related symptoms associated with this disorder.  However, it’s important to remember that not all children will exhibit the same symptoms and the severity of each symptom will depend upon each individual child.

Common muscle tone-related symptoms include:

• Lack of muscle coordination.
• Shaky, spastic movements.
• Extremely stiff muscles or extremely loose muscles.
• Abnormal muscle movement and control.
• Difficulty in controlling certain body movements.
• Inability to grasp small objects.
• Using the arms to pull themselves around while the legs drag behind (most prominent after 6 months of age and into the toddler years).
• Slow, writhing movements.
• Excessive drooling due to the inability to control facial muscles.
• Favoring one side of the body over the other side.

Reflex-Related Symptoms

Children with cerebral palsy may have abnormal reflex responses.  These reflexes are defined as: 

• Tonic Neck Reflex: A reflex causing the infant’s head to turn to one side with the arm on that side outstretched, while the other arm is bent at the elbow.  This is sometimes called the “fencing position.” This reflex generally resolves around 5-7 months old.  
• Palmar Grasp Reflex: When the palm of the infant’s hand is stroked, the infant grasps his or her fingers around the object.  This is commonly seen in infants who grasp a family member’s finger.  This reflex generally resolves within 5-6 months.  
• Spinal Galant Reflex: The Spinal Galant reflex causes an infant to curve their hip outward when their lower back is stroked.  Generally, this reflex resolves by nine months, but it can last longer.  
• Moro Reflex: Moro reflexes may be present in some infants with CP.  The Moro reflex refers to a reaction where your infant’s head shifts abruptly and his or her arms and legs extend quickly when startled.  After extension, the infant brings his or her arms together and often cries loudly.  The Moro reflex generally resolves in two months or so after birth.   

Coordination and Control

Both coordination and control are limited in children who have cerebral palsy.  Problems with coordination and control are usually more pronounced when the child is stressed or overwhelmed. 

Common issues with coordination and control include:

• Spastic movements
• Walking with a wide gait
• Walking with toes pointed inward or outward
• Dragging one leg while walking
• Waddling when walking

Oral Motor Problems

Many people with cerebral palsy have trouble with communication because of the spastic movements of face muscles.  In fact, around 90 percent of preschool-age children with the disorder have difficult oral-motor problems, such as trouble speaking, excessive drooling and trouble chewing or swallowing.

Intellectual Symptoms

Cerebral palsy hardly ever involves only intellectual disabilities. The most common symptoms involve muscle-related disabilities.  Injuries to the developing brain can certainly cause intellectual disorders. If your child has muscle-related disabilities, there is a chance that they may also have intellectual disabilities as well.  It is important to understand the mental health element of your child’s condition. Typical types of intellectual disabilities or neurological disorders associated with cerebral palsy include:

• Missed Milestones: Perhaps one of the most significant indications of CP (as long as other symptoms are present) is missed developmental milestones.  For example, if a child hasn’t started talking by two years of age or doesn’t understand basic grammar such as “she” or “he” by the age of five, this may be an indication of CP.  Keep in mind, though, that children hit developmental milestones at different ages, so a delay in milestones alone isn’t always an indicator of a more serious problem.
• Below Average IQ: According to the American Academy of Pediatrics (AAP), children with an IQ below 70 are considered “below average” intellectually.  Again, having a below-average IQ score is not an indicator of CP unless other symptoms are also present.  Children with low IQs may have problems with daily self-care skills, reasoning, problem-solving and learning.

Behavioral Disabilities

Almost every child goes through behavioral stages, such as the “terrible twos,” being rebellious and being self-centered.  However, with a disorder like cerebral palsy, these behavioral issues may be heightened.  Children may have neurological disorders that make symptoms and behavioral control much more difficult. Studies suggest that many children with cerebral palsy will exhibit behavioral symptoms such as:

• Excessive anxiety
• Mood swings
• Social withdrawal
• Prolonged crying 
• Temper tantrums

Developmental Delays

Along with delays in cognitive abilities, developmental disabilities or delays, in general, are usually the first indicator that your child may have cerebral palsy or other neurological disorders.  The most common forms of developmental delays include:

• Failure to smile by six weeks of age.
• Not rolling over without assistance by four months of age.
• Not sitting up without assistance by six months of age (learn more what age babies sit up).
• Failure to walk by age two.
• Inability to climb stairs by three years of age.
• Failure to stand on one foot (for a few seconds) by three years of age.

How CP Affects Children

We’ve talked about the symptoms of cerebral palsy, but not exactly how the disorder affects children.  Parents often look for symptoms of an injury, but may not understand exactly how a disorder like CP affects their child and the numerous other children with a similar disorder.  Here are some of the ways that this disorder affects children: 

Ability to Walk

Due to the brain sending the wrong messages to muscle groups, walking is very difficult for many people with cerebral palsy.  According to the CDC, among children with cerebral palsy:

• Around 58 percent of children can walk independently.
• Three percent of children require mobility assistance devices.
• Around 30 percent of children have limited or no walking ability.
• Around 41 percent of children have limitations in their ability to crawl, run, walk or play.
• Thirty-one percent of children require special equipment like a walker or wheelchair.
• Black children are 1.7 times more likely to have limited or no ability to walk than white children.

Pain

No matter what type of cerebral palsy your child has, one thing that most sufferers have in common is pain.  Three out of every four patients with cerebral palsy report being in pain.  This could be due to spasticity. It may also be due to inconsistent muscle tone that causes a chain reaction of pain through other muscles.  Overcompensation, the inability to achieve a consistent gait and spinal problems are usually the cause of this pain.

Speech Difficulties

One out of every four people with cerebral palsy is unable to talk.  Children and adults alike often have the following difficulties:

• Gag reflex problems
• Problems with controlling the esophageal muscles
• Spinal problems that affect the position of esophageal muscles
• Excessive drooling

Speech therapy can often help children exercise these areas and hopefully gain control.  Unfortunately, some children never gain complete control and struggle with speech problems permanently.

Hearing Loss

Due to nerve damage, one out of every 10 people with cerebral palsy suffers from hearing loss.  Around one in every 50 people are completely deaf.

Sleep Disorders

One out of every five people with cerebral palsy has some variation of a sleep disorder.  Sometimes this is because spasticity keeps them awake. Other times, it is because of the pain that the individual is in.  In addition, abnormal muscle tone may affect the chest muscles, which in turn, makes it hard for some people to breathe deeply.

Behavioral and Emotional Problems

Children with cerebral palsy often have a number of special needs that require them to be home-bound or under constant supervision. One out of every four children with the disorder has behavioral problems or problems socializing with others.  Neurological disorders are extremely common among children with CP. The most common behavior-related neurological disorders include symptoms like:

• Emotional outbursts
• Anxiety
• Depression
• Poor social skills
• Poor decision-making skills
• The tendency to “blackout” when angered

Tests to Confirm Cerebral Palsy Diagnosis

As with most neurological disorders, early diagnosis of cerebral palsy begins with a detailed medical history and physical examination. It also involves standardized assessments of neurologic and motor development.  Your pediatrician will review the prenatal and birth history of your child, which can identify risk factors for cerebral palsy. They will also review birth assessment records and family history. 

During an assessment, your doctor will look for variances in muscle density (some muscles being too stiff and others being too floppy), coordination development, motor development, posture and growth. They will also look at signs of intellectual disability and accompanying impairments (vision, hearing, attention, behavior or cognitive).  Beyond the general assessment, your doctor will likely order one or more tests that can help confirm a diagnosis.  Some of the tests that your doctor may order include: 

PET Scan

One test that your doctor can perform is a PET scan.  A PET scan is a Positron Emission Tomography (PET) exam that uses radiation to produce 3-dimensional color images of the functional processes of the human body.  Tracking gamma rays, the PET scan observes communication between the brain and the rest of the body. 

EEG

An EEG is an Electroencephalogram – a test that identifies if there are any abnormalities in the brain waves or electrical activity in the brain. It is useful in evaluating severe hypoxic-ischemic injury.  The EEG exclusively tests brain activity to be sure that it’s working properly.  Sometimes when a child has CP there is a problem with the way that alpha, beta, delta and theta waves are transmitted in the brain. 

MRI

Magnetic Resonance Imaging (MRI) is a scan that can be conducted on the whole body. It produces a density-related image of the body.  When an MRI is used on the brain, it is generally to get an image of the brain to clearly see the cortical and white matter structures. They will look to see if there is a hemorrhage, inflammation or anything abnormal.  In the case of CP, doctors use MRIs to examine and detect appropriate myelination – a white, fatty substance that creates a cover around certain nerve fibers in the brain. 

Cognitive Assessments

Cognitive assessments and medical observations are also useful to help confirm a diagnosis.  Additionally, evaluations of the child’s mobility, speech and language, hearing, vision, gait, feeding and digestion are also useful to determine the extent of the disorder.

Keep in mind that sometimes a diagnosis of cerebral palsy takes time.  Depending on factors like malformations and congenital issues, diagnosis can take up to several years after a brain injury occurs.  Furthermore, there isn’t a single test that can completely confirm or completely exclude cerebral palsy.  Instead, a combination of factors and a series of tests, observations, assessments and evaluations are the best way to confirm a diagnosis.

CP Treatment

There is currently no cure for cerebral palsy. However, there are many treatment options that are successful in helping children live more productively and independently.  If you’re the parent of a child or infant with cerebral palsy, it’s important to understand treatment options in order to determine what will work best for your child.  

cerebral palsy is a complex disorder that ranges from mild to severe.  Treatment will depend upon your child’s individual circumstances.  Some of the most common treatment options include:

Physical Therapy

According to the American Physical Therapy Association, getting a child with cerebral palsy in physical therapy is one of the most important things you can do.  Physical therapy involves rehabilitating the child’s physical disabilities through a series of muscle training exercises.  

Since each child’s situation is different, a professional physical therapist will typically perform an assessment. Based on those findings, they will develop a physical therapy plan.  Common exercises included in physical therapy sessions include:

• Specialized strength exercises
• Therapeutic endurance exercises
• Stretching and joint mobilization training
• Balance and coordination practice

In some instances, children with cerebral palsy will have swimming therapy during their physical therapy sessions.  These therapy sessions should be done with careful assistance and caution. Therapy is extremely important as it allows children to utilize muscle groups and do therapeutic exercises they otherwise aren’t able to do.  For those who are unable to move without assistance, special computers may be available, as well as wheelchairs and braces.

Surgery

In some cases, surgery is an option to control pain, prevent deformities and improve mobility.  There are several different types of surgeries that are useful in treating symptoms.  The most common forms of surgery include:

Hearing Surgery

Hearing surgery treats ear blockages or infections. Many people with cerebral palsy are prone to these.  This type of surgery also helps treat nerve fiber damage to the inner ear. Nerve damage is also a common problem among children with the disorder.  Alongside surgery, hearing aids, sign language, computer visuals, lip cues and body gesture training are helpful to improve hearing function. 

Surgery for Medicinal Needs

Children who rely on medication for chronic pain may benefit from a surgical procedure to install a pump. A pump is a device that provides medicine continuously.  A Baclofen pump is the most common method. Baclofen is a muscle relaxer that is helpful for severe pain associated with CP.  

Orthopedic Surgery

Orthopedic surgery is the most common type of surgery for CP patients.  This type of surgery is the least invasive than other surgeries.  Most children undergo orthopedic surgery in their lower extremities (legs, ankles, feet).  However, depending on the type of disorder, some children benefit more from surgery on their upper extremities (arms, shoulders, upper back).

Vision Surgery

Vision surgery helps patients with CP have more control over eye movement.  Surgery can also help repair vision loss and/or impairment.  However, before surgery is offered physicians generally try eyeglasses or contacts first.  If the child’s vision is still poor, surgery may follow.  

Medications

Medications are meant to help cerebral palsy patients control pain and reduce complications.  As with other forms of treatment, the type of medication your child needs will depend on the type and severity of the disorder.  The most common types of medication for cerebral palsy include:

• Muscle Relaxants: Muscle relaxants like Valium and Baclofen promote muscle relaxation by reducing spasms and stiff muscles.  Most muscle relaxants are given orally.
• Seizure Medication: Seizures are a common problem for many people who have CP.  Anti-seizure medication like Depakene helps control seizures.  Anticonvulsant medications such as Trileptal and Lamictal are also useful.
• Anticholinergic Medication: For people who suffer from dystonic CP, anticholinergic medications like Robinal, may be prescribed.  These types of medications help those who drool often and have uncontrollable body movements.  

It’s important to note that many doctors feel that giving muscle relaxants to growing children is harmful. This is because the side effects may be more detrimental than the symptoms.  Some doctors, however, feel that the benefits that muscle relaxants give to children with CP outweigh side effects.  

Stem Cell Injections

Currently, researchers are exploring many experimental treatments to alleviate or cure cerebral palsy. One possibility is stem cell therapy.  In 2013 an 11-year-old boy from Detroit participated in a trial by the U.S. Food and Drug Administration (FDA) in which his cord blood stem cells were used to treat his CP.  His condition was so severe that he could not walk, talk or hold his head up for more than a few seconds.

According to reports, it took two rounds of stem cell injections between January and May of 2013 before he showed any sign of improvement.  However, after the second round of injections began, he was able to sit up on his own for the first time in his life.  His mother noted,

“It was incredible.  I never thought I would see it, honestly, and to see if for the split second or the couple seconds that it was happening, made my day, made my week, my month.  And then now, just a couple months later, you know, seeing him able to sit for minutes at a time, it’s incredible.  I never thought that I would see that.”

Though the stem cell injection treatment improved Drew’s ability to control some of his movements, it did not cure him. Stem cell therapy presents a promising treatment option for children. However, this treatment is still in its infancy and more research is needed. Currently, there are clinical trials of this therapy happening in Georgia and Texas.

Alternative and Complementary Treatments

Although most alternative and complementary treatments for cerebral palsy have not been approved by the FDA, numerous parents have seen positive results.  Keep in mind, however, that not all treatment options work the same for each person. If you want to learn more about natural and holistic ways to help your child, consider the following:

• Hyperbaric oxygen therapy
• Therapeutic electrical stimulation (TES)
• Alternative learning, such as conductive education
• Equestrian therapy
• Acupuncture
• Massage therapy
• Energy-channeling therapy

Prognosis

Many infants and children with cerebral palsy have a normal lifespan.  However, it’s important to note that the prognosis is different for each person depending on the severity of the disorder and any other medical conditions.  

Cerebral palsy is not a progressive condition and many children can lead productive and fulfilling lives. However, there are certain factors that parents should take into account when dealing with the prognosis and life expectancy of a child with a disorder that is so complex.  Understanding these factors will help parents reduce health risks and help their children maintain the best quality of life possible with their given situations:

Amount of Impairments and Disabilities

The more impairments and disabilities a child suffers from, the more likely the prognosis will be poor.  Yet, how bad each impairment is also plays a role in the prognosis.  For example, a child with severe seizures and acute cognitive impairment may have a more grim prognosis when compared to a child who only has occasional mild seizures and mild cognitive impairment.

Mobility Limitations

Another important aspect of a child’s prognosis is mobility issues.  The risk of other health-related issues heightens depending on how limited mobility is.  For instance, a child who has severe impairments, such as a quadriplegic, will have a different prognosis than a child who can walk without assistance.  Children with severe mobility impairments are often more likely to:

• Have physical and emotional health problems due to lack of exercise.  
• Get sick more often than others with less severe manifestations of the condition.  Since they are unable to exercise their muscles, their immune systems are weaker and they are more susceptible to infections and viral diseases.
• Suffer from pressure ulcers.  If left untreated, pressure ulcers can become life-threatening.

Feeding Problems

Children who are able to feed themselves are more likely to have a better prognosis than those who rely on others for nutrition.  Children who cannot feed themselves are more prone to problems like:

• Malnutrition
• Choking
• Lung inflammation
• Pneumonia

Visual Problems

Studies continue to assess whether vision problems affect the prognosis of children with CP.  Researchers and scientists are unsure whether the visual problems alone reduce life expectancy or if a brain injury that leads to vision impairment affects the prognosis at all.

Life Expectancy

If your child has cerebral palsy, you may have concerns about cerebral palsy life expectancy. That means, the average number of years that someone who has a medical disorder may live. The first thing you should know is that there is no set life expectancy for people who have CP. Life expectancy varies with each person depending on a variety of factors including:

• Lifestyle
• Co-morbid medical conditions
• Severity of the disorder
• Mobility limitations
• Intellectual disability
• Seizure disorders

Individuals with CP often have other medical conditions that affect their overall health and wellbeing. For example, around 40 percent of people who have CP also have intellectual disabilities. Many others have difficulty with speech or hearing, and others have difficulty swallowing or eating.

These are all factors that impact the individual’s overall health. They also impact the individual’s ability to communicate their needs and get help. However, with proper care, individuals with CP can live quality lives.

How to Optimize Your Child’s Prognosis

Even though problems related to cerebral palsy create many challenges for children, their families and caregivers, there are several ways to improve your child’s prognosis.  Keep in mind that not every case of CP is the same.  You and your child’s healthcare team must tailor a care plan around your child’s needs.  This requires everyone involved to be aware of the child’s physical and cognitive issues. Doctors must provide the necessary treatments and promptly address issues that require attention.  Setting goals is also an important factor in the success of your child’s comprehensive care plan. 

To optimize a prognosis, you and your child’s healthcare team should:

• Determine and consistently follow goals to treat your child’s physical disability.
• Start physical therapy and other forms of treatment as soon as possible to ensure positive results.
• Be mindful of any complications that may arise.  These complications can be life-threatening, but being observant and reporting them to your child’s physician can lessen their negative effects.

An effective life care plan for a child with cerebral palsy should include strategies for:

• Improving your child’s ability to move
• Instilling a sense of independence for your child as much as possible
• Encouraging self-care
• Encouraging your child to interact with others
• Cultivating and maximize learning skills
• Finding solutions to common health problems
• Learning about pain management and which methods work best for your child

Living with cerebral palsy takes adjustments, planning and patience.  It is important to remember that a diagnosis of cerebral palsy does not mean that the individual will not have a fulfilling life.  Yes, it is a challenging disorder.  However, there are options for therapy and treatments that can help overcome some challenges and promote a healthy and full life.

Page Medically Reviewed By Kim Langdon, M.D.

Kimberly Langdon, M.D. is a retired board-certified OB/GYN with 19 years of clinical experience. She currently works as a medical writer and featured healthcare expert. She is a regular medical reviewer for Birth Injury Guide.

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Written By Sam Uribe

Sam Uribe is a researcher and writer. She lends her expertise to the team at Birth Injury Guide to provide up-to-date and relevant content that clients can count on.