Help Line : +23481 7097 3349

Cerebral Palsy 101

Brief history Of Cerebral Palsy

The medical profession did not begin to study cerebral palsy as a distinct medical condition until 1861. That year, an English orthopaedic surgeon, Dr William John Little, published the first paper describing the neurological problems of children with spastic diplegia a condition which is still sometimes called Little's Disease. This was a disorder that struck children in the first years of life, characterized by stiff, spastic muscles in their arms and legs. These children had difficulty grasping objects, crawling, and walking. Later on, they neither showed signs of improvement with age, nor did their condition become any worse.

The term cerebral palsy came into use in the late 1800's. Sir William Osler, a British medical doctor, is believed to have coined the term. Dr Sigmund Freud, the Austrian neurologist better known for his work in psychiatry, published some of the earliest medical papers on cerebral palsy.

In the past few decades, information on the many facets of cerebral palsy has significantly increased and today, the medical community has great interest in studying cerebral palsy to determine its causes and the most effective ways to treat it. As knowledge and treatment techniques have expanded and improved, so too have the prospects of all children living with cerebral palsy.


Cerebral Palsy is a term used to describe a group of chronic conditions affecting body movements and muscle coordination. It is caused by damage to one or more specific areas of the brain, usually occurring during foetal development, or during infancy. It can also occur before, during or shortly after birth.

"Cerebral" refers to the brain and "Palsy" to a disorder of movement or posture. If someone has cerebral palsy it means that because of an injury to their brain (cerebral) they are not able to use some of the muscles in their body in the normal way (palsy). This explains why children with cerebral palsy may not be able to walk, talk, eat or play in the same ways as most other children.

Cerebral palsy is neither progressive nor communicable. It is also not "curable" in the accepted sense, although education, therapy and applied technology can help persons with cerebral palsy lead productive lives.

It is important to know that cerebral palsy is not a disease or illness. It isn't contagious and it doesn't get

worse. Children who have cerebral palsy will have it all their lives.

Types of Cerebral Palsy

Cerebral palsy is a broad term which encompasses many different disorders of movement and posture. To describe particular types of movement disorders covered by the term, paediatricians, neurologists, and therapists use several classification systems and many labels. To understand the different types of cerebral palsy more clearly, one must first understand what professionals mean by muscle tone.

All children with cerebral palsy have damage to the area of the brain that controls muscle tone. As a result, they may have increased muscle tone, reduced muscle tone, or a combination of the two (fluctuating tone). Consequently, the parts of their bodies are affected by the abnormal muscle tone depends upon where the brain damage occurs.

The three main types of cerebral palsy are:

  • Spastic Cerebral Palsy -(stiff and difficult movement)
  • Athetoid Cerebral Palsy - (involuntary and uncontrolled movement)
  • Ataxic Cerebral Palsy - (disturbed sense of balance and depth perception)

It is possible that there may be a combination of these types for any one person. In which case the condition would be described as; Mixed Cerebral Palsy

Cerebral Palsy Statistics

Because cerebral palsy influences the way children develop, it is known as a developmental disability. In the United States today, more people have cerebral palsy than any other developmental disability, including Down syndrome, epilepsy, and autism. About two children out of every thousand born have some type of cerebral palsy. Studies have shown that at least 5000 infants and toddlers and 1,200 - 1,500 pre-schoolers are diagnosed with cerebral palsy each year.

In all, approximately 500,000 people in the United Stateshave some degree of cerebral palsy. There is still no system in place to monitoring cerebral palsy's occurrence. Therefore it is not known whether the incidence of cerebral palsy is increasing, declining, or staying the same. However, studies have shown that the use of the electronic foetal heart rate monitor during labour and delivery has not decreased the rate of cerebral palsy primarily because of the mistakes made by doctors and nurses during the birthing process.

Though children with very mild cerebral palsy occasionally recover by the time they are school-aged, cerebral palsy is usually a lifelong disability. In most cases, the movement and other problems associated with cerebral palsy affect what a child is able to learn and do to varying degrees throughout their life.

Diagnosis of Cerebral Palsy

When an infant or child has brain damage, a variety of symptoms can lead doctors and parents to suspect that something is wrong. In the first few months of life, an infant with brain damage may demonstrate some or all of the following symptoms:

  • Lethargy or lack of alertness
  • Irritability or fussiness
  • Abnormal, high-pitched cry
  • Trembling of the arms and legs
  • Poor feeding abilities secondary to problems of sucking and swallowing
  • Low muscle tone
  • Abnormal posture, such as the child favoring one side of their body
  • Seizures, staring spells, eye fluttering, body twitching
  • Abnormal reflexes.

During the first six months of life, other signs of brain injury may also appear in an infant's muscle tone and posture. These signs include:

  • Gradual change in muscle tone from low tone to high tone; a baby may go from floppy to very stiff.
  • The child may hold his or her hand in tight fists.
  • There may be asymmetries of movement, that is, one side of the body may move more easily and freely than the other side.
  • The infant may feed poorly, with their tongue forcefully pushing food out of their mouth.

Once a baby with brain damage reaches six months, it usually becomes quite apparent that he or she is picking up movement skills slower than normal. Infants with cerebral palsy are more often slow to reach certain developmental milestones, such as rolling over, sitting up, crawling, walking and talking. Parents are more likely to notice these developmental delays and abnormal behaviours, especially if this is not their first child. Sometimes when they express their concerns to their physicians, their child is immediately diagnosed as having cerebral palsy. More often, however, medical professionals hesitate to use the term "cerebral palsy"at first. Instead, they may use such broader terms as:

  • Developmental delay, which means that a child is slower than normal to develop movement skills such as rolling over and sitting up
  • Neuromotor dysfunction, or delay in the maturation of the nervous system
  • Motor disability, indicating a long term movement problem
  • Central nervous system dysfunction, which is a general term to indicate the brain's improper functioning
  • Static encephalopathy, meaning abnormal brain function that is not getting worse.

What this all means is that a cerebral palsy diagnosis is not made over night. Rather, the condition is diagnosed by a complete examination of your child's current health status. Doctors will test motor skills and look carefully at his or her medical history. They will also look for slow development, abnormal muscle tone, and unusual posture. When diagnosing cerebral palsy, doctors must rule out other disorders that can cause abnormal movements.

Cerebral palsy does not get worse, in other words, it is not progressive. Based on this fact, doctors must make the determination that your child's condition is not progressively getting worse. Doctors will also use a number of different specialized tests in diagnosing cerebral palsy. For example, the doctor may order a CT (computed tomography). This is an imaging of the brain that can determine underdeveloped areas of brain tissue.

Your doctor may also order an MRI (magnetic resonance imaging). This test also generates a picture of the brain to determine areas that may be damaged. In addition to these imaging tests, intelligence testing is also used. This helps to determine if a child is behind from a mental standpoint. In addition to diagnosing cerebral palsy through a complete and thorough examination of the child's abnormalities and behaviours, a review of the mother's pregnancy, labour and delivery and care received is also conducted.

Jerald Chan