Cognitive palsy

Cognitive palsy (too called CP) is a group of conditions that affects the parts of your brain that control your muscles. This can cause issues with movement, posture (standing up straight) and residuum.

Some merely not all children with CP also may have other conditions, similar intellectual and developmental disabilities. These  are problems with how the brain works that can cause a person to accept trouble or delays in physical evolution, learning, communicating, taking intendance of himself or getting along with others.

About one in 300 children (less than ane percent) has CP. Most children are diagnosed by the fourth dimension they're ii years old.

CP is the near common crusade of movement problems in childhood. There are four kinds of CP that are based on the type of movement problems a child has.

What is spastic CP?

Spastic ways tight or strong muscles, or muscles that spasm (go tight). This is the virtually common kind of CP. Most four in v children (80 per centum) with CP have spastic CP. These children have strong muscles and may have awkward torso movements.

Signs and symptoms of spastic CP include:

  • Tight muscles that do non stretch
  • Trouble walking, crossing knees, having a scissor-like walk or walking on toes
  • Tight joints
  • Weak muscles or no move in a group of muscles

There are three kinds of spastic CP:

  1. Spastic diplegia. Children with this kind have muscle stiffness by and large in the legs. They may have trouble walking considering tight muscles in the hips and legs cause their legs to turn inwards and cross at the knees (as well called scissoring). These children may need a walker or leg braces to help them move from place to place.
  2. Spastic hemiplegia. This kind usually affects one side of the body. The arm and leg on the affected side may be shorter and thinner than the other side of the body. These children oftentimes walk later than others and may walk on tip-toe. Some have a curved spine (as well call scoliosis), seizures or speech problems.
  3. Spastic quadriplegia. This is the well-nigh serious kind of spastic cerebral palsy. It affects most of the torso, including all arms and legs, the torso (the body's midsection) and the face. These children usually can't walk and they often have intellectual disabilities, problem speaking and seizures.

Are there other kinds of CP?

Yes. Other kinds of CP include:

  • Dyskinetic CP (includes athetoid CP, choreoathetoid CP and dystonic CP). Children with this kind of CP have musculus tone that ranges from being too tight to too loose. This tin can cause uncontrolled movements that tin can exist dull and twisting or quick and jerky. Children with dyskinetic CP may have problems decision-making the movements of their hands, artillery, feet and legs. This makes it hard to sit down and walk. Some of these children also take problem speaking. Bug in their face up and tongue muscles may make them pout or drool.
  • Ataxic CP. This type of CP is rare. These children take bug with balance and coordination. They may exist unsteady when they walk. They also may take tremors (shaking muscles) when they make quick movements or movements that demand a lot of control, like writing.
  • Mixed CP. This is when a child shows symptoms of more than one type of CP. The nigh common type of mixed CP is spastic-dyskinetic CP.

How practice you know if your baby has CP?

CP can be different in each child. Some children accept mild CP. They may have some awkward body movements and demand little or no special help. Other children have more serious CP. They may need a lot of special intendance their whole lives. CP doesn't get worse over time, but its symptoms can change.

Some but non all babies with CP often have developmental delays. This ways your child doesn't attain developmental milestones when expected. A developmental milestone is a skill or activity that virtually children can exercise at a certain age. Milestones include sitting, walking, talking, having social skills and having thinking skills. Tell your kid's wellness care provider if yous notice any of these signs in your baby at these ages:

Younger than 6 months

  • His head falls back when you pick him upward from lying on his back.
  • He feels strong or floppy.
  • He seems to push away when y'all hold him.
  • His legs get stiff legs and cantankerous or "scissor" when you pick him up.

Older than 6 months

  • He doesn't roll over.
  • He can't bring his hands together.
  • He has trouble bringing his hands to his mouth.
  • He reaches with simply one hand while keeping his other hand in a fist.

Older than 10 months

  • He crawls by pushing off with one manus and one leg while dragging the other hand and leg.
  • He scoots around on his bottom or hops on his knees, just does not crawl on all fours.

Older than 1 year

  • He tin't crawl.
  • He tin't stand up with support.

If you remember your infant has developmental delays or other signs of CP, talk to her provider. Diagnosing CP usually happens in 3 steps.

  1. Developmental monitoring. Your baby's provider checks her growth and evolution over time. If your baby shows signs and symptoms of CP, her provider recommends developmental screening.
  2. Developmental screening. These tests cheque for developmental delays, similar problems with motility. The American Academy of Pediatrics recommends that all children accept developmental screening tests during their well-infant visits at nine months, eighteen months and 24 or xxx months.
  3. Developmental and medical evaluations. If results of your baby's screening tests aren't normal, your baby'due south provider recommends developmental and medical evaluations. These can exist done by your baby'southward provider or by a child neurologist. This is doctor with special training in treating brain conditions in babies and children.

Your baby's provider also may recommend these tests for your baby:

  • Blood tests
  • Computed tomography (also chosen CT scan). This test uses special X-rays to make a picture of your babe's encephalon.
  • Electroencephalogram (also chosen EEG). This test records electrical activity in your baby's brain. It can help diagnose epilepsy, which sometimes happens in children with CP. Epilepsy is a seizure disorder that affects how the nerve cells in your brain work.
  • Magnetic resonance imaging (also called MRI). MRI is a medical test that makes a detailed picture of the inside of your torso.
  • Ultrasound. This examination uses sound waves and a figurer screen to show a picture of your infant inside the womb.

How is CP treated?

You lot can work with a team of health intendance providers to effigy out your kid'south needs and come up with a treatment plan. Members of the squad can include:

  • Pediatrician. This is a medico who has special training to take intendance of babies and children.
  • Child neurologist. This is a md who has special training in treating brain weather condition in babies and children.
  • Social worker. This is a person with special training to aid people solve problems and make their lives better.
  • Psychologist. This is a person with special training to have care of people with emotional or mental health problems, like depression.
  • Orthopedic surgeon. This is a medico with special grooming do surgery on bones and muscles.
  • Physical therapist. This is a person with special training to create exercise programs for your child.
  • Occupational therapist. This is a person who tin teach your child how to do everyday things, like eating, getting dressed and writing.
  • Speech and linguistic communication pathologist. This professional can help your child speak more clearly or communicate in other means.
  • Special educational activity teacher. This person has special training to help your child with learning.

Your child's treatment plan may include special equipment to help with movement and getting around. These can include a walker, leg or arm braces, a wheelchair or scooter. He may also need a special computer to assist him communicate.

Your kid may need medicines to help relax muscle spasms, including:

  • Diazepam (Valium®), baclofen (Lioresal®), dantrolene (Dantrium®) and tizanidine (Zanaflex®). Your child takes these past mouth.
  • Baclofen, a medicine that your child gets through a pump placed nether his skin. The pump releases the medicine into the fluid that surrounds the spinal cord.
  • Botox® (besides called botulinum toxin). Your kid gets this through a needle.

If your child has severe spasms and medicines don't assistance, your baby'due south provider may recommend surgery called selective dorsal rhizotomy. This is when a surgeon cuts some of the nerves at the base of the spine. It may aid with musculus spasms and help your child sit down, stand, walk or move around more easily.

What wellness problems are mutual for people with CP?

People with CP may accept these health problems:

  • Constipation. This is when y'all have painful gas or it's hard to take a bowel move.
  • Drooling
  • Feeling hurting, particularly in adults. Pain is almost common in the hips, knees, ankles and back.
  • Problems urinating
  • Seizures
  • Throwing upward
  • Trouble breathing
  • Trouble swallowing, sucking or eating
  • Trouble talking, seeing or hearing

What causes CP?

CP happens when your baby has encephalon damage or at that place are problems in how your babe'due south encephalon develops. Near children with CP accept congenital CP. This means they have CP at birth. In many of these children, nosotros don't know what the exact cause of CP is.

Changes in genes that affect encephalon development may play a office in causing CP. Genes are a function of your trunk'due south cells that stores instructions for the way your body grows and works. Genes are passed from parents to children. A gene change (likewise called mutation) is a change to the instructions that are stored in a gene.

The brain harm that leads to CP can happen before birth, during labor and birth or after birth, while the encephalon is however developing. Your babe may be more probable than other babies to develop CP before nascency if:

  • You're pregnant with multiples (twins, triplets or more than). The more than babies you lot're significant with, the greater the gamble of CP.
  • You take sure infections during pregnancy. Infections that can lead to CP include chickenpox, rubella (too chosen German language measles), cytomegalovirus (likewise called CMV), toxoplasmosis, chorioamnionitis (an infection in the uterus) and infections in the placenta. The placenta grows in your uterus (womb) and supplies your baby with food and oxygen through the umbilical cord.
  • You have a health condition, similar seizures or a thyroid condition. The thyroid is a gland in your cervix that makes hormones that aid your body shop and use free energy from food.
  • Your blood and your babe'due south blood are incompatible (can't exist together). This puts your babe at chance of Rh affliction, which can cause serious problems — even decease — for your babe. You lot can become a claret examination during pregnancy to see if your blood and your baby's blood are incompatible.
  • Y'all come up in contact with a harmful substance, similar mercury. During pregnancy, don't swallow fish with high levels of mercury, similar swordfish, rex mackerel, shark and tilefish.
  • Your baby doesn't get enough oxygen in the womb. This can happen if the placenta isn't working properly or it tears away from the wall of the uterus before birth.
  • Your baby has bleeding in the brain. Sometimes a babe has a stroke in the womb that causes bleeding in her brain. Stroke happens when a claret clot (a mass or clump of blood) blocks a blood vessel that brings blood to the brain, or when a blood vessel in the brain bursts open up. Claret clots in the placenta, weak claret vessels and high blood pressure during pregnancy tin can crusade a baby to have a stroke in the womb.

Your babe may exist more likely than other babies to develop CP during labor and birth if:

  • He's in the breech position at the start of labor. This is when your baby's bottom or anxiety are facing down correct earlier birth.
  • He doesn't get plenty oxygen during labor and birth. This tin happen if in that location are bug with the umbilical cord or you have a health condition, like uterine rupture. Uterine rupture is when the uterus tears during labor. This happens very rarely.
  • He's born prematurely. This is when a baby is built-in too early, before 37 weeks of pregnancy.
  • He'southward born with low birthweight or he's built-in small for gestational historic period (also called SGA). Low birthweight means a baby weighs less than 5 pounds, viii ounces at nascence. SGA means a babe is smaller than normal based on the number of weeks he's been in the womb.

Babies who accept certain health weather after birth are more likely than others to develop CP. These weather condition include:

  • Severe jaundice, especially if it's not treated early. Jaundice is when your infant's eyes and skin look yellow. A baby has jaundice when her liver isn't fully developed or isn't working well. Some blood diseases, like Rh affliction, can cause severe jaundice and encephalon damage in babies.
  • Head injuries. A infant may get a head injury from being in a motorcar accident or falling and striking her head.
  • Brain infections, similar encephalitis and meningitis. Encephalitis is swelling of the brain; it's usually caused past a virus. Meningitis is an infection that causes swelling in the brain and spinal cord.
  • Seizures


Final reviewed: July, 2014