What is cerebral palsy?

Cerebral is another word for the brain. Palsy means a complete or partial loss of the ability to move a body part.

Cerebral palsy is not a disease or an illness. It is the description of a physical impairment that affects movement. The movement problems vary from barely noticeable to extremely severe. No two people with cerebral palsy are the same; it is as individual as people themselves.

What are the main types of cerebral palsy?

Cerebral palsy is classified into four main types - spastic, athetoid, ataxic and mixed. The type of cerebral palsy that occurs depends on the exact part of the brain that is affected.

Spastic cerebral palsy

This type of cerebral palsy occurs in about 7 in 10 cases. Spastic means that the affected muscles are more stiff than normal. The degree of spasticity in an affected arm or leg can vary greatly from case to case. Movements of an affected arm or leg are stiff and jerky. Some muscles may become permanently contracted.

There are different words that are used to describe the type of types of spastic cerebral palsy. For example:

Hemiplegia - means that the leg and arm of one side of the body are affected

Diplegia - means that both legs are affected. Arms are not affected or are only mildly affected.

Quadriplegia - means that both arms and legs are affected. Arms are equally or more affected than legs.

Athetoid or dyskinetic cerebral palsy

This type occurs in about 2 in 10 cases. Some people with this type of cerebral palsy have slow, writhing movements of the hands, arms, feet or legs. Some people have sudden muscle spasms. The movements cannot be controlled and so are 'involuntary'. Sometimes the tongue or face muscles are affected. The tone (stiffness) of the muscles can vary from too high to too low. As a result of these problems, people with athetoid cerebral palsy have difficulty in staying or sitting in one position and in using their arms or hands properly, for example, to hold objects.

Ataxic cerebral palsy

This type occurs in less than 1 in 10 cases. People with with ataxic cerebral palsy have difficulties with balance and fine movement. So, this can mean loss of balance and being unsteady when walking, and difficulty with doing fine tasks with their hands such as writing. The muscle tone is usually decreased.

Mixed cerebral palsy

People with mixed cerebral palsy have a combination of two or three of the above types. It is most often a combination of spastic and athetoid cerebral palsy, which results in stiff muscle tone plus involuntary movements.

How does it happen?

Cerebral palsy is most commonly the result of failure of a part of the brain to develop, either before birth or in early childhood. This is sometimes because of a blocked blood vessel, complications in labour, extreme prematurity or illness just after birth. Infections during pregnancy, or infancy and early childhood, e.g. meningitis or encephalitis, can also be causes. Occasionally it is due to an inherited disorder; in such cases genetic counselling may be helpful.

It is sometimes possible to identify the cause of cerebral palsy, but not always.

How serious is cerebral palsy?

Cerebral palsy can range in severity from mild to severe.

The main effect is difficulty in movement. Many people are hardly affected, others have problems walking, feeding, talking or using their hands. Some people are unable to sit up without support and need constant enabling.

Sometimes other parts of the brain are also affected, resulting in sight, hearing, perception and learning difficulties. Between a quarter and a third of children and adolescents, and about a tenth of adults, are also affected by epilepsy.

People often have difficulty controlling their movement and facial expressions. This does not necessarily mean that their mental abilities are in any way impaired. Some are of higher than average intelligence, other people have moderate or severe learning difficulties. Most, like most people without cerebal palsy, are of average intelligence.

Every case of cerebral palsy is different, and every case needs fully assessing by a specialist team.

Is there a cure?

No, but we do know that correct treatment from an early age can ease the effects of cerebral palsy. Occasionally children who appear to have cerebral palsy lose the signs as they get older. Most importantly, having a disability does not mean that someone cannot lead a full and independent life.

How prevalent is cerebral palsy?

Improvements in maternity services and neonatal care have meant that fewer babies develop cerebral palsy as a result of lack of oxygen (from difficulties at birth) or jaundice, but they have also meant that more babies with very low birth weights survive. These babies are more likely to have cerebral palsy.

In recent years there has been a slight increase in the proportion of children who have cerebral palsy; currently about one in every 400 is affected.

A wealth of valuable information can be found at www.scope.org.uk