Cerebral palsy is a group of conditions that can affect children through their movement, coordination, muscles and other body functions.

Overview

What is cerebral palsy?

Cerebral palsy affects muscle tone, coordination, movement and motor skills. It is the name given to a group of conditions that can affect children in different ways and is currently irreversible. Body functions that can be affected include breathing, bladder and bowel control, eating and speech. The impact of cerebral palsy on children can vary from mild to severe and the problems a child may experience will depend on which part of the brain has been damaged.

Cause

The cause of cerebral palsy is brain damage, and this can be before, during or after a baby’s birth. It may be that the baby has a reduced oxygen supply to their brain, or an infection caught by the mother during pregnancy is passed on to the baby.

If a child is born prematurely, there is a higher chance of cerebral palsy.

Diagnosis

It may be difficult to diagnose cerebral palsy soon after birth, so doctors may look at any early development delays such as when a child is able to reach for toys by four months or sit up by seven months.

Brain scans, such as an MRI, may also be used to look for any damage to suggest cerebral palsy.

There is a Gross Motor Functional Classification System that will describe the severity of a child’s motor problems, on a scale of one to five, with five being the most severe. Doctors will use this system to determine the best treatment.

Treatment

Multi-disciplinary approach

As cerebral palsy can affect so many different parts of the body, children are often seen by a team of doctors and nurses. This multidisciplinary approach allows us to treat various parts of the condition and different symptoms. Furthermore, as a child develops and gets older, the care and treatment they need may change.

Orthopaedic treatment

As cerebral palsy can affect muscles and movement, there is nearly always some involvement with orthopaedics. We meet with children and their families to understand how cerebral palsy affects them and to find ways we can provide treatment. This may be to help with the following:

• Muscle tightness
• Joint pain
• Balance and coordination

Botox injections

These provide a temporary reduction in increased tone to allow more stretching of muscles and tendons.

Surgery

There are a number of different surgeries that may be carried out, which may be one of the following:

• Muscle or tendon lengthening: this can relieve tightness in muscles, allowing children to grasp objects or have improved fine motor skills. It can also allow children to straighten their knees and walk more on their feet and less on their toes
• Tendon transfer: tendons can be cut and moved to the ankles or knees to relieve walking problems or in the wrists, to improve flexibility.
• Selective Dorsal Rhizotomy: for children with spastic cerebral palsy, this can reduce the muscle stiffness that they may have. It involves cutting certain sensory nerves inside the spine at the lower back. These nerves are responsible for muscle stiffness and can improve mobility

Helpful resources

• NHS: cerebral palsy
• NHS England: Selective Dorsal Rhizotomy