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Cerebral palsy is a group of disorders involving movement, learning, hearing, seeing, and thinking that occur due to problems with brain development.

Spastic paralysis; Paralysis - spastic

Cerebral palsy is caused by injuries or abnormalities of the brain. Most of these problems occur as the baby grows in the womb, but they can happen at any time during the first 2 years of life, while the baby's brain is still developing.

In some people with cerebral palsy, parts of the brain are injured due to low levels of oxygen (hypoxia) in the area. It is not known why this occurs.

Trauma and low oxygen levels during birth (birth asphyxia) is an uncommon cause of cerebral palsy.

Premature infants have a slightly higher risk of developing cerebral palsy. Cerebral palsy may also occur during early infancy as a result of several conditions, including:

• Bleeding in the brain
• Brain infections (encephalitis, meningitis, herpes simplex infections)
• Head injury
• Infections in the mother during pregnancy (rubella)
• Severe jaundice

Types of cerebral palsy include:

• Spastic cerebral palsy is the most common type.
• Dyskinetic (athetoid) cerebral palsy involves abnormal movements (twisting, jerking, or other movements).
• Ataxic cerebral palsy involves tremors, unsteady gait, loss of coordination, and abnormal movements.
• Hypotonic cerebral palsy involves floppy muscles, especially at rest, and increased range of motion in the joints.
• Mixed cerebral palsy involves any combination of symptoms.

Injury to the largest part of the brain (cerebrum) can lead to the loss of nerve functions in different areas. Many children with this condition have increased muscle tone (spasticity). Spasticity may affect:

• One arm or leg
• One side of the body (spastic hemiplegia)
• Both legs (spastic diplegia)
• Both arms and legs (spastic quadriplegia)

Symptoms are usually seen before age 2. In severe cases, they may appear as early as 3 months.

Symptoms may include:

• Abnormal movements
• Abnormal sensations
• Abnormal muscle tone
• Decreased intelligence
• Difficulty sucking or feeding in infants
• Hearing problems
• Increased drooling
• Irregular breathing
• Learning disabilities
• Limited range of motion
• Pain
• Partial or full loss of movement (paralysis)
• Peg teeth
• Problems swallowing (at all ages)
• Seizures
• Speech problems (dysarthria)
• Urinary incontinence
• Vision problems
• Vomiting or constipation

A doctor's examination may reveal:

• Abnormal walk (gait), with a tendency to tuck the arms in toward the sides, make "scissors" movements of the legs, and walk on the toes
• Abnormal slow, writhing movements that get worse with stress and don't occur during sleep
• Delayed development of motor skills (reaching, sitting rolling, crawling, walking)
• Infant reflexes (such as sucking and startle) that continue past the age where they usually disappear
• Joint contractures
• Muscle contractions
• Muscles that do not stretch (spasticity)
• Muscle tremors
• Muscle weakness

The following tests may be performed:

• Blood tests
• CT scan of the head
• Electroencephalogram (EEG)
• Hearing screen
• MRI of the head
• Vision testing

For organizations that provide support and additional information, see cerebral palsy resources.

Cerebral palsy is a lifelong disorder. Long-term care may be required. The disorder does not affect expected length of life. The extent of disability varies.

• Bone thinning
• Bowel obstruction
• Hip dislocation and arthritis in the hip joint
• Injuries from falls
• Joint contractures
• Pneumonia caused by choking
• Poor nutrition
• Reduced communication skills (sometimes)
• Reduced intellect (sometimes)
• Scoliosis
• Seizures (in about half of patients)
• Social stigma

Call your health care provider if symptoms of cerebral palsy develop, especially if you know that an injury occurred during birth or early infancy.

Getting the proper prenatal care may reduce the risk of some rare causes of cerebral palsy. However, dramatic improvements in care over the last 15 years have not reduced the rate of cerebral palsy. In most cases, the injury causing the disorder may not be preventable.

Pregnant mothers with certain medical conditions may need to be followed in a high-risk prenatal clinic.

Krigger KW. Cerebral palsy: an overview. Am Fam Physician. 2006;73:91-100.

Johnston MV. Encephalopathies. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 598.

Whelan MA. Practice parameter: diagnostic assessment of the child with cerebral palsy: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology. 2004;63:1985-1986.