11 Things to Know about Cerebral Palsy


Cerebral palsy (CP) is the most common motor disability in childhood, and children with CP and their families need support. Learn more about CP and what signs to look for in young children.

  1. Cerebral palsy (CP) is a group of disorders that affect a person’s ability to move and maintain balance and posture.
  2. CP is the most common motor disability of childhood. About 1 in 345 children has been identified with CP according to estimates from CDC’s Autism and Developmental Disabilities Monitoring (ADDM) Network.
  3. CP is more common among boys than girls, and more common among black children than among white children.
  4. Most (about 75%-85%) children with CP have spastic CP. This means that their muscles are stiff, and as a result, their movements can be awkward.
  5. Over half (about 50%-60%) of children with CP can walk independently.
  6. Young girl with cerebral palsy
  7. About 1 in 10 children identified with CP walk using a hand-held mobility device.Many children with CP have one or more additional conditions or diseases along with their CP, known as co-occurring conditions. For example, about 4 in 10 children with CP also have epilepsy and about 1 in 10 have autism spectrum disorder.
  8. Most CP is related to brain damage that happened before or during birth and it is called congenital CP. The following factors can increase the risk for congenital CP:
  9. A small percentage of CP is caused by brain damage that happens more than 28 days after birth. This is called acquired CP. The following factors can increase the risk for acquired CP:
    • Having a brain infection, such as meningitis
    • Suffering a serious head injury
  10. The specific cause of CP in most children is unknown.
  11. CP is typically diagnosed during the first or second year after birth. If a child’s symptoms are mild, it is sometimes difficult to make a diagnosis until the child is a few years older.
  12. With the appropriate services and support, children and adults with CP can stay well, active, and a part of the community. Read the stories of children, adults, and families living with CP.

Early Signs of CP

From birth to 5 years of age, a child should reach movement goals―also known as milestones―such as rolling over, sitting up, standing, and walking. A delay in reaching these movement milestones could be a sign of CP. It is important to note that some children without CP also might have some of these signs. The following are some other signs of possible CP.

In a baby 3 to 6 months of age:

  • Head falls back when picked up while lying on back
  • Feels stiff
  • Feels floppy
  • Seems to overextend back and neck when cradled in someone’s arms
  • Legs get stiff and cross or scissor when picked up

In a baby older than 6 months of age:

  • Doesn’t roll over in either direction
  • Cannot bring hands together
  • Has difficulty bringing hands to mouth
  • Reaches out with only one hand while keeping the other fisted

In a baby older than 10 months of age: 

  • Crawls in a lopsided manner, pushing off with one hand and leg while dragging the opposite hand and leg
  • Scoots around on buttocks or hops on knees, but does not crawl on all fours

Mediators of the association between pre-eclampsia and cerebral palsy: population based cohort study.


Abstract

Objective To test the hypothesis that pre-eclampsia is a risk factor for cerebral palsy mediated through preterm birth and being born small for gestational age.

Design Population based cohort study.

Setting Clinical data from the Norwegian Cerebral Palsy Registry were linked with perinatal data prospectively recorded by the Medical Birth Registry of Norway.

Participants All singleton babies who survived the neonatal period during 1996-2006 (849 children with cerebral palsy and 616 658 control children).

Main outcome measures Cerebral palsy and cerebral palsy subtypes.

Results Children exposed to pre-eclampsia had an excess risk of cerebral palsy (unadjusted odds ratio 2.5, 95% confidence interval 2.0 to 3.2) compared with unexposed children. Among children born at term (≥37 weeks), exposure to pre-eclampsia was not associated with an excess risk of cerebral palsy in babies not born small for gestational age (1.2, 0.7 to 2.0), whereas children exposed to pre-eclampsia and born small for gestational age had a significantly increased risk of cerebral palsy (3.2, 1.5 to 6.7). Non-small for gestational age babies born very preterm (<32 weeks) and exposed to pre-eclampsia had a reduced risk of cerebral palsy compared with unexposed children born at the same gestational age (0.5, 0.3 to 0.8), although the risk was not statistically significantly reduced among children exposed to pre-eclampsia and born small for gestational age (0.7, 0.4 to 1.3). Exposure to pre-eclampsia was not associated with a specific cerebral palsy subtype.

Conclusions Exposure to pre-eclampsia was associated with an increased risk of cerebral palsy, and this association was mediated through the children being born preterm or small for gestational age, or both. Among children born at term, pre-eclampsia was a risk factor for cerebral palsy only when the children were small for gestational age.

Discussion

In this study we found that pre-eclampsia was associated with an increased risk of cerebral palsy and that the excess risk was mainly mediated through preterm birth, but also through being born small for gestational age. Exposed children born at term as non-small for gestational age did not have an excess risk of cerebral palsy and we did not find that a specific cerebral palsy subtype was more common in children exposed to pre-eclampsia than not exposed. Thus we were not able to find evidence for a direct effect of pre-eclampsia on the risk of cerebral palsy.

What is already known on this topic

  • Pre-eclampsia is a frequent cause of preterm birth and being born small for gestational age, both of which are known risk factors for cerebral palsy
  • Observational studies have shown conflicting results with respect to whether pre-eclampsia is a risk factor for cerebral palsy
  • Pre-eclampsia is a risk factor for cerebral palsy mainly mediated through preterm birth and being small for gestational age
  • Among term born children exposed to pre-eclampsia only those born small for gestational age had an excess risk of cerebral palsy
  • Pre-eclampsia was not associated with specific subtypes of cerebral palsy

What this study adds

 

Source: BMJ