Introduction to cerebral palsy
This information sheet describes cerebral palsy, its causes and some of the terms used to describe its effects. Some of the people and organisations that may be able to help those with cerebral palsy and their carers are listed at the end.
Cerebral palsy is a condition that affects movement, posture and co-ordination. This may be seen at or around the time of birth or may not become obvious until early childhood. Cerebral palsy is a wide-ranging condition and can affect people in many different ways.
Cerebral palsy is more common than generally realised. Currently, it is believed that about one in every 400 children is affected by the condition, i.e. about 1,800 babies are diagnosed with cerebral palsy in Great Britain each year. Cerebral palsy can affect people from all social backgrounds and ethnic groups.
It is often not possible for doctors to give an exact reason why part of a baby's brain has been injured or failed to develop, as there may be no obvious single reason why a child has cerebral palsy. Causes of cerebral palsy can be multiple and complex. Some studies suggest that cerebral palsy is mainly due to factors affecting the brain before birth. Known possible causes include:
- Infection in the early part of pregnancy.
- Difficult or premature birth.
- A cerebral (brain) bleed. This is more common following premature or multiple birth.
- Abnormal brain development.
- A genetic link (though this is quite rare).
Cerebral palsy affects the messages sent between the brain and the muscles. There are three types of cerebral palsy: spastic, dyskinetic (also known as athetoid or dystonic) and ataxic and generally relate to which part of the brain has been affected. The effects of cerebral palsy vary enormously from one person to another, with some people having a combination of two or more types.
It is often difficult for a doctor to predict accurately how a young child with cerebral palsy will be affected later in life. Cerebral palsy is not progressive, i.e. it does not become more severe as the child gets older, although some difficulties may become more noticeable.
There is no cure for cerebral palsy. If children are positioned well from an early age and encouraged to move in a way that helps them to improve their posture and muscle control, they can be supported to develop and achieve more independence for themselves. There are also a number of therapies, which may be beneficial for some individuals.
Spastic cerebral palsy
‘Spastic' means ‘stiff' and this form of cerebral palsy causes the muscles to stiffen and decreases the range of movement in the joints. It is the most common form of cerebral palsy and can affect different areas of the body. Generally someone with spastic cerebral palsy has to work hard to walk or move. If the person is only affected on one side of their body the term used to describe this is ‘hemiplegia'. If their legs are affected but their arms are unaffected or only slightly affected this is known as ‘diplegia'. If both arms and both legs are equally affected, then the term used is ‘quadriplegia'.
Dyskinetic (also dystonic or athetoid) cerebral palsy
Dyskinetic means difficulty with movement. People with dyskinetic cerebral palsy make involuntary movements, because their muscle tone changes rapidly from floppy and loose to tense and still, in a way they cannot control. Speech can be hard to understand as there may be difficulty controlling the tongue, breathing and vocal cords. Hearing problems are also common.
Dystonic cerebral palsy affects the movement of the body and presents as slow, rhythmic twisting movements of the trunk, or an arm or leg. It can also include abnormal postures.
Ataxic cerebral palsy
People with ataxic cerebral palsy find it very difficult to balance. They may also have poor spatial awareness, which means it is difficult for them to judge their body position relative to other things around them. Ataxia affects the whole body. Most people with ataxic cerebral palsy can walk but they will probably be unsteady. They may also have shaky hand movements and irregular speech.
It can be difficult to state what type of cerebral palsy a person has as they may have a combination of two or more types. It is important to bear in mind that no two people with cerebral palsy are affected in the same way. Some have cerebral palsy so mildly that its effects are barely noticeable. Others may be extremely affected and require help with many or all aspects of daily life.
Other associated difficulties
Other difficulties and medical conditions may occur more commonly in people with cerebral palsy but just because a person has cerebral palsy does not mean that they will also have other difficulties. However it may help you to be aware of some of them:
- Children with cerebral palsy may have problems with constipation or sleeping. The doctor or health visitor should be able to offer advice about this.
- People with cerebral palsy may have problems with speech and associated difficulties in chewing and swallowing. They may also have problems understanding the spoken word. A speech and language therapist may be able to offer advice.
- Some people with cerebral palsy may also have epilepsy. Often medication can help to manage this.
- Some people with cerebral palsy may have difficulty distinguishing and comparing shapes. This is to do with visual or spatial perception, which is about a person's ability to interpret what they have seen and not a problem with their eyesight.
- People with cerebral palsy may also have some form of learning difficulties, making them slow to learn. The difficulties can be mild, moderate or severe. There may be a ‘specific learning difficulty' or problems with a particular activity such as reading, drawing or arithmetic because a specific area of the brain is affected.
- It is important to remember that even someone severely physically affected by cerebral palsy may have average or above average intelligence.
Some of the professionals who work with people with cerebral palsy
Below is a list of some professionals who work with people with cerebral palsy together with what they do.
GP - General Practitioner, also known as the family doctor. This is the local doctor who advises on a wide range of health concerns. Your GP can put you in touch with other medical services and may also be able to provide information that will help you apply for welfare benefits or other kinds of assistance.
Audiologists work with people who have hearing impairments and offer advice on hearing aids.
Community or District Nurse is a nurse who treats people in their homes.
Educational Psychologists visit schools to assess children and advise on their learning and behaviour.
Genetic Counsellor It is rare for cerebral palsy to be inherited but if you are concerned it may help to talk to a genetic counsellor at a genetic advisory centre (usually attached to large hospitals). Ask your GP, hospital doctor or family welfare centre to refer you.
Health Visitors are nurses with extra training in advising parents of children under five years. They can be contacted via the GP.
Neurologists are doctors specialising in the brain and nervous system.
Occupational Therapists assess and evaluate condition and function through selected activities in order to enable people to function as effectively as possible in daily life. They can also supply and recommend specific equipment. They can be contacted via the GP.
Orthopists work with people who have visual problems and abnormal eye movements.
Paediatricians are doctors specialising in the care of children.
Physiotherapists specialise in assisting people with movement difficulties, using techniques such as exercise, manipulation, heat and massage to develop efficient patterns of movement. When working with a child with cerebral palsy they can also advise carers on ways of carrying, holding and positioning the child.
Social Workers from your local authority can advise on practical and financial problems, or tell you how to access local services. You can contact a social worker via your local social services department. Some areas will have special child and adult disability teams; in others you may not be assigned a named person and instead may have to speak to the duty social worker.
Speech and Language Therapists can assess and support those with communication difficulties. If appropriate they may recommend communication aids or languages using signs or symbols. They also support those with eating, drinking and feeding difficulties.
Other helpful contacts
There are other people that may be useful contacts. The Benefits Agency can help people with cerebral palsy and/or their carers claim any benefits they may be entitled to. Your local benefit agency office should be able to advise you and they can provide leaflets in several languages. You can obtain independent information on benefits from your local Citizens Advice Bureau.
Further information
Focussing on Cerebral Palsy: Reviewing and Communicating Needs for Services
Dr J Parkes, Dr M Donnelly and Dr N Hill
Scope 2001
0946828717
A report commissioned by Scope and carried out by Queen's University Belfast that studies the prevalence of diagnoses of cp in children in the UK.
Available from Scope Response. £3.30 to individuals/£12.75 to organisations.
Cerebral Palsy - A Complete Guide to Caregiving
F Miller and SJ Bachrach, John Hopkins University Press, 1995. 0801850916
Cerebral Palsy Handbook - A Practical Guide for Parents and Carers (currently out of print but copies may be available at your local library)
M Stanton, Vermillion, 2002.
009187676 1
Living with Cerebral Palsy
P Pimm, Wayland Publishing, 1999.
For more information about cerebral palsy and Scope services
Contact Scope Response for information, advice and support. Copies of all Scope's information sheets can be downloaded from the website or obtained from Scope Response.
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Email: response@scope.org.uk
Scope acknowledges the help and support of everyone who has been involved in the production of this information.
This information can be made available in other formats if required (such as large print or tape). We also have information about Scope and cerebral palsy available in 13 languages on audiotape and can offer a telephone interpreting service to people whose preferred language is not English.
Please contact Scope Response for more details of these services.
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