Understanding cerebral palsy: Symptoms, diagnosis, treatment

What is cerebral palsy?

Cerebral palsy (CP) is a broad term used to describe a group of chronic "palsies", disorders that impair control of movement due to damage to the developing brain. Cerebral palsy usually appears in children before age 3 and is a non-progressive brain disorder, meaning the brain damage does not worsen throughout their lifetime. However, the symptoms resulting from the brain damage often do change over time; sometimes getting better and sometimes getting worse.

Cerebral palsy is one of the most common causes of chronic childhood disability. It affects about one in every 400 children with about 1,800 babies being diagnosed with cerebral palsy each year, says Scope, the charity for people with cerebral palsy.

Children with cerebral palsy may have an accompanying seizure disorder and may have some level of learning disability, vision, speech, hearing or language problems.

Much remains unknown about the disorder's causes, but evidence supports theories that infections, birth injuries and poor oxygen supply to the brain before, during and immediately after birth result in up to 15% of cases. Premature infants are particularly vulnerable. Severe illness (such as meningitis) during the first years of life, physical trauma and severe dehydration can cause brain injury and result in cerebral palsy.

What causes cerebral palsy?

Congenital cerebral palsy is present at birth and, according to US studies, accounts for 80% of cases. It may be caused by the following:

• Infections during pregnancy that may damage the nervous system of a developing foetus. These include rubella (German measles), cytomegalovirus (a herpes-type virus) and toxoplasmosis (an infection caused by a parasite that can be carried in cat faeces or undercooked meat). Other infections in pregnant women that may go undetected are now being recognised as important causes of developmental brain damage in the foetus. 
• Severe jaundice in the baby. Jaundice is caused by excessive bilirubin in the blood. Normally, bilirubin is filtered out by the liver. But often a, newborn baby’s livers needs a few days to start doing this effectively, so it's not uncommon for babies to have jaundice for a few days after birth. In most cases, phototherapy (light therapy) clears up jaundice and there are no lasting health effects. However, in rare cases, severe untreated jaundice can damage brain cells. 
• Rh (rhesus) incompatibility between mother and baby. With this blood condition, the mother's body produces antibodies that destroy the foetus's blood cells. This, in turn, leads to a form of jaundice in the baby and may cause brain damage. 
• The physical and metabolic trauma of being born. This can precipitate brain damage in a foetus whose health has been threatened during development. 
• Severe oxygen deprivation to the brain or significant trauma to the head during labour and delivery.