Each year an estimated 8,000–10,000 infants are diagnosed with cerebral palsy. This chronic condition affects the central nervous system, especially the brain, and causes changes in motor control. The Centers for Disease Control and Prevention (CDC) considers cerebral palsy to be the most common childhood motor disability. (1) While it’s not usually a life-threatening condition — most children who have cerebral palsy survive into adulthood — typically, managing the disorder requires a high level of care long-term due to how it makes everyday tasks like speaking, eating and writing more difficult.
There is currently no cure for cerebral palsy. But many options are available to help children with the disorder deal with physical and mental difficulties. Symptoms of cerebral palsy can sometimes affect many parts of the body, making it hard for someone to live on their own. But not every person with cerebral palsy will be very physically or intellectually challenged. Some can overcome many limitations with early intervention and have normal — or near-normal, sometimes even above-average — levels of intelligence.
Treatments for cerebral palsy vary depending on the severity of symptoms. Some common treatment approaches include:
- special education training and resources
- physical therapy and stretching muscles to prevent shortening and risk for deformities
- using a walker or braces
- in some cases, surgery to help decrease symptoms like spasms or developmental deformities
What Is Cerebral Palsy?
Cerebral palsy is a neurological condition that causes abnormal motor control and other symptoms due to changes that take place in the brain. (2) It affects about 2 to 4 of every 1,000 infants born. The disorder is much more common among prematurely born infants, especially those who are underweight, compared to full-term infants who are born at a normal weight. (3)
During early development of infants’ brains who have cerebral palsy, injuries occur that affect functions including movement, language and social skills. Symptoms associated with cerebral palsy can develop either before birth in the womb, during birth, or at some point during the first several months of life.
What is the underlying cause of cerebral palsy, and are there known risk factors? Researchers believe there are actually many causes and factors that can contribute to cerebral palsy in newborns or infants; however, sometimes no known cause can be found. When a cause is known, it can include: reduced blood flow/circulation to the brain during pregnancy, oxygen deprivation, infections affecting the brain or damage due to other illnesses, or brain injury that takes place during delivery.
Types of Cerebral Palsy:
Cerebral palsy is not one specific condition but rather refers to a group of symptoms including: poor motor and muscle control, weakness, developmental problems, spasticity and sometimes paralysis. There are four general categories of cerebral palsy, which have some overlaps but are different from one another due to the symptoms that tend to occur: (4)
- Spastic cerebral palsy — This is the most common type, which causes convulsions and abnormal reflexes in newborns/infants. Infants with spastic cerebral palsy can experience prolonged newborn reflexes, such as having a very tight grip (the hand is held in a tight fist), and stiff, spastic limbs. In some infants a level of intellectual disability will also occur (no longer referred to as “mental retardation'”). Some only experience symptoms that affect their arms, called diplegia, but have near-normal mental capabilities and intelligence.
- Athetoid cerebral palsy — This type affects up to 20 percent of children with cerebral palsy and is characterized by slow, uncontrolled writhing movements. Symptoms usually cause abnormal control of the hands, feet, legs and arms. Sometimes the tongue and other muscles of the face are also impaired. This can cause trouble eating, difficulty speaking, drooling or grimacing (scowling or frowning).
- Ataxic cerebral palsy — A rarer type of cerebral palsy, characterized by trouble with balance, coordination, walking and depth-perception. Having a wide-based stance and struggling with precise movements are some of the common symptoms that occur. This can cause problems with writing, gripping objects, and other everyday activities.
- Mixed form cerebral palsy — When a child has symptoms of one or more of the above types of cerebral palsy, they are considered to have a mixed form of the disease. The most common mixed form of cerebral palsy is spastic combined with athetoid.
Signs & Symptoms of Cerebral Palsy
As described above, symptoms of cerebral palsy vary depending on the specific type of the disorder a child has. Symptoms can range considerably, from barely noticeable to severely limiting. Even though it might seem that in some cases a child’s symptoms are getting worse or changing as they get older, symptoms of cerebral palsy are not believed to be progressive. Some of the most common signs and cerebral palsy symptoms in infants and young children include:
- convulsions, lack of coordination, clumsiness and spasming
- stiffness and shortening of the muscles, joints and tendons
- paralysis, typically affecting one side of the body (called spastic hemiplegia)
- impaired intellectual abilities
- prolonged newborn reflexes
- trouble walking, which might cause criss-cross motions or one leg crossing over the other
- developmental delays that affect speech, vision, hearing and language
- trouble swallowing and chewing, which can increase risk for choking
- difficulty breathing due to aspiration and abnormal secretions
- crossed or wandering eyes
- difficulty using the hands, such as for drawing and writing
- behavioral problems due to temperamental issues
- seizure disorders such as epilepsy
Cerebral Palsy Causes & Risk Factors
It’s believed that in most cases more than one cause contributes to the types of brain injuries that cause symptoms of cerebral palsy. Causes can include one or more of the following:
- Inadequate blood flow reaching tissues in the developing brain, especially during early pregnancy in the first trimester.
- Injury to the brain that occurs during labor and delivery.
- Infection or illnesses that occur inside or near the brain during pregnancy. This can include rubella, toxoplasmosis, or cytomegalovirus.
- Bleeding in the brain during pregnancy, which can happen due to fetuses having vulnerable blood vessels and sometimes high levels of bilirubin, which contribute to brain injury.
- Illnesses that cause inflammation of brain tissue during the first year of life, such as meningitis, sepsis, impact/trauma, or severe dehydration.
Conventional Treatments for Cerebral Palsy
Only those with the most severe types of cerebral palsy have a higher risk of death before reaching adulthood. For children with mild-to-moderate cases of cerebral palsy, a number of treatment approaches are available including: (5)
- Physical therapy, speech and occupational therapy, walkers, braces and other assistance devices (more on these treatments below).
- Special Education — If a child with cerebral palsy does not have intellectual disabilities, then he or she can attend regular school and develop normally as much as possible. If available, special education classes can help a child with cerebral palsy to manage or overcome problems with learning, speech and/or motor control. Many schools offer assistance programs, which can make a big difference in terms of improving quality of life. The earlier that special education is received, the better the outcome usually is.
- Muscle relaxers — Oral medications may be used to relax stiff, contracted muscles. However, these aren’t always a good option since they can sometimes cause side effects such as high blood pressure, indigestion, fatigue or drowsiness and, potentially, liver damage. Other options that have recently shown better results include local injections into overactive muscles, or an implantable pump to slowly reduce excitability of certain nerves.
- Anticonvulsant drugs — If seizures are very serious, certain drugs might be used to control symptoms. Examples of anticonvulsant drugs include: AMPA receptor antagonists, barbiturate anticonvulsants, benzodiazepine, carbamates, carbonic anhydrase inhibitors, and dibenzazepine anticonvulsants. (6)
- Surgery — In some cases, surgery might be recommended to cut or lengthen stiff muscles or tendons that are contributing to physical limitations. Some surgeries are performed to cut nerve roots extending away from the spine that contribute to spasticity. This type of surgery is usually only safe for children with near-normal intellectual capabilities who are mostly suffering from physical symptoms.
5 Natural Treatments for Cerebral Palsy
1. Physical Therapy, Stretching & Gentle Exercises
In people with cerebral palsy, stiffness and spasticity tends to affect the arms and legs most often, especially the lower parts of the legs. This can cause trouble with growth, walking and balance. Stretching and exercise has many benefits including helping to keep the muscles of the lower body, along with the arms, limber and strong. This aids in movement and motor control. Research shows that stretching is very beneficial for decreasing contractures — which is the shortening and hardening of muscles, tendons, or other tissues that can lead to deformity in some cases. (7) Because contractures shorten muscles, they make it harder to flex and exhibit any force, which leads to instability and weakness.
Physical therapy is adapted at different stages of development in order to help children with cerebral palsy continue to reach their potential. According to the Cerebral Palsy Guide website, physical therapy for cerebral palsy has some of the following benefits: improving coordination, balance, strength, range of motion/flexibility and endurance, increasing pain management, correcting posture, improving gait, increasing independence and boosting overall health. (8) Treatments can involve strength and flexibility exercises, muscle relaxation techniques, heat treatments and massages.
Some stretches and exercises used in treating cerebral palsy include:
- strength-building exercises using exercise balls
- resistance bands or free weights
- sitting stretches
- rolling over exercises for infants
- use of swimming pools
- hot and cold packs
- electric muscle stimulation to help with recovery
Sometimes “recreational therapies” are also incorporated, which can include horseback riding, swimming and other outdoor activities to improve moods and motor skills.
2. Assistance Devices (Walkers, Bracers, Orthotics, etc.)
To help improve mobility and functionality, some people with cerebral palsy might use assistance devices including: a walker, wheelchair, crutches, cane, braces, splints or shoe inserts/orthotics. The best outcomes are usually experienced when these devices are coupled with physical/occupational therapy from a very young age, which helps to train the muscles and improve motor control in the brain. For example, orthotics are commonly combined with physical therapy to help lengthen and stretch muscles in order to help with normal development. They can also help improve posture and support a normal gait.
3. Speech Therapy
Some research shows that speech problems affect between 20–50 percent of all children with cerebral palsy. Even more have at least some difficulty controlling the muscles in their face, throat, neck and head. (9) Some parents choose to have their child receive frequent rehabilitation services at an early age to give them the best chance of overcoming physical speech, vision and hearing limitations.
Speech therapy can help children with cerebral palsy learn how to articulate words better, use their tongue effectively and to chew and swallow food safely. (10) Speech can often become clearer with ongoing help. Plus the risk for serious problems related to choking or aspiration/difficulty breathing can be reduced. Some of the exercises that might be included in treatment are those that address position and function of the lips, jaw and tongue, or practice breathing, blowing and swallowing. Tools that speech pathologists use to help their clients with cerebral palsy include:
- tongue straws or positioning devices (also called intraoral devices)
- oral sensory chews
- books and flashcards
- symbol charts
- dry erase boards
- drawings/pictures to help with expression
- a computer hooked up to a voice synthesizer
Other benefits associated with speech therapy for those with cerebral palsy include:
- reduced slurring and stuttering
- enhanced sentence formation and communication
- improvements in listening
- improved pitch
- better vocabulary
- increased self-esteem
- enhanced body language
- better academic performance
- positivity regarding learning
- less shyness and self-consciousness
- better problem solving
- overall improved literacy
4. Occupational Therapy
Occupational therapy focuses on helping to improve everyday tasks associated with independent living, such as eating, dressing, bathing, preparing food, etc. This type of therapy can often increase a child’s self-esteem, independence, mobility and functionality in many ways. One of the biggest benefits comes from increasing independence. This reduces the need for intensive care long-term and takes some of the burden off of family members and caretakers.
Many occupational therapy techniques aim to improve coordination, use of the upper body and posture. A report published in the Indian Journal of Pediatrics states that types of occupational therapy treatments that can be useful include those involving: (11)
- Biofeedback training, which may help with learning motor control.
- Electrical stimulation, which pulses electricity into certain muscles and nerves.
- Sensory integration.
- Body-weight support treadmill training.
- Constraint-induced therapy, which improves upper extremity function by increasing use of an affected limb.
- Hyperbaric oxygen therapy, which forces high amounts of oxygen into certain tissues of the body.
- The Vojta method, which helps address reflexes and patterns of movement.
A number of nonconventional approaches also exist, although research studies have shown mixed results about how effective they are. Examples include rhythmic activities (also called conductive education), music therapy (using clapping and singing, for example) and therapies involving physical maneuvers using special equipment.
5. Psychological Therapy and/or Support
It’s common for parents with a child who has cerebral palsy to feel very stressed and anxious about their child’s situation. This is especially true if the parent feels there are limitations stopping their child from getting the care they need, such as lack of financial resources, not enough availability of nearby therapists, no convenient appointment times, and transportation issues. (12)
Many experts recommend parents speak with a therapist or counselor, if available, to learn how they can best manage their child’s situation without feeling overwhelmed or resentful. To help relieve stress and prevent anxiety, mind-body exercises can also be helpful, including exercise, yoga, meditation, deep breathing or tai chi.
The good news is that there are now organizations and foundations that are working hard towards establishing improved plans for treating children with cerebral palsy and taking some of the burden off of families. This includes forming collaborative initiatives between affected families and therapy providers; holding community educational forums that are accessible and low-cost; having schools help provide services and relevant information; creating more opportunities for networking; and promoting patient advocacy.
Precautions When Treating Cerebral Palsy
Cerebral palsy is usually diagnosed at a very young age. So if symptoms begin appearing after the age of about 2 to 3 years, another disorder is likely the cause. Other conditions that should be ruled out, which may be contributing to symptoms, can include: Bell’s palsy, paralysis due to Lyme disease, genetic disorders, brain tumors, stroke, ear infections and physical trauma.
Final Thoughts on Cerebral Palsy
- Cerebral palsy is a chronic neurological disorder affecting newborns and infants that is caused by brain injury.
- Not actually considered a disease but a group of symptoms, cerebral palsy can include changes in motor skills, muscle development, control of the extremities, balance, coordination, language and speech.
- Cerebral palsy cannot be cured. But treatments to help overcome limitations include special education classes, physical therapy, stretching, exercises, speech therapy, occupational therapy, medications to reduce stiffness and convulsions, and sometimes surgery.