Injuries: Cerebral Palsy
Cerebral palsy, or CP, is a condition that affects the outer layer of the brain called the cerebral cortex. The cerebral cortex is responsible for directing and controlling the movement of muscles. There is no one “type” of cerebral palsy; rather, the name applies to a group of neurological conditions than could affect your child. The condition is not progressive, and people with CP will not experience any increase in their symptoms later on in life.
What causes CP?
There is no one definitive cause for cerebral palsy, but a tremendous amount of research has gone into finding the cause. Some studies have found that cerebral palsy may be due to a problem in the development of the cerebral cortex before baby is born. It may also be caused by an injury to the white matter in baby’s brain before birth, during birth, or after birth.1
Scientists and doctors have been able to determine some risk factors1 for cerebral palsy:
- Babies born prematurely between the mother’s 23rd and 27th week have a higher risk of developing CP.
- Babies that are delivered in the breech position, babies that come down the birth canal face first (face presentation), and babies in a transverse lie position (sideways) before birth have a higher risk. Babies that do not receive enough oxygen before birth have a higher risk for developing CP.
- Before birth, oxygen is delivered to baby by the blood that flows from the placenta through the umbilical cord. If the amount of blood that flows through the umbilical cord is reduced, the baby’s oxygen supply is reduced.
- Babies that have both a low or normal weight at birth, with low Apgar scores at 5 minutes after birth, seem to have a higher risk of CP.2
- In cases where there is an abnormal amount of amniotic fluid during mom’s pregnancy (hydramnios), there is a risk of baby having some degree of CP.
- Babies born to moms that develop an infection during pregnancy (chorioamniotis) have a higher risk for CP.
Recognizing the signs of cerebral palsy
A child that has been diagnosed with cerebral palsy has difficulty with his movement, such as how he is able to use his hands, and move his arms, legs, and feet. Newborns may not have any symptoms of CP, as th4 condition may manifest over the course of the first two or three years. As baby grows, symptoms begin to appear. His body may be stiff or floppy. He may have trouble rolling over and sitting up. As he gets older, he may have difficulty holding a spoon, and he may have trouble dressing himself (Ataxic).1
The muscles in his arms and legs may be tight, and his reflexes may be exaggerated. Sometimes, only one arm, or one leg is affected (Spastic). He may have trouble controlling his movements in his arms and legs, face, or tongue (Dyskinetic).
A child with cerebral palsy may also have difficulties with learning. He may also have difficulty with his vision and hearing, and he may have seizures. He may not be able to control his bowels or bladder. He may also have difficulty sitting or standing.
The different forms of cerebral palsy
There are different forms of CP3 ranging from mild disabilities to severe handicaps.
Spastic Quadriplegia (also called tetraplegia). A child with Spastic quadriplegia usually has severe handicaps that affects all four limbs, as well as difficulty with forming her thoughts, learning, and communicating with others. Feeding a child with spastic quadriplegia may be difficult. She is also likely to have difficulty with her vision and hearing. She may have seizures.
Spastic Diplegia. Spastic diplegia affects the legs more than the arms and hands. It is more common in premature babies, and is caused by a lack of blood flow to the periventricular area in baby’s brain, which can cause Periventricular Leukomalacia. Blood does not flow through a premature baby’s brain in the same way that it flows through a full-term baby’s brain. When the amount of blood flow through the periventricular area of the brain is less than it should be, the white matter in that area of the brain is damaged. If a premature baby’s mother had an infection before baby was born, baby may develop Periventricular Leukomalacia.
During baby’s first few months after birth, his legs may be floppy. By the time he is 6 months old, he will have tightness in his hips and ankles. After his 5th birthday, it may become much more difficult to move his legs due to the stiffness in his hamstring muscles, as well as the muscles around his hips. His legs may be shorter than normal, and his legs may turn inward at his knees. He may need leg braces, or a walker to help him move around. Although his legs will be more affected than his hands, he may have trouble using his hands.
Spastic Hemiplegia. Spastic hemiplegia affects only one side of the body, usually the arm, but it may also affect the leg. It occurs most often in children that are born prematurely, or those that suffered a stroke during the first month of life. Symptoms may not be present in a baby. As he grows, his posture may be different on the affected side, and he cannot use both hands to reach for and hold an object. When he is on his stomach, me may not be able to use the affected arm to help hold himself up. During the first couple of years of life, he will not use his arm on the affected side as much. It will become more floppy, then become more stiff as he gets older. The arm is fixed in a position that is close to the body, and the elbow is usually bent. The hand on the affected side is kept in a closed position. Children with spastic hemiplegia usually have difficulty with hearing and sight. Many children are able to walk.
Is there a cure for CP?
Not yet – but scientists and doctors are researching potential cures every single day, so don’t give up hope. If your child is born with, or later begins to manifest symptoms of, cerebral palsy, there are treatments available that could help.
If you or your loved one was seriously injured by an act of medical negligence, Crandall & Pera Law may be able to help. We are a nationally recognized team of medical malpractice and birth injury attorneys serving clients throughout Ohio and Kentucky. To learn more about who we are, or to schedule a consultation with an experienced birth injury attorney, please call 877-955-0020 or fill out our contact form.
- Cunningham, F., Leveno, K., Bloom, S., Spong, C., Dashe, J., Hoffman, B., Casey, B., & Sheffield, J. (2013). Diseases and Injuries of the Term Newborn. In Cunningham, F., Leveno, K., Bloom, S., Spong, C., Dashe, J, Hoffman, B., Casey, B., & Sheffield, J. (Eds). Williams obstetrics (24th ed.). New York, NY: McGraw-Hill
- Lie, K., Groholt, E., & Eskild, A. (2010). Association of cerebral palsy with Apgar score in low and normal birthweight infants: Population based cohort study. The BMJ, 341, c4990. Retrieved from http://doi.org/10.1136/bmj.c4990
- Patterson, M. (2016). Clinical features and classification of cerebral palsy. UpToDate. Retrieved from http://www.uptodate.com/contents/clinical-features-and-classification-of-cerebral-palsy