Cerebral Palsy

Cerebral palsy refers to a group of conditions that affect control of movement and posture. Cerebral refers to the brain and palsy to muscle weakness/poor control. Because of damage to one or more parts of the brain that control movement and posture, an affected child cannot move his or her muscles normally. Thus, these disorders are not caused by problems in the muscles or nerves. Instead, faulty development or damage to motor areas in the brain disrupt its ability to adequately control movement and posture. Depending on which areas of the brain have been damaged, one or more of the following may occur: muscle tightness or spasticity (increased muscular tone with exaggeration of the reflexes); involuntary movement; disturbance in gait (manner of walking) or mobility; difficulty in swallowing; and problems with speech.

Many children with cerebral palsy also have other problems that require treatment. These include mental retardation; learning disabilities; seizures; and vision, hearing, and speech problems. Cerebral palsy itself is not progressive (i.e., brain damage does not get worse); however, secondary conditions, such as muscle spasticity, can develop, which may get better over time, get worse, or remain the same. Cerebral palsy is not a communicable disease. Although cerebral palsy is not “curable” in the accepted sense, training and therapy can help improve function.

It is estimated that some 764,000 children and adults in the United States manifest one or more of the symptoms of cerebral palsy. This is more people than any other developmental disability, including Down syndrome, epilepsy, and autism. Cerebral palsy usually is not diagnosed until a child is about 2 to 3 years of age. Currently, about 8,000 babies and infants are diagnosed with the condition each year. In addition, some 1,200 to 1,500 preschool-age children are recognized each year to have cerebral palsy.

In the 1860s, an English surgeon named William Little wrote the first medical descriptions of a puzzling disorder that affected children in the first years of life, causing stiff, spastic muscles in their legs and, to a lesser degree, in their arms. These children had difficulty grasping objects, crawling, and walking. They did not get better as they grew up nor did they become worse. Their condition, which was called Little's disease for many years, is now known as spastic diplegia. It is one of several disorders that affect control of movement due to developmental brain injury and are grouped together under the term cerebral palsy.

Because it seemed that many of these children were born following premature or complicated deliveries, Little suggested their condition resulted from a lack of oxygen during birth. He proposed this oxygen shortage damaged sensitive brain tissues controlling movement. However, in 1897, the famous psychiatrist Sigmund Freud disagreed. Almost a century later, in the 1980s, scientists analyzed extensive data from a government study of more than 35,000 births and were surprised to discover that such complications account [Page 366]for only a fraction of cases—probably less than 10 percent. In most cases of cerebral palsy, no cause of the factors explored could be found. These findings from the National Institute of Neurological Disorders and Stroke (NINDS) perinatal study have profoundly altered medical theories about cerebral palsy and have spurred researchers to explore alternative causes.

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