Symptoms appear during infancy or preschool years and vary from very mild to serious. Children with cerebral palsy may have exaggerated reflexes. The arms, legs and trunk may appear floppy. Or they may have stiff muscles, known as spasticity. Symptoms also can include irregular posture, movements that can't be controlled, a walk that's not steady or some combination of these.
Cerebral palsy may make it hard to swallow. It also can cause eye muscle imbalance, in which the eyes don't focus on the same object. People with the condition might have reduced range of motion in their joints due to muscle stiffness.
The cause of cerebral palsy and its effect on function vary from person to person. Some people with cerebral palsy can walk while others need assistance. Some people have intellectual disabilities, but others do not. Epilepsy, blindness or deafness also might affect some people with cerebral palsy. There is no cure, but treatments can help improve function. The symptoms of cerebral palsy may vary during the child's development, but the condition doesn't get worse. The condition generally stays the same over time.
Symptoms
Symptoms of cerebral palsy can vary greatly. In some people, cerebral palsy affects the whole body. In other people, symptoms might only affect one or two limbs or one side of the body. General symptoms include trouble with movement and coordination, speech and eating, development, and other issues.
Movement and coordination
Muscle Stiffness
Stiff muscles and exaggerated reflexes, known as spasticity. This is the most common movement condition related to cerebral palsy. Stiff muscles with regular reflexes, known as rigidity.
Coordination Issues
Lack of balance and muscle coordination, known as ataxia. Variations in muscle tone, such as being either too stiff or too floppy.
Uncontrolled Movement
Jerky movements that can't be controlled, known as tremors. Slow, writhing movements.
- Favoring one side of the body, such as only reaching with one hand or dragging a leg while crawling.
- Trouble walking. People with cerebral palsy may walk on their toes or crouch down when they walk. They also may have a scissors-like walk with their knees crossing. Or they may have a wide gait or a walk that's not steady.
- Trouble with fine motor skills, such as buttoning clothes or picking up utensils.
Speech and eating
Delays in speech development. Trouble speaking. Trouble with sucking, chewing or eating. Drooling or trouble with swallowing.
Development
- Delays in reaching motor skills milestones, such as sitting up or crawling.
- Learning disabilities and Intellectual disabilities.
- Delayed growth, resulting in smaller size than would be expected.
Other symptoms
Damage to the brain can contribute to other neurological symptoms, such as:
Seizures, which are symptoms of epilepsy. Children with cerebral palsy may be diagnosed with epilepsy.
Trouble hearing, vision and changes in eye movements. Pain or trouble feeling sensations such as touch.
Bladder and bowel issues, including constipation and urinary incontinence. Mental health conditions.
The brain condition causing cerebral palsy doesn't change with time. Symptoms usually don't worsen with age. However, as the child gets older, some symptoms might become more or less clear. And muscle shortening and muscle rigidity can worsen if not treated aggressively.
When to see a doctor
Contact your child's health care professional and get a prompt diagnosis if your child has symptoms of a movement condition. Also see a health professional if your child has delays in development. See your child's health care professional if you have concerns about episodes of loss of awareness or of irregular bodily movements or posture.
Diagnosis
Symptoms of cerebral palsy can become more apparent over time. A diagnosis might not be made until a few months to a year after birth. If symptoms are mild, diagnosis may be delayed longer.
Brain scans
MRI
An MRI uses radio waves and a magnetic field to produce detailed 3D or cross-sectional images of the brain. An MRI can often identify changes in your child's brain.
Cranial ultrasound
This can be performed during infancy. A cranial ultrasound uses high-frequency sound waves to produce images of the brain.
Tests and Evaluation
- Electroencephalogram (EEG): If your child is suspected of having seizures, an EEG can evaluate the condition further.
- Laboratory tests: Tests of the blood, urine or skin might be used to screen for genetic or metabolic conditions.
- Additional tests: Tests for Vision, Hearing, Speech, Intellect, Development, and Movement.
Spastic cerebral palsy (most common), Dyskinetic cerebral palsy (voluntary muscle control), and Ataxic cerebral palsy (balance and coordination issues).
Treatment
Children and adults with cerebral palsy may require lifelong care with a health care team. Early intervention can improve outcomes. Treatment options can include medicines, therapies, surgical procedures and other treatments as needed.
Medications
Muscle or nerve injections (Botox), Oral muscle relaxants (Baclofen, Valium), and medicines to reduce drooling.
Therapies
Physical therapy (strength & balance), Occupational therapy (independence), Speech and language therapy, and Recreational therapy.
Surgical procedures
Orthopedic surgery (bone/joint correction) and Selective dorsal rhizotomy (cutting nerve fibers to relax muscles).
Adults with cerebral palsy
As a child with cerebral palsy becomes an adult, health care needs can change. Ongoing care is needed for vision/hearing maintenance, muscle tone, pain/fatigue management, and orthopedic issues such as contractures or arthritis.
Alternative medicine
Some children and teenagers with cerebral palsy use complementary and alternative medicine. Alternative therapies are not proved and have not been adopted into routine clinical practice. Talk with your child's health care professional about potential risks and benefits.