Cerebral Palsy Frequently Asked Questions

What is Cerebral Palsy?
Cerebral means brain, and palsy is defined as a loss of control or weakness in movement. Putting the two words together, cerebral palsy (CP) is a loose term which is given to a number of central nervous system (CNS) motor disorders which are characterized by impairment of voluntary muscle movement. In individuals who have cerebral palsy, the parts of the body that provide for movement, such as the muscles, nerves, and the spinal cord are normal. However, the brain, which is the command center for sending messages to those parts of the body that coordinate movement, is unable to do so in its usual manner. There are a number of conditions that may be associated with cerebral palsy. Mental retardation is commonly associated with cerebral palsy. The percentage of individuals experiencing mental retardation in some form ranges from 25 to 75 percent. Some individuals with cerebral palsy may have seizure disorders. Others may experience problems with vision, such as Strabismus. In some instances, individuals with cerebral palsy may experience difficulty swallowing (dysphasia). Learning disabilities are also a possibility. Problems may arise in bowel and bladder control, as well as in hearing or speech, and in gross or fine motor control.

What causes cerebral palsy and how is it diagnosed?
In many instances, the cause of cerebral palsy in an individual may be difficult to pin down. For decades, it had been thought that in the majority of cases anoxia, or the lack of oxygen, either prior to birth or during birth was the main cause of cerebral palsy. Recent studies, however, have found that anoxia is the cause of cerebral palsy in only between 3 and 12 percent of the cases. Approximately 85 percent of the brain damage related to cerebral palsy occurs prior to birth. Some of the prenatal causes may be prematurely, lack of proper nutrition, or virus. In 75 percent of prenatal cerebral palsy, the cause can not be determined. Of the other 15 percent of cerebral palsy that occurs post-natally, the main cause is infection, usually measles. Other post-natal causes are automobile accidents, falls, and child abuse. Since in many cases the cause of cerebral palsy is difficult to determine, risk factors are difficult to establish with any measure of statistical certainty. However, there is a risk to children who are born prematurely and are of low birth weight when the mother has had a history of reproductive problems. Women who have had multiple miscarriages are at an increased risk of giving birth to a child with cerebral palsy. Statistically, more whites than African-Americans are affected, as are more males than females.

What do the different types of cp mean?
There are four different types of cerebral palsy. Spastic cerebral palsy is the most common form, affecting approximately 70 percent of all individuals with cerebral palsy. Spasticity can be either a mild or severe impairment of motor functions. The affected limbs are usually underdeveloped, and there is a tendency for the individual to have a "scissor gait" or to toe walk. It is also common for the affected individual to have hypertonicity, an excessive tension of muscles.
There are four sub-groups of Spasticity:
1. Hemiplegia- involvement of both limbs on one side; the arm usually more affected.
2. Paraplegia- involvement of both legs; arms minimally involved, or not at all.
3. Quadriplegia or Tetraplegia- involvement of all limbs, usually to the same degree.
4. Diplegia- intermediate form between paraplegia and quadriplegia; both legs involved.
Athetoid or Dyskinetic cerebral palsy occurs approximately 20 percent of the time. It is characterized by low muscle tone, slow, writhing movement patterns and involuntary jerking of the head or of the arms and legs. The movements generally increase with emotional tension and decrease while the individual is asleep.
Ataxic cerebral palsy is rare, occurring in only about 10 percent of all individuals affected. It is characterized by weakness, uncoordinated movements, and unsteadiness. A wide gait and difficulty with fine motor skills is also common.
Mixed forms or cerebral palsy are common, and is exactly what the name implies. There can be a combination of any of the cerebral palsy forms, however, Spasticity and athetosis are the most common combination.

Does Cerebral Palsy get worse?
No. Cerebral palsy is a non progressive disorder. This means that whatever damage was done to the brain will not get any worse. The problem that many parents face is that, generally, it is impossible to diagnose cerebral palsy with any certainty in infancy. Many cases are not diagnosed until somewhere around age two. It only appears that the disorder is progressive because the symptoms may not appear until the child's lack of motor skills, or other developmental delays begin to emerge. For example, a child at age two may have difficulty walking and at age six difficulty in writing and reading. The difficulty in reading and writing is not a progression of the cerebral palsy, but has appeared as a developmental milestone should have been attained. In other words, the difficulty at age six will occur if the brain injury affected that particular developmental milestone, regardless of any interventions on the part of the parents.

Can Cerebral Palsy be cured?
There is no treatment, as such, that will cure cerebral palsy. The main goal of professionals who work with individuals affected by cerebral palsy is to foster as much independence for the individual as his or her impairment will allow. Individuals with seizure disorders may be effectively controlled with anticonvulsive medications. Physical therapy, speech therapy, and occupational therapy are frequently utilized to maximize participation and independence. For individuals who do not have intellectual involvement, accommodations can be made to living spaces, places of employment, and schools so that they may be included in the everyday world of business, education, and recreation. For many individuals with cerebral palsy, inclusion is more a matter or management of their disorder, rather than treatment or a cure
 

Glossary of Terms

Commonly Used Acronyms

CE-Conductive Education

CRS-Children's Rehabilitative Services

DD-Developmental Disability/Developmental Delay

DES-Department of Economic Security

DHS-Department of Health Services

ESY-Extended School Year

FAPE-Free, Appropriate Public Education

HCBS-Home and Community Based Services

IDEA-Individuals with Disabilities Education Act

IEP-Individualized Education Plan

IFS-Individual Family Service Plan

IHS-Indian Health Services

ISPP-Individual Service and Program Plan

MCP-Mercy Care Plan

OSHCN-Office of Special Health Care Needs

OT-Occupational Therapy

PAS-Pre-Admission Screening

PCP-Primary Care Physician

PT-Physical Therapy

RSANR-Rehabilitation Services Administration/Vocational Rehabilitation

SDR-Selective Dorsal Rhizotomy

SI-Sensory Integration Therapy

SSI-Supplemental Security Income (Social Security Administration)

ST-Speech Therapy

WIC-Women, Infants and Children Program