Cerebral palsy (CP) is a group of neurological disorders that affect the ability of patients to move, and maintain balance and posture. It mainly occurs because the cerebral cortex, the area of the brain that controls muscle movement, has not developed normally during fetal growth or is injured before, during, or after birth.
Broadly, the symptoms of CP can be classified into three categories: motor, neurological, and secondary symptoms. The manifestations of these symptoms may vary in infants and children depending on the part of the brain that is not well-developed or injured, and the severity of the defect or injury.
Symptoms in infants
The main symptoms in infants with CP include:
- Low muscle tone
- Preference to use only one side of the body
- Inability to hold up the head when lying on the stomach or in a supported sitting position
- Stiff muscles, muscle spasms, and poor muscle control and reflexes
- Delays in the ability to sit up or roll over independently even after six months of age
- Difficulties in feeding and swallowing
Motor symptoms
Movement problems are the most obvious signs of CP, with variations in types, manifestations, and severity. The most common movement symptoms include spasticity, dyskinesia, and ataxia.
Spasticity
Spasticity symptoms include jerky reflexes, hypertonia or stiff muscles, and exaggerated reflexes.
Dyskinesia
Symptoms of dyskinesia include tremors, shakiness, involuntary reflexes, hypertonia or hypotonia (decreased muscle tone), and slow, writhing movements.
Ataxia
Ataxia is characterized by a lack of coordination, difficulty with balance, and trouble with fine motor skills.
Overall, these movement disorders may be limited to one side of the body, one limb, or all four limbs. While movement problems usually do not worsen over time, issues such as a shortening of muscles or tendons may develop if the condition is not managed properly.
Neurological symptoms
CP patients may also experience neurological symptoms, with the most common being:
- Seizures and epilepsy
- Intellectual disorders
- Learning disability
- Attention deficit hyperactivity disorder
- Hydrocephalus (buildup of pressure in the brain because of the abnormal accumulation of cerebrospinal fluid in the brain ventricles)
- Behavioral problems
- Visual problems such as reduced vision, squinting, or uncontrollable eye movements
- Hearing loss
- Speech and language problems (dysarthria)
- Sensory impairments, including pain
Epilepsy occurs in nearly 41% of children with CP, and the severity and frequency of seizures depend on the part of the brain that is affected.
Secondary symptoms
The inability to control motor function can lead to several secondary symptoms. These include:
- Stunted growth
- Gastroesophageal reflux disease — where stomach acid leaks into the esophagus
- Problems with feeding, swallowing, and drooling
- Sleep disorders
- Airway obstructions
- Tooth and gum disease
- Urinary incontinence (difficulty in controlling the bladder)
- Constipation
- Contractures
- Frequent fractures
- Hernia
- Scoliosis (abnormal sideways curvature of the spine)
Last updated: Feb. 20, 2020
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