Cerebral Palsy Symptoms

Symptoms of cerebral palsy can be very different between people with this group of disorders. Symptoms may:

• Be very mild or very severe
• Only involve one side of the body or both sides
• Be more pronounced in either the arms or legs, or involve both the arms and legs
• Symptoms are usually seen before a child is 2 years old, and sometimes begin as early as 3 months. Parents may notice that their child is delayed in reaching, and in developmental stages such as sitting, rolling, crawling, or walking.

There are several different types of cerebral palsy. Some people have a mixture of symptoms.


Symptoms of spastic cerebral palsy, the most common type, include:


Muscles that are very tight and do not stretch. They may tighten up even more over time.
Abnormal walk (gait): arms tucked in toward the sides, knees crossed or touching, legs make "scissors" movements, walk on the toes
Joints are tight and do not open up all the way (called joint contracture)
Muscle weakness or loss of movement in a group of muscles (paralysis)
The symptoms may affect one arm or leg, one side of the body, both legs, or both arms and legs
The following symptoms may occur in other types of cerebral palsy:


Abnormal movements (twisting, jerking, or writhing) of the hands, feet, arms, or legs while awake, which gets worse during periods of stress

• Tremors
• Unsteady gait
• Loss of coordination

Floppy muscles, especially at rest, and joints that move around too much
Other brain and nervous system symptoms:


Decreased intelligence or learning disabilities are common, but intelligence can be normal
Speech problems (dysarthria)
Hearing or vision problems
Seizures
Pain, especially in adults (can be difficult to manage)
Eating and digestive symptoms


Difficulty sucking or feeding in infants, or chewing and swallowing in older children and adults
Problems swallowing (at all ages)
Vomiting or constipation
Other symptoms:


Increased drooling
Slower than normal growth
Irregular breathing
Urinary incontinence.

Exams and Tests

A full neurological exam is critical. In older people, testing cognitive function is also important.


The following other tests may be performed:

• Blood tests
• CT scan of the head
• Electroencephalogram (EEG)
• Hearing screen
• MRI of the head
• Vision testing

Treatment

There is no cure for cerebral palsy. The goal of treatment is to help the person be as independent as possible.

Treatment requires a team approach, including:

• Primary care doctor
• Dentist (dental check-ups are recommended around every 6 months)
• Social worker
• Nurses
• Occupational, physical, and speech therapists

Other specialists, including a neurologist, rehabilitation physician, pulmonologist, and gastroenterologist

Treatment is based on the person's symptoms and the need to prevent complications.

Self and home care include:

Getting enough food and nutrition

Keeping the home safe

Performing exercises recommended by the health care providers

Practicing proper bowel care (stool softeners, fluids, fiber, laxatives, regular bowel habits)

Protecting the joints from injury

Putting the child in regular schools is recommended, unless physical disabilities or mental development makes this impossible. Special education or schooling may help.

The following may help with communication and learning:

• Glasses
• Hearing aids
• Muscle and bone braces
• Walking aids
• Wheelchairs

Physical therapy, occupational therapy, orthopedic help, or other treatments may also be needed to help with daily activities and care.

Medications may include:

Anticonvulsants to prevent or reduce the frequency of seizures

Botulinum toxin to help with spasticity and drooling

Muscle relaxants (baclofen) to reduce tremors and spasticity

Surgery may be needed in some cases to:

Control gastroesophageal reflux

Cut certain nerves from the spinal cord to help with pain and spasticity

Place feeding tubes

Release joint contractures

Stress and burnout among parents and other caregivers of cerebral palsy patients is common, and should be monitored.

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