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Back to the Basics: Cerebral Palsy

The Law Firm of Michael H. Bereston

Finding out that your child has Cerebral Palsy can be life-altering news. Although, by educating yourself on things like treatment options and how to help manage the disorder, you can help make sure your child is able to lead a productive life.

What is Cerebral Palsy?

Cerebral Palsy (CP) is a neurological disorder that impacts the child’s ability to perform motor skills, movement, and muscle tone. In many cases, hearing, sensation, and vision are also impacted. According to a study done by the Centers for Disease Control and Prevention, Cerebral Palsy is the most common childhood motor disability.

The word “cerebral” means relating to the brain. The word “palsy” means paralysis that may be accompanied by weakness, tremors or problems with body movement.

What Are the Symptoms of Cerebral Palsy?

The symptoms of CP may be different for each affected individual and can vary in severity, ranging from mild to severe. For example, one individual with CP may have trouble sitting and walking, while another individual suffering from CP may have trouble with their grip strength, rendering them unable to pick up objects.

The part of the brain affected determines the symptoms suffered.

Some of the more common symptoms of Cerebral Palsy include:

  • Missed milestones including, rolling over, moving toys from one hand to the other, crawling, walking, kicking a ball

  • Abnormal muscle tone - increased muscle tone or decreased muscle tone

  • Spastic movements

  • Consistent poor coordination

  • In-toeing/Out-toeing - toes pointing inward/outward

  • Difficulty walking

  • Neurological issues - seizures, blindness, intellectual disability

What Causes Cerebral Palsy?

When a parent is first informed that their baby has been diagnosed with Cerebral Palsy, it’s common for their first thought to be “how did this happen?” The truth is, Cerebral Palsy can be caused by many different factors.

Cerebral Palsy may also be caused by the negligence of healthcare providers before, during or after birth.

Some examples of this include:

  • Asphyxia or hypoxia during pregnancy, labor, and delivery - the baby had an injurious lack of oxygen to the brain during pregnancy or labor and delivery that went undiagnosed or untreated

  • Birth trauma - excessive force or injury to the brain during delivery

  • C-section delay

  • Forceps and/or vacuum extractor misuse

  • Umbilical cord issues

  • Inadequate or incorrect interpretation of fetal monitoring tracings showing fetal compromise

  • Missed diagnosis of high-risk problems in pregnancy

  • Premature birth

These issues do not mean that your child will have Cerebral Palsy. If the healthcare providers are diligent and provide care to you and your baby in the safest manner possible, it will help to diminish the risk of Cerebral Palsy from these conditions.

What are the Different Types of Cerebral Palsy?

There are different types of Cerebral Palsy, each of them having different symptoms due to the part of the brain affected. Each of the different types causes a different movement disorder and shows different symptoms.

The different types of CP are:

Spastic Cerebral Palsy

Spastic Cerebral Palsy is caused by damage or developmental differences to the Cerebral Cortex. This is also the most common form of Cerebral Palsy.

Stiff muscles and jerky movements (spasticity) may affect the upper part of the body, the lower part of the body or both upper and lower; one side of the body or both sides.

This can lead to difficulty with:

  • Getting dressed

  • Walking, crawling, sitting up

  • Showering/bathing

  • Eating/drinking

  • Writing/typing

  • Grasping objects

  • Sitting/standing upright

  • Walking/running

Dyskinetic Cerebral Palsy

Dyskinetic Cerebral Palsy is associated with damage to the Basal Ganglia. The Basal Ganglia is essentially the brain’s delivery system between the movement center and the spinal cord, it’s responsible for regulating voluntary movements.

There are three different types of Dyskinetic Cerebral Palsy, based on which area of the Basal Ganglia was damaged, they are as follows:

Dystonia

Dystonia is known for resulting in involuntary muscle contractions that result in a slowly twisting movement or repetitive movement, that is triggered by trying to move.

Characteristics:

  • Repetitive Motions

  • Unusually awkward posture

  • Rapid or extremely slow movements which often cause pain

  • Involuntary, sporadic movement

  • Sensory ticks to suppress unwanted movement - touching of the face or chin with hands, tucking the hand under chin, sitting on hands

Athetosis

Athetosis shows itself by slow, involuntary movements that are displayed while at rest and amplified by movement. There is also a vast fluctuation in muscle tone, with some being extremely floppy and some being very tight.

Characteristics:

  • Restlessness

  • Constant slow movements

  • Drooling due to a lack of facial muscle control

  • Challenging to hold objects

  • Unwanted sporadic movements

Chorea

Chorea stems from a Greek word meaning “dance.” Fittingly, Chorea shows symptoms of restlessness, causing brief movement that is often unpredictable.

Ataxic Cerebral Palsy

Ataxic Cerebral Palsy is caused by damage to the Cerebellum, which is the balance center for our brain. It’s the Cerebellum’s job to fine-tune motor commands to maintain proper posture.

Characteristics:

  • Tremors/shakiness - caused by the brain trying to under/overcorrect movements

  • Difficult to perform precise hand movements

  • Walking wide using a “wide-base gait” to try to fix their poor balance

  • Breathy sound during speech

  • Hard time tracking movement visually

Mixed Cerebral Palsy

When multiple regions of the brain are damaged, it’s possible for multiple types of CP to be present.

How is Cerebral Palsy Classified?

Cerebral Palsy has been classified according to the Gross Motor Function Classification System (GMFCS) which is broken down into 5 different levels. The GMFCS categorizes the level of CP based on movements and the use of mobility devices.

This tool is helpful because it allows for families to have a clear understanding of their child’s current motor function skills, as well as gives them an idea as to which mobility devices would assist their child.

The five different levels of the GMFCS increase as the mobility decreases, they are as follows:

Level 1

The child is able to walk without any limitations. They are able to climb stairs without the use of rails, as well as being able to perform gross motor skills (running, jumping, etc.) although their speed and coordination may be limited.

Level 2

The child is able to walk in most situations and can climb stairs with the use of a rail. In certain situations, like unlevel terrain, long distance or crowded places, the child may have troubles walking. They may also use some form of a handheld mobility device to traverse long distances. Children have a very limited ability to perform gross motor skills.

Level 3

Whether it’s a short distance indoors stroll or a long walk outside, some form of mobility device is necessary for the child to walk. They are still able to make their way upstairs, as long as they are holding onto a rail along with supervision. Wheeled mobility is necessary when the child is going to travel long distances.

Level 4

In most cases, the child requires manual assistance or powered mobility. At home or in the comfort of their own time, the child may walk short distances with the assistance of a walker with body support or a powered mobility tool. While the child is in public, they will be in a wheelchair or use powered mobility to get around.

Level 5

The most severe level of CP, the child must be taken in a wheelchair anywhere they go and their head and neck must remain supported, due to the lack of ability they have to control them on their own. They also must have a support system in place for their trunk as well as their arms and legs.

For more information about Cerebral Palsy and some of the possible routes to take towards your child’s recovery, reach out to our *Nationwide Birth Injury Attorney Michael H. Bereston today at (410) 220-6581.

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Mother kissing her baby's feet