Cerebral palsy (CP) is a group of disorders that affect a person’s ability to move and maintain balance and posture. Cerebral means having to do with the brain. Palsy means weakness or problems with using the muscles. CP affects the part of the brain that controls muscle movements. CP is the most common motor disability in childhood. Cerebral palsy (CP) is an umbrella term for a group of disorders caused by a nonprogressive lesion to the developing brain. The 2 largest groups of movement disorders in CP are spasticity (77% to 93%) and dyskinesias (2% to 15%),sometimes both movement disorders can be present at the same time.
What causes CP?
CP is caused by abnormal brain development or damage to the developing brain that affects a person’s ability to control his or her muscles. This damage can happen during pregnancy, at birth, or in the first years of a child’s life.
Types of CP
Cerebral Palsy is classified according to the main type of movement disorder involved. Depending on which areas of the brain are affected, one or more of the following movement disorders can occur:
- Stiff muscles (spasticity)
- Uncontrollable movements (dyskinesia)
- Poor balance and coordination (ataxia)
Cerebral Palsy is classified into four types:
Spastic Cerebral Palsy
Spastic CP is the most common type of CP. People with spastic CP have increased muscle tone. Spasticity is a category of movement disorders where the brain’s inability to control or fine tune muscle activation result in stiffness of an arm, hand or leg. Spastic CP is described by what parts of the body are affected:
- Spastic hemiplegia/hemiparesis typically affects the arm and hand on one side of the body, but it can also include the leg.
- Spastic diplegia/diparesis involves muscle stiffness that is predominantly in the legs and less severely affects the arms and face.
- Spastic quadriplegia/quadriparesis is the most severe form of cerebral palsy. It is caused by widespread damage to the brain or significant brain malformations.
What is Diplegia?
Diplegia is a term used when cerebral palsy compromises the movement control of the lower limbs (legs) more significantly than those of the upper limbs
What is Quadriplegia?
Quadriplegia is a term used when all four limbs, both arms and both legs have impaired control
What is Hemiplegia?
Hemiplegia is a term used when one side including upper and lower limbs (arm and leg) is severely impaired (usually the upper limb more so than the lower limb).
Dyskinetic Cerebral Palsy
Dyskinetic Cerebral Palsy (also includes athetoid, choreoathetoid, and dystonia) is a category of movement disorders represented by abnormal uncontrolled jerky movements that occur when an area of the brain called basal ganglia is damaged. Patients with dystonia are unable to “fine tune voluntary movements,” like shaking hands with a friend.
Ataxic Cerebral Palsy
Ataxia Cerebral Palsy affects balance and depth perception. Individuals with ataxic CP may be unsteady when they walk and may have a difficult time controlling their hands or arms.
Mixed types of CP refer to symptoms that do not correspond to any single type of CP but are a mix of types. The most common type of mixed CP is spastic-dyskinetic CP.
Cerebral Palsy is described using several different classification systems that are shared among multiple medical and allied health care specialties. Some classification systems describe a patient’s functional mobility or movement disorder while others focus on affected body parts. None of these systems address the intellectual capability of the patient, which is frequently normal across all classification levels.
What are Movement Disorders?
Movement disorders are abnormal movements that are the result of brain damage (central nervous system injury) and noticed as the patient’s inability or difficulty to move their arms, legs, head, neck, and trunk in a purposeful way.
What is 3D Movement/Gait Analysis?
3D Movement/Gait Analysis is a state-of-the-art method “to scan” and precisely measure the movements of a person moving/walking. It uses modern video capture technology as well as force plates and electromyography equipment to measure the forces the body generates and the muscle activity during movements. The amount of oxygen a person uses during those movements can also be measured. This technology offers very accurate data for the understanding pathological movements and walking.
What is a "Catch"?
A “catch” is a joint movement like bending or stretching the knee or elbow is blocked or prevented for an instant when the doctor or physical therapist is trying to examine the range of motion of that joint.
What is Posturing?
Posturing is term used to describe a fixed limb, neck or trunk position.
What is Equinus Deformity?
Equinus Deformity is when the calf muscles and the Achilles tendons are shortened or tight, the foot is driven downwards. This means that when someone has an equinus deformity he/she will tend to walk on tip toes.
What is Hip Flexion Deformity?
Hip Flexion Deformity is when the muscles that help lift up the hip (muscle iliopsoas) are shortened or tight,this prevents one from stretching the hips all the way when standing, walking, or lying down.
What is Psoas?
Psoas is a muscle located in the lower region of the spine that extends through the pelvis to the femur and helps us to lift up or flex our hips.
What is the Gross Motor Function Classification System (GMFCS)?
The Gross Motor Function Classification System is an internationally accepted system to classify the impairments of persons with cerebral palsy. This classification ranges from levels I to V. Persons at GMFCS I, II and III tend to be able to walk independently or with assistive devices such as canes, crutches or walkers. Wheel-chair users tend to be at levels IV and V.
Symptoms of CP
The symptoms of CP vary from person to person and range from mild to severe. CP does not get worse over time but symptoms may change (get better or worse) as a child grows.
All people with CP have problems with movement and posture. Many also have related conditions such as intellectual disability ; seizures; problems with vision , hearing, or speech; changes in the spine (such as scoliosis); or joint problems (such as contractures).
Learn More about CP from The Centers for Disease Control and Prevention