Causes
Cerebral palsy is defined as a non-progressive disorder of movement or posture, and it can be caused by hundreds of things. It’s amazing how many medical people still think that cerebral palsy is usually caused by problems at birth. The notion that cerebral palsy is caused by issues at birth is the general, prevailing wisdom. However, that is not always the case. If you look at the data, not more than 10-20% of cases of cerebral palsy are related to anything having to do with birth, including prematurity and/or difficult labor and delivery. The rest of the cases are due to another problem. Birth issues are part of the story, but they are not the whole story. If you do an MRI, you are probably going to see something that would explain the child’s disability, but you can certainly see people with cerebral palsy who have normal MRI scans.
David Coulter, MD, Pediatric Neurologist
A range of issues
Cerebral palsy is such a broad diagnosis. Children who have cerebral palsy present with a range of different issues. Many of the kids who are admitted to the hospital have more complex needs with multisystem involvement. For example, we see a lot of kids with spastic quadriplegic cerebral palsy who also have difficulty with swallowing required gastrostomy tube feeding, have seizures, and may be admitted to the hospital with aspiration pneumonia. For children who have difficulty coordinating the muscles of their throat and mouths, verbal communication can be very challenging and it is extremely important to understand the different systems for communication that each child and family develops.
Emily Davidson, MD, MPH, Pediatrician, Complex Care Services
Variable manifestations
The causes of CP are really variable, as are the manifestations of CP. Some children have really rigid muscle tone, some kids have involuntary movements, and some kids have really loose muscles and low tone. Associated with those conditions can be any number of medical or developmental issues, so there’s not a single profile. I would caution families about generalizing information to their own child based one some of what they might find in on the web.
Laurie Glader, MD, Pediatrician, Cerebral Palsy Program
CP and the associated complications
I think a really important concept to understand about CP is that whatever caused the CP is something that happened in the developing brain and it happened once and it’s done. It is not progressive, so the child’s brain isn’t going to change very much overtime. So from that standpoint, it’s very reassuring. This fact differentiates CP from other medical conditions, which may be progressive over time. On the other hand, some of the symptoms, the clinical issues that kids have associated with CP, may change overtime. For example, a child may have very low muscle tone when he or she is born and over the first year and a half to two years of life develop much stiffer muscles. And then over the years, he or she may develop contractures that require surgery, or require different types of bracing. Because of those changes, a child may be able to do certain activities at one point in time but have more difficulty with the same activities later. The CP itself hasn’t changed, but some other problems can change. So we watch and wait and do our very best to prevent what we know are common complications.
Laurie Glader, MD, Pediatrician, Cerebral Palsy Program