Cerebral palsy

• Two thirds of children with cerebral palsy are able to walk
• Three quarters of children with the condition are able to do everyday tasks – like feed themselves
• Around one in ten children with cerebral palsy has a visual impairment
• Only one in fifty children with cerebral palsy has a hearing impairment
• Adults living with cerebral palsy can also be prone to develop other conditions as they get older such as osteoarthritis
• There are many people with cerebral palsy in the UK living a full and productive life

It may be that no one cause can be found in an individual, but there are three types of damage which can occur to the baby’s brain, resulting in cerebral palsy:

• Abnormal brain development during pregnancy
• Serious infections during the early stage of pregnancy
• Lack of oxygen to the baby’s brain during birth or within the first 3 years of a child’s life - there are a lot of other possible reasons for oxygen deprivation

This is the most common form of the condition and affects around 75–88% of those living with cerebral palsy. Here muscle tone is very tight, causing people to have painful muscle spasms. This version can be divided into three types, depending on how the body is affected:

• Hemiplegia: both the arm and leg on one side of the body is affected;
• Diplegia: both legs are affected, but the arms may not be or are only mildly involved;
• Quadraplegia: both arms and both legs are affected, to a greater or lesser extent.

You may also hear this type of cerebral palsy called dyskinetic or dystonic. It occurs in about 15% of cerebral palsy cases. This causes uncontrolled and involuntary movements and peoples’ muscle tone will vary from spastic to very low tone (loose). Speech might be more difficult as it can be harder to control the tongue and vocal cords.

This is the least common type of cerebral palsy, affecting approximately 5% of all people with the condition. This can affect the whole body and make it more difficult to control balance when walking, causing those with the condition to be unsteady and shaky.

• Very tight tone which can make movement of arms and legs more difficult
• Stiff and jerky movements
• Muscles shortening with age

• Uncontrolled movements caused by muscle tone which varies from tight to very loose
• Uncontrolled twitching or writhing

Symptoms are generally less obvious than for the other two types.

• Difficulty with balance
• Problems with spatial awareness
• Unsteady movements

There are some associated conditions which may affect people with cerebral palsy too:

• Learning disabilities (although children with cerebral palsy have the same range of intelligence as other children)
• Speech difficulties
• Epilepsy can affect up to a third of children with cerebral palsy
• Problems with toileting

Some of these common effects which can affect older people with cerebral palsy include:

• Increased pain from joints causing inflexibility
• Shortening of muscles (contractures) leading to fixed limbs
• Breakdown of the skin
• Post-impairment syndrome – damage and weakness to muscles and joints, often caused by poor posture or strain from consistent use of walking equipment
• Intestinal problems due to pressure on internal organs

Treatment for cerebral palsy related pain includes:

• Anticholinergic medication to treat uncontrolled movements and spasms
• Muscle relaxants to relieve stiff or over-contracted muscles
• Painkillers
• Physiotherapy to stretch and exercise muscles and joints
• Good seating and sleep positions to improve posture and maintain flexibility
• Surgery is often recommended to lengthen leg muscles and tendons to make walking easier and less painful

A wheelchair or a wheeled supportive walking frame can help people move around more safely and can also help with maintaining a good posture. It is important to get professional advice before choosing either a frame or a wheelchair.

Bath hoists or bath lifts can be very useful to make use of an ordinary bath and bath cushions can give some protection for those who have uncontrolled movements. It may be easier to have a level access / walk in shower with a shower chair to provide support for the person and easier access for a carer.

Raised toilet seats and toilet frames can make toileting and personal hygiene much easier. You can also get wheeled toilet chairs for use over the toilet to provide support. Many children benefit from using additional harnesses and supports fixed to the toilet. People can also be more independent and dignified if they use an automatic wash / dry toilet.

Adapted cutlery, plates and cups can help during mealtimes and there are many holding, cutting and pouring aids for the kitchen to help when cooking.

there are many adaptive toys and games for children and older people with cerebral palsy. These can help to make exercise more fun and less of a routine.

This may include:

• Pureeing or chopping food and adding liquid to make it easier to swallow
• Looking at feeding methods. Wherever possible, those living with the condition are encouraged to feed themselves and can be given training to use adaptive equipment. However, if this isn’t possible, then carers can be taught how to allow enough time for swallowing and, if necessary, how to give food through a feeding tube
• Meal timings may need adjustment to allow for slower digestion rates. Smaller, more frequent meals may be helpful and may need to be structured around medication times, as some treatments are best given with food to avoid stomach upsets

Although we always try to explain things as simply and as clearly as possible, sometimes it’s necessary to use the correct medical terminology.

Medical terms are often known for being tricky to pronounce and if you’re not an expert in the subject, they can also be a little difficult to understand. Below, we’ve put together a list of terms used on this page along with a brief explanation of what they mean to help make your understanding of cerebral palsy as straightforward as possible.