Cerebral palsy is the name given to a range of conditions affecting muscle control, movement and co-ordination caused by damage to or problems with the brain that occur before, during or shortly after birth. The impact can vary from subtle disabilities to severe problems with movement and control of limbs requiring 24 hour care.
Cerebral palsy is a lifelong condition. Although the damage to the brain is not progressive and will not worsen over time, the impact that cerebral palsy has and the challenges it presents evolve as a child grows and transitions in to adulthood. Finding and putting in place the right support, therapies, and equipment to help children and their families can make all the difference.
What are the types of cerebral palsy
There are three main forms of cerebral palsy that can occur separately or in combination (Mixed Cerebral Palsy) depending on the areas of the brain affected:
- Spastic Cerebral Palsy is caused by damage to the motor cortex of the brain and involves muscle stiffness or weakness making movement difficult.
- Athetoid/Dyskinetic Cerebral Palsy, often caused by damage to the basal ganglia and the cerebellum, is characterised by variations in muscle tone that can cause involuntary spasms. It can be divided into sub-categories based on specific symptoms including: slow finger or facial movements (athetosis), slow rotating arm, leg or torso movements (dystonia), sudden spasms in fingers and toes (chorea), restricted movement (rigidity) and or involuntary movement (dyskinesia).
- Ataxic Cerebral Palsy affects the areas of the brain responsible for motor function. This can cause problems with posture, balance, coordination and communication as well as fine motor skills.
Cerebral palsy symptoms
Symptoms and their severity will vary greatly from child to child, but may include:
- Delays in learning and development
- Uncontrolled, involuntary, jerky or clumsy movements
- Problems with balance and co-ordination
- Muscle weakness or stiffness
- Difficulty moving arms and legs
- Walking on tip-toes
- Difficulties with visual perception
- Fits or seizures
- Speech difficulties
- Difficulty swallowing or eating
- Problems sleeping
Some children may also have other symptoms or conditions such as visual or hearing impairments or learning disabilities resulting from brain damage or the malformation of their brains in addition to their cerebral palsy.
Diagnosis and Causes of cerebral palsy
Muscle and coordination symptoms can be subtle and difficult to detect, particularly in young babies. Difficulties may not become apparent until a child is two or three years old and falls behind in their developmental milestones. As a result it can sometimes be years before a diagnosis of cerebral palsy is made or before there is an investigation into the cause. If you have any concerns regarding your child’s development or suspect they may have cerebral palsy then you should raise your concerns with a doctor as soon as possible.
Cerebral palsy usually results either from brain damage caused by an obstruction or disruption in the blood or oxygen supply to the brain or from underlying (i.e. genetic) problems with the development of the brain itself.
Potential causes of cerebral palsy include:
- Stroke: a blood clot or a bleed within the babies brain either before or after birth can result in brain damage both through physical damage to blood vessels and surrounding brain tissue and through disruption of the oxygen supply to affected parts of the brain;
- Hypoxia (shortage of oxygen to the brain) or asphyxiation (disruption of oxygen to the brain)
- Premature birth (contributing to difficulties in maintaining temperature, circulation and or oxygen to the brain)
- Infection in the mother prior to birth
- Infection, meningitis or encephalitis in newborn
- Very low blood sugar levels in newborn
- Head injury or trauma during or shortly after birth
- Genetic (including chromosomal or mitochondrial) changes affecting the development of the brain
In cases where a baby is born in a poor condition, is seriously unwell or there are specific concerns, then brain scans may be taken at an early stage to help identify any areas of brain damage malformation or swelling. These early scans and any other brain scans taken as the child ages can help to establish the likely cause as well as to confirm the diagnosis.
When might there be a claim for cerebral palsy?
Whether or not they had concerns at the time, a diagnosis of cerebral palsy will often lead parents to question whether difficulties during pregnancy, labour or delivery were dealt with appropriately or if issues with medical care could have played a part in their child’s condition.
Cerebral palsy claims relating to antenatal care might involve delays in the treatment of maternal infections (such as chicken pox or rubella) that result in damage to the unborn baby prior to birth. Alternatively there could be errors in the management of high risk pregnancies to avoid premature delivery or failures to diagnose and manage conditions that put the baby at risk or are likely to complicate the labour or delivery (such as gestational diabetes).
Brain injuries (including cerebral palsy) suffered during labour and delivery are often the result of lack of oxygen and may involve failures to recognise and act on signs that the baby is in distress during labour in order to ensure that delivery takes place before the child suffers brain damage due to lack of oxygen. Alternatively there may be a failure to diagnose and treat maternal infections which are then passed to the child during labour and cause seriously illness.
After birth, there may be a claim for failure to monitor blood sugar levels or delays or errors by medical professionals in diagnosing and treating strokes, bleeds, infection (including meningitis) or other conditions.
More articles on cerebral palsy
Produced by Catherine Bell of Freeths Solicitors
Catherine Bell is a Senior Associate specialising in brain injury claims as a result of clinical negligence at Brain Injury Group member law firm Freeths Solicitors. She has considerable experience representing both children and adults who have suffered brain damage as a result of medical treatment including claims involving strokes, hypoxia (lack of oxygen), negligent treatment with drugs or anaesthetic, surgical negligence and birth injuries. Catherine regularly represents children suffering from cerebral palsy as a result of birth injuries or negligent neonatal care.
What is the Brain Injury Group?
The Brain Injury Group exists to support individuals and families affected by brain injury and the health and social care professionals working in this specialist field. Our mission is to provide anyone affected by brain injury with access to advice on legal, financial and welfare benefit issues delivered by proven experts in the field who have been chosen not only for their skills and knowledge, but also for their passion and dedication to helping people.
Brain Injury Group provide training for legal, health and social care professionals who support those with Cerebral Palsy. Full details of our 2020 Cerebral Palsy training event will be released in Autumn 2019. View the Brain Injury Group brain injury training events.
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