What is cerebral palsy?
Definition, signs & symptoms

Cerebral palsy definition and meaning

Cerebral palsy (CP) is a group of neurological movement disorders that affect posture, coordination, muscle tone and how a person moves. The term "cerebral" refers to the brain, while "palsy" describes a lack of muscle control.

These challenges can range from mild to severe and differ from one individual to another. CP is typically the result of brain damage, often occurring before, during, or shortly after birth. However, it's not always diagnosed immediately; it's common for symptoms to become more noticeable during a child's first or second year.

Because the severity and type of cerebral palsy can vary so widely, the effects on the body also differ. In mild cases, a child may have a slight limp or subtle motor difficulties. In more severe cases, CP can lead to significant physical disabilities and impact overall development.

While cerebral palsy is a lifelong condition and has no known cure, fortunately it does not worsen over time. Early support, therapy, and medical care can make a significant difference.

CP can present a significant financial burden on families of those affected, with estimates for lifelong care up to $1.7 million. If your child has been diagnosed with CP, it's important to find out if you're entitled to an award to improve their wellbeing.

The Cerebral Palsy Center works only with lawyers who specialize in birth injury lawsuits, and have handled thousands of cases nationwide. Contact us today to speak directly with a lawyer.

Early signs of cerebral palsy

Delays in reaching key developmental milestones (such as rolling over, sitting up, crawling, or walking) are often some of the first signs of cerebral palsy.

Infants affected by cerebral palsy can have trouble with balance, muscle control and coordination. This may be displayed with certain early behavior or symptoms of cerebral palsy.

Early cerebral palsy shows itself in a few recognizable ways.

Early signs cluster around posture and movement: a baby who holds an unusual posture, moves stiffly or floppily, consistently favors one side, or has trouble swallowing and feeding.

Other early signs that are noticeable to parents involve delayed motor skills, like struggling to bring hands to their mouth or grasping objects.

Finally, babies that have difficulty focusing their vision, who display extraordinary fussiness, or who have decreased reflexes may be exhibiting early signs of cerebral palsy.

While these types of delays in development don't always mean a child has cerebral palsy, they are important signs that may warrant a closer medical evaluation. If you have concerns about your child's rate of development, it is important to speak with a healthcare provider as soon as possible.

Key facts about cerebral palsy

Cerebral palsy is the most common movement disorder among children in the United States, affecting around 1 in every 345 children born.

The population numbers are worth having in one place. Cerebral palsy affects about 1 in 345 children, and a meta-analysis of 49 population-based studies put prevalence at 2.11 per 1,000 live births. It occurs more often in boys than girls. Spastic cerebral palsy accounts for roughly 80% of cases. About 40% of people with cerebral palsy have epilepsy, more than 75% have a speech or language disorder, and almost half have some degree of reduced cognitive function, which means more than half do not. Most children walk independently. The condition is present at birth in most cases but frequently not identified for up to two years, and prematurity and low birth weight raise risk sharply: prevalence reaches 111.80 per 1,000 among children born before 28 weeks. Prevalence is also higher among Black children in United States data, a disparity that tracks preterm birth rates and access to prenatal care rather than anything inherent.

Signs of cerebral palsy in babies and newborns

Cerebral palsy symptoms in babies can lead to a range of physical and neurological challenges that impact early development. Because every child is different, symptoms may vary depending on the location, type and extent of brain injury.

Physical symptoms of cerebral palsy

Common signs include challenges with balance and posture, involuntary movement, muscle stiffness and poor coordination.

The symptoms themselves span more than movement. Muscles may tighten or stiffen, or stay unusually soft. Movements may be involuntary, and reflexes exaggerated or jerky. Balance and coordination are commonly affected, and in some children one side of the body more than the other. Beyond the motor picture come difficulty swallowing or sucking, drooling, gastrointestinal problems affecting digestion, and loss of bladder control.

Neurological symptoms of cerebral palsy

Other effects trace to the nervous system and brain, and show up as communication, sensory and learning problems.

Associated conditions travel with it often enough to be screened for rather than waited on: speech and language impairment, hearing and vision difficulty, delays in motor skill development, sensory limitations, behavior that is hard to place, and hydrocephalus, a build-up of fluid raising pressure inside the brain.

If you detect any of these symptoms in your child, it is important to speak with their pediatrician.

When to talk to a doctor about cerebral palsy signs

If you suspect your child may be exhibiting signs of cerebral palsy, you should contact their doctor as soon as possible. The following are concerning signs by age.

For babies under six months of age

Before six months, the signs to watch for are poor head control when lying on the back or being picked up, muscles that feel tight or contracted, muscles that feel soft or weak, legs that scissor and cross when the baby is lifted, and a baby who pushes away repeatedly.

From 6–10 months of age

Between six and ten months, watch for a child who cannot roll over, cannot bring their hands together, has trouble getting their hands to their mouth, or reaches out with one hand while the other stays fisted. That last one matters most: a strong hand preference before 12 months is a reason to ask rather than a sign of early talent.

For babies over 10 months old

After ten months the pattern shows in how a baby moves across a floor: crawling with the hand and leg of one side while dragging the other, crawling crooked, or getting around by sliding on the buttocks or hopping on the knees instead of crawling on all fours.

What causes cerebral palsy in children?

Cerebral palsy may be caused by a number of different factors that interfere with brain development. These are typically classified as congenital (about 85–90% of cases, occurring before, during or just after birth) or acquired (brain damage occurring more than 28 days after birth).

The most common risk factors and causes of cerebral palsy are well documented.

Risk factors are well characterized. Premature birth is the largest, with children born before 37 weeks at risk and those before 32 weeks at the highest, and low birth weight adds risk on top of gestational age rather than merely reflecting it. Multiple births raise both, as does infertility treatment through the same route. Delivery itself contributes where prolonged labor, a cord complication or a delayed birth restricts oxygen, or where forceps or a vacuum extractor are misapplied. Infection during pregnancy causes injury through inflammation, and untreated jaundice can produce kernicterus. Periventricular leukomalacia, white matter damage near the ventricles, is the characteristic preterm pattern. Prenatal exposure to alcohol and drugs completes the list.

Cerebral palsy caused by medical mistakes

Sadly, many cases of cerebral palsy are caused by preventable birth injuries resulting from medical malpractice. This occurs when healthcare professionals fail to provide the standard of care expected during labor and delivery.

A minority of cases follow a preventable error during care.

A minority of cases involve a preventable failure during care, and the recurring ones are specific: an abnormal fetal heart rate pattern that nobody acted on, forceps or a vacuum extractor used improperly, a prolapsed cord mishandled, a necessary cesarean delayed or never performed, and an infection during pregnancy or delivery left undetected or untreated. It is worth being clear that most cerebral palsy is not caused this way. In the classic analysis of 189 affected children, only 9% had markers suggestive of asphyxia without another intrinsic defect that could explain the outcome.

Doctors and hospital staff receive years of expert training in order to act quickly and carefully to protect both mother and infant. When that care falls short and causes harm to a child, their insurance coverage should be held accountable for the damages.

Very often, parents don't receive a full explanation of what mistakes caused their child's injury, or doctors evade questions about negligence. Therefore, if you suspect a mistake was made, it is important to speak with a qualified birth injury lawyer.

How is cerebral palsy diagnosed?

Although a child may show signs of cerebral palsy as early as 6 months of age, doctors follow a process of developmental and medical testing to form a definitive cerebral palsy diagnosis. It usually takes between the ages of 18 months and 5 years to properly diagnose CP.

Developmental monitoring

Developmental monitoring is an important part of well-child visits, especially for children at higher risk of cerebral palsy due to factors like low birth weight or premature birth. During these checkups, doctors track your child's growth, observe their movements, and discuss any concerns you may have. If CP is suspected, your child's development will be closely monitored over time to identify delays or signs of motor issues.

Developmental screening

These quick tests can identify potential delays in your child's motor skills or overall development. They typically involve short assessments conducted by a healthcare provider or simple questionnaires completed by parents.

The American Academy of Pediatrics recommends screenings at 9 months, 18 months, and 24–30 months to catch developmental delays early. If concerns emerge during a screening, your pediatrician may refer your child for further evaluation.

Developmental evaluations

Developmental evaluations are thorough assessments designed to pinpoint the specific developmental disorder affecting your child. These are typically conducted by specialists such as pediatric rehabilitation experts, developmental pediatricians or pediatric neurologists.

During this evaluation, experts will discuss your child's detailed medical history, then carefully assess their motor skills, muscle tone, posture, movements, and reflexes.

Medical evaluations & imaging

Specialized evaluation gives clearer answers than an initial screening, and four imaging tools do most of that work.

Imaging supports the diagnosis rather than making it. Cranial ultrasound works at the bedside while the fontanelle is open and is good at finding hemorrhage. CT is faster but uses radiation and has largely been displaced in children. MRI is the reference standard, abnormal in roughly 86% of children with cerebral palsy and able to indicate roughly when the injury occurred. An EEG records electrical activity rather than structure, so it answers questions about seizures and diagnoses no cerebral palsy at all.

In addition, doctors may request other medical testing to confirm a diagnosis, including hearing and vision tests, cognitive functioning tests, genetic or metabolic testing, speech and language tests, oral tests that measure feeding and swallowing, neurological muscle and nerve tests, and gait testing.

A combination of these methods is often used to arrive at a clear diagnosis. Identifying the specific type of CP can be as important as early detection to effectively manage your child's condition.

How CP Affects the Brain

The brain regions behind cerebral palsy

Motor Cortex

Controls voluntary muscle movement. Damage here is the primary cause of spastic CP (the most common type), leading to stiff muscles and difficulty with coordination.

Spastic CP (80% of cases)

Motor Cortex Frontal Lobe Parietal Lobe Temporal Lobe Cerebellum Brainstem

Can you prevent cerebral palsy?

At present, we don't understand enough about the brain damage that causes cerebral palsy to prevent it entirely. However, there are steps expectant mothers can take to limit the risk factors.

Some of the risk is reducible before and around birth.

Not every case is preventable, but several risks are reducible. Attending all scheduled prenatal visits and testing. Avoiding tobacco, alcohol and drugs. Managing diet and activity. Monitoring for high blood pressure and diabetes, both of which damage placental function long before they produce symptoms. Identifying conditions leading to anemia or jaundice early. Guarding against infection, which includes hand hygiene around toddlers, since cytomegalovirus is the most common congenital infection in the country. Working with clinicians to reduce the chance of preterm delivery. And watching closely for jaundice after birth, because screening and phototherapy prevent kernicterus almost entirely.

Doctors and hospital staff are specially trained to monitor for signs of fetal distress before and during delivery. However, mistakes can be made that have long-term effects.

What are the types of cerebral palsy?

Cerebral palsy is generally classified into five main types, depending on which area of the brain is damaged, the severity of the damage, and the parts of the body or movement affected.

There are five recognized types of cerebral palsy.

Spastic cerebral palsy accounts for around 80% of cases, follows damage to the motor cortex, and produces stiff muscles and awkward movement. Ataxic cerebral palsy follows cerebellar damage and affects balance, motor control and depth perception, showing as instability and difficulty with precise movement. Athetoid or dyskinetic cerebral palsy produces involuntary movement of the hands, arms, feet, legs, face or tongue, and follows damage to the basal ganglia. Hypotonic cerebral palsy, the rarest, presents as floppy muscles with motor, speech and feeding delays. Mixed cerebral palsy describes damage across several regions producing features of two or three types at once.

Through screening and medical testing, doctors can usually determine which type of cerebral palsy a child has within the first 2–5 years. The CDC recommends testing as soon as possible in order to begin effective treatment and maximize benefits.

Other conditions associated with cerebral palsy

The brain injuries that lead to cerebral palsy can also cause other related conditions, sometimes referred to as comorbidities. Fortunately, most of these associated conditions can be managed with proper treatment.

Conditions that commonly co-occur include epilepsy, speech problems, autism, vision or hearing impairment, attention deficit hyperactivity disorder, chronic pain syndromes, learning disabilities and mental health conditions. Adults report the last two more often than the older literature suggested: across 1,705 adults with cerebral palsy matched to 5,115 without, the adjusted hazard of depression was 1.28 and of anxiety 1.40, and the risk concentrated in those with no co-occurring intellectual disability.

It's important for children with cerebral palsy to be properly screened for coexisting conditions like these to ensure they're receiving the most complete care necessary.

What is my child's prognosis from cerebral palsy?

While cerebral palsy can present physical and cognitive limitations, the condition doesn't generally worsen over time and doesn't affect life expectancy. Many people with CP live full and rewarding lives.

Similar to the screenings and medical testing needed to diagnose cerebral palsy, doctors will measure a child's reflexes, motor skills, and whether they reach certain developmental milestones in order to determine their prognosis.

From those examinations a doctor will offer a prognosis and describe the limitations to expect.

The complications that shape day-to-day life are epileptic seizures, learning and intellectual disability, impairment of speech, vision or hearing, difficulty eating and swallowing, restricted movement and mobility, musculoskeletal problems including hip displacement and scoliosis, and respiratory problems. Swallowing safety deserves particular attention, because it is the single function most tied to long-term outcomes and no motor scale measures it.

According to the American Academy of Pediatrics, around 40% of children with cerebral palsy will experience epilepsy, 33% will have limited mobility, and 50% are likely to have a learning disability. Depending on your child's prognosis, a treatment and therapy plan can be customized to best manage their symptoms.

Cerebral palsy treatment

Although there is no cure for cerebral palsy, treatment can be especially effective at managing symptoms and optimizing a child's quality of life. A thorough treatment plan typically focuses on mobility, muscle control and the ability to independently perform daily activities.

Cerebral palsy treatment plans are designed by your child's doctor, and often use a combination of therapy, medication, assistive devices, mobility aids, and surgery. Each plan is unique to the child's needs.

As with early detection, it is essential to start a treatment plan as early as possible to foster brain development and overcome difficulties related to movement and mobility.

Therapy for cerebral palsy

Therapy can be especially helpful to children diagnosed with CP to help strengthen muscles, improve fine motor skills, and uncover creative strategies to boost their independence.

Physical therapy addresses stiffness, weakness, limited movement and tremor, targeting walking, wheelchair use and transfers. A 2019 systematic review of the evidence names goal-directed training, task-specific training, bimanual training and constraint-induced movement therapy among the approaches with demonstrated effect, and open-ended exercise is not among them. Speech and language therapy matters for the roughly 1 in 4 people with cerebral palsy who have speech difficulty, and covers swallowing safety as well as communication. Occupational therapy builds independence in self-care, school and work. And recreational therapy, from swimming to adaptive riding, earns its place on adherence: a child who will get in a pool every week is getting more therapy than one who resists a clinic.

The power of early therapy

Children who begin physical and occupational therapy before age three show significantly improved motor function and independence. A consistent therapy routine helps build neural pathways and strengthen muscles during the brain's most adaptable years.

Your care team can help design a therapy plan tailored to your child's specific type of CP and developmental goals.

Explore therapy options →

Medications used to treat cerebral palsy

No medication treats the underlying brain injury, but several manage specific symptoms well.

Medication is organized by symptom rather than by diagnosis. Over-the-counter pain relievers such as ibuprofen and acetaminophen handle ordinary musculoskeletal pain. Botulinum toxin injections reduce muscle contraction and improve range of motion, with an effect on a treated muscle lasting roughly three to four months, so holding the benefit means repeating them. Oral muscle relaxants include tizanidine, baclofen, dantrolene sodium and diazepam, and baclofen can also be delivered by an implanted pump. Anticholinergics such as benztropine and trihexyphenidyl manage tremor and involuntary movement. And anticonvulsants matter for the roughly 40% of children with cerebral palsy who have epilepsy.

Assistive devices for cerebral palsy

Specialized devices ease the tasks tied to learning, communication and sensory detection.

Assistive technology covers communication, access and sensory support. Speech-generating devices and communication boards give a route to be understood, which matters because about half of people with cerebral palsy have typical intelligence and may have no other way to demonstrate it. Eye-tracking systems serve people with very limited voluntary movement. Ordinary computers, phones and tablets now carry adaptive features that once required dedicated hardware. Hearing aids, cochlear implants and amplifiers address hearing loss, and glasses, magnifiers and large-print materials address vision.

Mobility aids for cerebral palsy

Mobility aids are designed to help children with cerebral palsy gain independence by allowing movement around the home, school or while away from home. Depending on a child's limitations, mobility aids may focus on allowing them to stand or walk more freely, or serve as a substitute for walking altogether.

Mobility aids are prescribed to match what a specific child needs.

Mobility equipment runs from walkers and gait trainers through manual and powered wheelchairs to standing frames, forearm crutches and canes. Ankle-foot orthoses and other braces hold position between therapy sessions. Adapted strollers, seating systems and transfer equipment complete the picture, and specialized seating does medical work rather than convenience work, because it is what prevents pressure injuries.

Surgery for cerebral palsy

Some children with cerebral palsy may benefit from surgery. This is usually considered only after less-invasive treatments like therapy and medication have failed. Most surgeries focus on relieving tight muscles (spasticity), managing uncontrollable movement, or correcting abnormalities.

Several surgical options exist.

Surgery addresses structural problems that therapy cannot reach. Selective dorsal rhizotomy interrupts the nerve signals driving spasticity and gives durable relief in carefully selected children. Muscle ablation relieves tightness. Orthopedic procedures correct bone and foot deformity, repair joints and tendons, and reconstruct hips, and hip surveillance on a schedule is what keeps that last one from becoming an emergency: a Swedish population program took hip dislocation from 8% to zero across two decades. Spinal surgery addresses curvature severe enough to compromise breathing.

For many people dealing with cerebral palsy, these surgical procedures can provide a more permanent treatment for symptoms than ongoing therapy and medications alone.

Experimental & alternative treatments

Research is advancing quickly, and it is worth separating what is still being studied from what has already become standard care.

Several lines of research are active. Stem cell infusion is in clinical trials, with umbilical cord blood cell therapy the furthest along and already appearing among the interventions with demonstrated effect in the 2019 evidence review. Genetic research is identifying risk factors and enabling earlier diagnosis, and exome sequencing already finds a causative variant in a substantial minority of cases. Functional electrical stimulation, robot-assisted treadmill rehabilitation and advanced neuroimaging biomarkers are each at different stages. Constraint-induced therapy is no longer experimental at all: it is established practice with evidence behind it. Nor is therapeutic hypothermia, which belongs under standard care rather than research. Cooling an infant with moderate or severe hypoxic-ischemic encephalopathy within hours of birth reduced death or major disability at 18 months across 11 randomized trials of 1,505 infants, with a number needed to treat of 7.

Much of this research is driven by leading organizations such as the National Institute of Neurological Disorders and Stroke (NINDS) and the National Institute of Child Health and Human Development (NICHD).

Living with cerebral palsy

While cerebral palsy can present unique challenges, it can also bring a renewed focus on love, resilience and priorities. Many types do not affect lifespan, and none worsen over time.

After the initial focus on your child's diagnosis, treatment and prognosis, your thoughts as a parent will turn to how your child and family will live with cerebral palsy.

People living with cerebral palsy frequently find creative approaches to engage in activities, reach their goals, and make valuable contributions to their communities.

An early focus will be optimizing your child's comfort and mobility, including transportation, sleeping adaptations, and mobility and assistive devices. It's also important to seek out activities and exercise habits that match your child's capabilities, offering significant advantages to their physical and mental health that persist into adulthood.

You'll learn about the special needs of your child for meal preparation, feeding, drinking and snacks. As many children with CP benefit from a healthy diet of whole foods, this can also inspire better nutrition for the entire family.

While many children with cerebral palsy face communication challenges, evolving assistive device technology offers continual promise. Encourage early adoption of communication aids and stay informed about the latest technology available to your child.

At the earliest opportunity, establish an education plan that matches your child's cognitive ability. It is essential to develop an Individualized Education Plan (IEP) with the help of professionals. Parents should encourage inclusion in general education classes whenever possible.

Finally, parents should set goals for their child's transition into adulthood. While cerebral palsy presents challenges in the teenage years, many young people can look forward to continuing their education into college or vocational school, and begin thinking of a career path that fits within their capabilities.

What are the costs of living with cerebral palsy?

Studies estimate that the cost to a family for lifelong care of a child with cerebral palsy can be up to $1.7 million. It's important to explore all financial support available.

The costs accumulate across a lifetime rather than arriving at once.

Lifetime cost spans therapy and medical treatment, medication, education, assistive and mobility devices, transportation, and the earnings lost by a parent who becomes a caregiver. That last item is routinely left out of estimates and is often the largest single line.

While health insurance, government programs, grants, community organizations, and charity may contribute to some of these costs, there is usually a shortfall that must be covered by the family itself.

In many cases, a child's injury can be traced back to a mistake made by doctors or hospital staff. These professionals and facilities are insured to help compensate victims for this very reason.