Conditions Associated with Cerebral Palsy

When the Centers for Disease Control (CDC) began studying the rate of childhood disabilities in several states, they uncovered a concerning fact — many children with cerebral palsy have at least one other disability. From epilepsy to deafness, several conditions commonly occur alongside cerebral palsy. Thankfully, most associated conditions can be improved through treatment.

Neurological Conditions Associated with Cerebral Palsy

Neurological conditions are problems of the brain, spine, and the connecting nerves. Children who suffer brain damage often develop other neurological conditions alongside cerebral palsy.

These conditions can cause a variety of issues, from learning disabilities to behavior problems.

Seizures

A seizure is a sudden electrical disruption in the brain that may affect behavior, movement, feelings, or consciousness.

According to the National Institute of Neurological Disorders and Stroke, up to 50% of children with cerebral palsy will experience at least one seizure in their lifetime. However, thanks to modern anti-seizure medications, most seizures can be effectively treated.

Epilepsy

When a child with cerebral palsy has more than one seizure or recurring seizures, the condition is called epilepsy. According to the CDC, epilepsy co-occurs in roughly 41% of cerebral palsy cases.

Most children with epilepsy can prevent seizures by taking one or more anti-seizure medications. Many children can eventually discontinue medications altogether.

Apraxia

Apraxia is a condition that makes it difficult or impossible to make certain movements even though muscle function is normal.

Apraxia may take the form of:

  • Orofacial apraxia: Problems moving facial muscles
  • Limb-kinetic apraxia: The inability to make exact movements with the fingers, arms, or legs
  • Apraxia of speech: The inability to effectively move the mouth and tongue, leading to difficult speech or muteness

Apraxia of speech is common in children with cerebral palsy, but it can be improved significantly or even completely overcome by working with speech-language pathologists.

Dysarthria

Dysarthria is a condition resulting in speech muscles that are weak or difficult to control.

It is a very common co-occurring condition, present in more than 50% of children with cerebral palsy, according to a 2013 study published in the journal Acta Paediatrica.

Symptoms of dysarthria include:

  • Abnormal speech rhythm
  • Monotone speech
  • Nasal, raspy, or strained voice
  • Slurred or slow speech
  • Speaking too softly or in whispers
  • Trouble moving the tongue or facial muscles

ADHD

Attention deficit hyperactivity disorder (ADHD) is a behavioral disorder that includes persistent problems such as difficulty paying attention, hyperactivity, and impulsiveness.

The 2005 study published in the journal Disability and Rehabilitation estimated that 19% of children who have cerebral palsy may also have ADHD.

Treatments for ADHD include:

  • Medications
  • Behavior therapy
  • Counseling
  • Special education services

ADHD cannot be cured, but these treatments may help children with the disorder manage their behavior.

Dyslexia

Dyslexia, also called reading disability, is a learning disorder that affects the areas of the brain that process language and that makes reading difficult. Children with cerebral palsy are more likely to have damage in these language-processing areas of the brain.

Children with dyslexia have problems matching written letters with the sounds they make. While dyslexia is a lifelong condition, detecting it early and forming a special education plan may greatly improve a child’s language ability.

Autism Spectrum Disorder

Autism spectrum disorder — including autism and Asperger’s syndrome — is a condition that affects how someone communicates and behaves, which causes problems with social interaction.

While autism spectrum disorder occurs in about 1% of all U.S. children, the CDC reports that it occurs in roughly 7% of children with cerebral palsy.

There is no cure or standard treatment for autism spectrum disorder, but early treatment tailored to the individual child can help with communication and learning.

Intellectual Disability

An intellectual disability is the limited ability to learn, reason, understand concepts, develop social skills, and perform other acts related to mental capacity or everyday life skills.

This ability is often measured with an IQ test, with a score of 70 or below indicating an intellectual disability.

According to the Cerebral Palsy Alliance Research Foundation (CPARF), about 50% of children with cerebral palsy have an intellectual impairment.

Physical Conditions Associated with Cerebral Palsy

Physical conditions associated with cerebral palsy are not neurological or mental in origin. For example, they may be caused by continuously contracted muscles (spasticity) or inflammation.

Dysphagia

Dysphagia is the medical term for difficulty swallowing. People with dysphagia may also experience pain when swallowing or may be unable to swallow at all.

Dysphagia is common in people with cerebral palsy because, like cerebral palsy, it is often the result of brain damage.

Depending on the cause, dysphagia may be treated with: 

  • Esophageal dilation
  • A feeding tube
  • A liquid diet
  • Medications
  • Speech or swallowing therapy
  • Surgery

Visual Impairment

Visual impairment or vision loss is a decreased ability to see that cannot be fixed by usual means, such as glasses.

According to a presentation at the American Academy for Cerebral Palsy and Developmental Medicine’s 2011 conference, as many as 75-90% of children with cerebral palsy have a visual impairment.

Visual impairments associated with cerebral palsy include:

  • Amblyopia (lazy eye): Causes a wandering eye and poor depth perception
  • Nystagmus: Repetitive, uncontrolled eye movements that harm vision and depth perception
  • Optic atrophy: Deterioration of the optic nerve after it is damaged
  • Visual field defects: An inability to see part of one’s usual visual field

Visual impairments may be treated by wearing an eyepatch or surgery, but results may vary.

Deafness

Deafness is the inability to hear — either partially or completely.

The CDC estimates that, among children with cerebral palsy, roughly 1 in 10 experience hearing loss. This is often caused by a buildup of liquid in a child’s ears due to difficulty swallowing or frequent colds.

There are two types of hearing loss that children with cerebral palsy may have:

  • Conductive hearing loss: A physical type of hearing loss that is the most likely to occur in children with cerebral palsy
  • Sensorineural hearing loss: A type of hearing loss related to the nerves in the inner ear

In a 2018 study posted in the journal Otology & Neurotology, only 4% of deaf children with cerebral palsy had sensorineural hearing loss.

Conductive hearing loss is far more treatable than sensorineural hearing loss. It may be treated with hearing aids, surgery, or by treating the underlying infections and inflammation.

Digestive Conditions Associated with Cerebral Palsy

Cerebral palsy causes abnormalities in the same parts of the nervous system that control involuntary body functions such as digestion. As a result, digestive issues are very common in children with cerebral palsy.

Common digestive conditions in children with cerebral palsy are: 

  • Bladder infections
  • Breathing in food or liquids
  • Constipation
  • Incontinence
  • Not being able to eat
  • Trouble swallowing or sucking
  • Substantial weight gain or weight loss
  • Vomiting

Respiratory Conditions Associated with Cerebral Palsy

Respiratory conditions are another common issue in children with cerebral palsy.

Respiratory conditions may be caused by:

  • Being unable to cough
  • Blocked airways
  • Excessive drooling
  • Low activity levels
  • Trouble swallowing
  • Unusual posture

Respiratory conditions related to cerebral palsy include:

  • Asthma
  • Aspiration
  • Bronchitis
  • Bronchopulmonary dysplasia
  • Chronic lung disease
  • Pneumonia
  • Respiratory distress syndrome (RDS)

Behavioral Conditions Associated with Cerebral Palsy

Many children with cerebral palsy struggle with various emotional and behavioral conditions. The many physical and mental issues associated with cerebral palsy can negatively affect a child’s quality of life, causing behavior issues.

Behavioral problems common in children with cerebral palsy include:

  • Anxiety
  • Arguing with other children
  • Depression
  • Frequent anger
  • Misbehaving in class
  • Not engaging with peers

Behavioral conditions are often treated by mental health providers. Parents can also help by learning how to handle the unique social and emotional challenges a child with special needs may encounter.

Sleep Conditions Associated with Cerebral Palsy

Sleep issues are common among children with cerebral palsy, usually due to other co-occurring conditions.

The most common health issues that contribute to sleep problems are:

  • Drooling
  • Gastrointestinal reflux disorder (GERD)
  • Muscle spasms
  • Pain
  • Skin ulcers
  • Unusual posture

Skin Conditions Associated with Cerebral Palsy

Skin conditions often affect children with cerebral palsy due to excessive drooling and the inability to perform hygienic tasks such as washing their faces.

Skin conditions associated with cerebral palsy include:

  • Boils
  • Impetigo
  • Ringworm
  • Skin infections
  • Staph infections
  • Ulcers

Oral Health Conditions Associated with Cerebral Palsy

Cerebral palsy may lead to oral health conditions because many of its symptoms make it difficult to perform tasks such as teeth brushing and flossing.

Children with cerebral palsy may also suffer from oral health problems because of issues with drooling and the inability to control facial muscles.

Oral health conditions related to cerebral palsy include:

  • Biting the inside of the mouth
  • Cavities and tooth decay
  • Gagging excessively
  • Gingivitis
  • Grinding teeth
  • Trouble drinking and eating

Treatment for Conditions Associated with Cerebral Palsy

Caregivers can work with their child’s doctor to create a comprehensive cerebral palsy treatment plan.

This plan involves a team of medical specialists and treatments aimed at optimizing the physical and mental health of a child with cerebral palsy. Treatment plans focus on cerebral palsy and other conditions.

Medical specialists involved in a cerebral palsy treatment plan may include:

  • A pediatrician
  • A physiatrist
  • A pediatric neurologist
  • Therapists
  • Mental health specialists

These specialists may use several types of treatments to help manage the associated conditions of cerebral palsy.

Medications

Medications that can lessen muscle tightness may be used to manage complications related to spasticity or other associated problems such as sleep issues.

Children may also be prescribed medication such as Botox injections to reduce drooling, which may help with breathing and oral health conditions. Further, cerebral palsy medications for seizures are often effective in managing epilepsy.

Therapies

Several types of cerebral palsy therapies may help children manage their co-occurring conditions.

Common therapies used to treat associated conditions of cerebral palsy include:

  • Occupational therapy: Occupational therapy aims to help children with cerebral palsy gain independence in daily activities and routines, helping with problems like nutritional imbalances and skin and oral health issues.
  • Physical therapy: Physical therapy can improve mobility and strength, helping with a variety of associated conditions that occur because of an inability to move, such as poor sleep or hygiene.
  • Recreational therapy: This type of therapy helps improve a child’s motor skills, speech, and emotional well-being.
  • Speech and language therapy: These therapies help with speaking, eating, and swallowing difficulties.

Surgeries

While cerebral palsy surgery may be an intimidating option for many parents, in some severe cases, it can lead to better long-term health and happiness for their child.

Orthopedic surgery may help lessen muscle tightness or correct bone abnormalities. The resulting pain relief and improved mobility can improve a child’s sleep, behavioral issues, and other problems.

The number of conditions associated with cerebral palsy can seem overwhelming for caregivers. However, by working with health professionals on a comprehensive treatment plan, parents can give their child the best possible physical, mental, and emotional care.