Understanding Cerebral Palsy Symptoms
Cerebral palsy is a group of chronic disorders caused by injury to parts of the brain that control muscles and movement. There are many different types of cerebral palsy. Each type has a unique set of symptoms that impact a person’s muscle control, mental ability and other aspects of their health.
Often, injuries that lead to cerebral palsy are caused by medical negligence during your pregnancy, labor and/or delivery.
Symptoms of Cerebral Palsy by Type
Cerebral palsy symptoms differ depending on the severity and type of the condition. Doctors at the Cleveland Clinic identify four types of cerebral palsy according to their effect on movement and motor control.
Types of cerebral palsy are:
- Spastic: Muscles are so rigid that they cause spasms and paralysis. Joints “freeze.”
- Ataxic: Loss of muscle coordination causes unsteady, shaky movements and loss of balance.
- Dyskinetic: Muscles are floppy. Movements can be involuntary and uncontrolled.
- Mixed Type: Symptoms of different cerebral palsy types appear in the same person.
Cerebral palsy symptoms may also include intellectual disabilities, seizures, speech issues, changes to the spine and joint problems.
Symptoms of Spastic Cerebral Palsy
Spasticity is a primary symptom in many cases of cerebral palsy. Spasticity is a condition that makes muscles abnormally stiff and interferes with movement and speech. Spasticity can also be associated with discomfort or pain.
Spasticity is caused by nerve damage in the areas of the brain and spinal cord that control movement.
Symptoms of spastic cerebral palsy can range from mild to severe and include:
- Scissoring (involuntary crossing of the legs)
- Fixed joints (contractures)
- Stiff muscles (hypertonicity)
- Rapid muscle contractions (clonus)
- Muscle spasms
These symptoms can be painful and interfere with daily activities and rehabilitation.
Fortunately, there are effective treatment options for spasticity. Medications for the condition include baclofen, diazepam, tizanidine, and clonazepam. Therapies to prevent contractures and discomfort can include muscle stretching and targeted exercise.
A newer treatment option for spasticity includes the targeted injection of Botox® to loosen stiff muscles and improve range of motion. For severe cases of spasticity, surgery can release tendons and sever painful nerve-muscle pathways.
Symptoms of Ataxic Cerebral Palsy
People with ataxic cerebral palsy have shaky movements or tremors in their limbs or other parts of the body. The condition also makes it difficult to maintain balance. Ataxia, or incoordination, can also be a symptom of any type of cerebral palsy or other nervous system disorders.
Because balance and depth perception are affected, a person with ataxic cerebral palsy may appear very unsteady. Ataxic movements may appear jerky and irregular, especially when a person is walking or handling objects.
Ataxia can affect a person’s muscles anywhere in the body.
Here’s how ataxia affects specific muscle groups:
- Legs: Children with ataxia in the legs tend to walk with their feet far apart.
- Arms and Hands: Ataxia in the hands will cause shaking when a child tries to grasp objects such as a fork or a pencil.
- Mouth, Throat and Neck: Children with cerebral palsy sometimes have ataxia in the muscles of the mouth and throat, affecting their ability to speak clearly or swallow properly.
Symptoms of Dyskinetic Cerebral Palsy
About 10% to 20% of people with cerebral palsy have dyskinesia. Dyskinesia affects the entire body. It is characterized by muscle tone that fluctuates from too tight to too loose. It also involves uncontrolled movements. These movements are caused by damage to the basal ganglia, a group of structures located deep inside the brain.
Damage to the basal ganglia affects the control of:
If the muscles of face, tongue or throat are affected, a person may drool, grimace or have difficulty speaking. Those whose arms, hands or fingers are affected may find it hard to pick up or hold on to objects.
A person with dyskinesia has trouble moving purposefully. They may not be able to direct their arms and legs. Dyskinetic patients often cannot control their posture while sitting or standing.
How to Spot Cerebral Palsy
Common signs of cerebral palsy include loose or rigid muscles and trouble controlling movements. However, cerebral palsy is not always easy to detect, especially if the symptoms are mild.
According to the U.S. National Institutes for Health (NIH), cerebral palsy signs usually appear before a child reaches three years of age.
How to spot cerebral palsy in babies:
- Does the baby fail to hit developmental milestones? Not reaching for objects, rolling over, smiling, sitting or crawling at the appropriate age could be early cerebral palsy signs.
- Does the baby favor one hand or side of the body? For example, always reaching for a toy with the left hand when the right hand is closer could indicate a lack of motor control. This may be an early sign of cerebral palsy.
- Does the baby seem to have trouble seeing or focusing on objects?
- Does the baby have abnormal muscle tone–either too floppy or too rigid?
How to spot cerebral palsy in toddlers:
- Is the child walking on his or her toes?
- Does the child lack fine motor skills?
- Is the child experiencing seizures? Epilepsy is present in about one-third of all cerebral palsy cases.
Monitoring these early cerebral palsy signs can help you get a proper diagnosis. The sooner you start therapy and treatment, the better the child’s chances are of being as healthy, active and comfortable as possible.
Physical and Neurological Characteristics
The various forms of cerebral palsy have a very wide range of characteristics. These characteristics typically appear during infancy or preschool years.
Physical cerebral palsy characteristics can be as mild as a slight limp. They can also be as severe as complete immobility. Neurological characteristics can range from slight learning disabilities to severe mental retardation.
Physical cerebral palsy characteristics include:
- Stiff muscles
- Floppy muscle tone
- Variations in muscle tone
- Involuntary movements or tremors
- Lack of coordination
- Delays in developmental milestones
- Trouble walking or toe-walking
- Favoring one side of the body or hand
- Difficulty with sucking, eating or swallowing
- Excessive drooling
- Lack of fine motor skills
Neurological cerebral palsy characteristics include:
- Trouble hearing or seeing
- Learning disabilities or mental retardation
- Abnormal pain or touch perception
If left untreated, some characteristics of cerebral palsy, such as rigid muscles, can worsen. This is why early and aggressive therapy is crucial as soon as potential symptoms are identified. Therapies can even start before a formal diagnosis is made to play it safe.
Developmental Delays and Cerebral Palsy
Developmental delays in children are some of the earliest warning signs of cerebral palsy.
When cerebral palsy affects developmental milestones, activities such as rolling over, sitting up, reaching for objects, crawling, standing, walking and talking may happen later in life when compared to normal children.
Developmental milestones commonly occur as follows:
- Smiling at 6 to 8 weeks old
- Rolling over by 6 months
- Sitting up at 5 1/2 to 7 months old
- Standing up by holding on to objects at 9 months
- Taking the first step by 15 months
How developmental milestones are affected by cerebral palsy will depend on the individual child and the severity of their condition.
Intellectual Disability and Cerebral Palsy
An intellectual disability is characterized by severe limitations both in mental functioning and adaptive behavior. The limitations of an intellectual disability affect everyday social and practical and life skills.
According to United Cerebral Palsy (UCP), about half of all people with cerebral palsy have an intellectual disability. Of that group, about one in five has a moderate or severe intellectual disability.
In people with cerebral palsy, the level of physical disability does not always match their intellectual impairment. For example, someone with a mild physical impairment might have a severe intellectual disability or vice versa.
Fortunately, kids with an intellectual disability caused by cerebral palsy have many treatment and therapy options that simply did not exist decades ago.
Growth Problems Caused by Cerebral Palsy
Due to the complex nature of their condition, children with cerebral palsy often experience growth problems. There are many different growth problems your child may have. Which issues your child may develop—if any—depend on how severe their condition is.
While not always harmful by themselves, growth problems in children can be the sign of a dangerous underlying condition. Of course, growth problems in children can be caused by issues other than cerebral palsy. It is important to take note of any growth issues and consult your doctor, as they can ruin your child’s health if left unchecked.
Growth problems in children with cerebral palsy may be caused by:
- Malnutrition: Because of their difficulty with sucking, swallowing and eating, some kids with cerebral palsy do not get the nutrients they need to grow properly.
- Inefficient eating patterns: Kids with cerebral palsy may take a very long time to eat, a process that can burn more calories than they can consume.
- Spasticity: This common symptom burns energy and calories. If a child cannot make up the calories, growth problems may be the result.
- Epilepsy medication: Medications for epilepsy can interfere with the metabolism of vitamin D and cause a deficiency. When used over a long time and in high doses, these medications may lead to growth issues.
Cerebral Palsy Communication Disorders
Communication problems in children with cerebral palsy are fairly common. Cerebral palsy communication disorders include dysarthria, which can affect the clearness of speech.
People with dysarthria have distorted speech because they are unable to control the muscles used to speak. Dysarthria is often characterized by slurred or slow speech that can be difficult to understand. A child with dysarthria may also drool and have problems chewing or swallowing.
Other cerebral palsy communication problems can include:
- Abnormal speech rhythms
- Hoarse or monotone voice
- Nasal voice that sounds like congestion
Cerebral palsy communication disorders can be frustrating for the speaker and the listener. Thankfully, there are other modes of communication that may help facilitate easier interactions.
For kids with more severe cerebral palsy symptoms, sign language is an effective method of communication. Computer programs are another popular and effective communication tool to help those with the condition express their thoughts, needs, and desires. Speech therapists can teach your child how to use these languages and tools.
Fine Motor Skills and Cerebral Palsy
One of the symptoms of cerebral palsy is a difficulty or inability to control fine motor movements. Cerebral palsy affects the fine motor skills of every child differently.
The Manual Ability Classification System (MACS) assesses fine motor skills from levels one to five. Level one in MACS means the child has some limitations but these do not affect daily life. A level five rating means the child cannot handle objects and needs complete assistance.
With disabilities like cerebral palsy, fine motor skills may be improved with therapy and daily activities depending on how severe the disorder is. Engaging in any activity that requires manipulating small objects is good for kids who struggle with fine motor skill issues.
Ways to help develop fine motor skills include:
- Finger painting
- Using toothpicks to make sculptures
- Making things from small Legos
- Gluing seeds on paper
- Squeezing stress balls
- Needle and thread sewing cards
- Practicing buttoning and unbuttoning
Of course, the outcome of these projects is not important. Just doing them can improve fine motor skills affected by cerebral palsy.
Dystonia Disorder Caused During Birth
Dystonia is a movement disorder where the muscles contract involuntarily. According to the Mayo Clinic, dystonia causes an uncontrollable twisting of the affected muscles. Symptoms of dystonia can range from mild to severe and can interfere with even the simplest day-to-day tasks.
Dystonia can be caused by several factors, including:
- Inherited or non-inherited neurological disorders
- Reactions to some toxic substances
- Lack of oxygen to the brain
While medications may help dystonia symptoms, they are not always effective. Sometimes Botox® injections may be recommended. Severe cases of dystonia can sometimes be treated with surgery. Physical therapy is almost always a part of the treatment plan, regardless of the severity of symptoms.
Hypotonia and Cerebral Palsy
Hypotonia is the medical term for muscle tone that is too low. According to the Cleveland Clinic, hypotonia is the most common sign of muscle abnormality. It is associated with non-spastic cerebral palsy.
Hypotonia indicates that the brain and nerves are not controlling muscles as they should. As a result, muscles are weak, and the child’s development may be slow.
Recognizing Hypotonia in Your Baby
If you are wondering whether your baby has hypotonia, consider the following questions.
- Has your child missed any important developmental milestones?
- Are their muscles appearing too tight or floppy?
- Are their legs spread wide when they lie on their back?
- Are their arms extended or flexed?
- Is their trunk limp?
- Is your child having difficulty supporting the weight of their head?
If the answer to any of these questions is yes, ask your doctor about hypotonia. Depending on the severity of your child’s condition, they could have cerebral palsy or a related condition.
Hypertonia and Cerebral Palsy
A baby with muscle tone that is too tight or rigid may have hypertonia. Hypertonia is a condition that essentially is the opposite of hypotonia. If left untreated, hypertonia can cause severe health issues in your child. Hypertonia may also indicate cerebral palsy. A qualified doctor can properly diagnose hypertonia and/or cerebral palsy.
Identifying Hypertonia in Your Baby
Several physical signs may indicate that your child has hypertonia.
These signs include:
- Too much tension in the muscles while the baby is at rest
- Rigid limbs and neck
- Difficulty bending and stretching the arms, legs and neck
- Very little or no movement of the limbs and neck
Treatment for Cerebral Palsy Symptoms
The key to reducing nearly all cerebral palsy symptoms is early intervention. A combination of cerebral palsy treatment by doctors and nurses with different therapies, such as occupational or speech therapy, can help manage symptoms and prevent them from getting worse. An early start to medications may also help your child adjust to them faster.
Unfortunately, therapy and other treatments for cerebral palsy are often expensive. According to the Centers for Disease Control and Prevention (CDC), the cost of caring for a person with cerebral palsy over their lifetime is about $1 million. Parents, taxpayers, government programs and nonprofit organizations may not have the means to pay for care.
If you believe your child’s cerebral palsy or birth injury may have been caused by medical negligence before, during or after delivery, you should seek legal action. A birth injury lawsuit may help you pay for your medical expenses and prevent other families from suffering a similar fate.