Cerebral Palsy (Pediatric)
What is cerebral palsy?
Cerebral palsy refers to a group of movement disorders affecting posture and balance due to injury to the immature or developing brain. This condition is detected in infancy or early childhood. While cerebral palsy permanently affects muscle coordination and limits physical activity, it does not worsen over time.
Who is affected by cerebral palsy?
Cerebral palsy affects 2 out of every 1,000 live births and may be related to intrauterine stroke, a gene mutation causing brain abnormality, lack of oxygen to the brain, or fetal infection. However, in most cases the exact cause is undetermined.
What are the symptoms of cerebral palsy?
Symptoms range in severity depending on the degree of injury to the brain.
A parent is often the first person to notice a child’s difficulty in walking, crawling, swallowing, or speaking. Other signs of cerebral palsy may be seizures or stiff or floppy muscle tone, involuntary movement, drooling, joint contractures, curvature of the spine, developmental dislocation of the hip (dysplasia), cognitive or visual impairment, and motor delay.
How is cerebral palsy diagnosed?
If cerebral palsy is suspected, a doctor will take a comprehensive history and perform a physical examination to check for stiff muscles and abnormal reflexes.
Laboratory and neuroimaging studies may also be ordered, such as brain magnetic resonance imaging (MRI), computerized tomography (CT) scan, or electroencephalogram (EEG). These tests are readily available at the NewYork-Presbyterian/Morgan Stanley Children's Hospital.
Once the diagnosis is made, our rehabilitation team works closely with family and caregivers to develop a treatment program that maximizes your child’s development. We address mobility, self-care skills, and communication as well as increased participation in school and society.
Due to the complexity of cerebral palsy, coordination of care is of utmost importance. Experts on your child’s team may include physiatrists (rehabilitation medical specialists), neurologists, developmental pediatricians, orthopedists, neurosurgeons, physical therapists, occupational therapists, speech and language pathologists, psychologists, psychiatrists, orthotists, and nutritionists.
What is the treatment for cerebral palsy?
The mainstays of cerebral palsy treatment are physical therapy, occupational therapy, and speech therapy.
Stiff muscles (hypertonia) are managed with oral medications, botulinum toxin (Botox) injections, and alcohol nerve blocks. We aim to minimize muscle spasticity and improve range of motion and mobility.
There are also neurosurgical interventions for cerebral palsy:
- Intrathecal baclofen pump is a drug delivery system implanted in the abdomen that brings medication directly to the spinal cord, nerve roots, and cerebrospinal fluid. This treatment reduces pain, making it easier for your child to perform daily activities.
- Selective dorsal rhizotomy is a surgery that permanently reduces spasticity by interrupting abnormal signals from the nerve roots to the spinal cord.
Orthopedic surgeons help to manage joint contractures, hip dislocation, or curvature of the spine (scoliosis).
Innovative therapies for cerebral palsy include constraint-induced movement therapy, functional electrical stimulation, and aquatic therapy.
The mobility needs of children increase with age. We address these needs with adaptive equipment. Our pediatric physiatrists work closely with our In-house Specialty Equipment Clinic where orthotists specialize in creating braces for children with special needs.