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Health condition · Clinically reviewed

Cerebral palsy, a lifelong condition with a modern, team-based plan.

The leading cause of physical disability in UK children. Non-progressive, deeply individual, and best managed by a specialist paediatric neurodisability team from the earliest weeks.

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A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Why trust this guide

  • 01

    Clinically reviewed

    Written by our editorial team and reviewed by a UK paediatric neurodisability clinician before publication.

  • 02

    Sourced from guidance

    Checked against NICE, the Royal College of Paediatrics and Child Health, and peer-reviewed neurodisability sources.

  • 03

    Current for 2026

    Reflects modern UK practice including GMFCS, hip surveillance, botulinum toxin, intrathecal baclofen and selective dorsal rhizotomy.

Key facts

Cerebral palsy at a glance.

The essentials, in plain English - what it is, how it is classified and who leads care in the UK today.

  • What it is

    A group of permanent, non-progressive disorders of movement and posture from a disturbance in the developing brain of a foetus or infant.

  • How common

    The leading cause of physical disability in UK children, affecting around two to three babies in every one thousand live births.

  • When it starts

    The underlying brain injury happens before, during or shortly after birth, though the clinical picture may only become clear over the first two years.

  • Motor types

    Spastic (around 80 per cent), dyskinetic, ataxic and mixed - each pointing to a different part of the brain.

  • Function scale

    The Gross Motor Function Classification System (GMFCS I to V) grades everyday movement, from community walking to full wheelchair support.

  • Team-based care

    A specialist paediatric neurodisability multidisciplinary team coordinates therapy, medicine, surgery, education and family support.

Why this guide matters

A coordinated plan, from first months to adult life.

Cerebral palsy is lifelong, but modern UK care is unrecognisable from a generation ago. Three ideas shape the rest of this page.

  • Early identification changes everything

    General Movements Assessment, HINE and structured screening in the first months open the door to earlier therapy and better outcomes.

  • MDT care beats scattered appointments

    A single specialist paediatric neurodisability team coordinates therapy, medicines, surgery, education and family support.

  • Targeted spasticity care matters

    Botulinum toxin, intrathecal baclofen and selective dorsal rhizotomy - used at the right time - can meaningfully change function and comfort.

How the diagnosis is made

From first concerns to a clear MDT plan.

The steps a UK paediatric neurodisability team will normally follow, in order - so families know what to expect and why.

  1. 01

    Assessing

    Early identification

    General Movements Assessment, the Hammersmith Infant Neurological Examination and developmental screening in the first months of life.

  2. 02

    Assessing

    Clinical examination

    Tone, reflexes, primitive reflexes, posture, symmetry, milestones and hand preference under a paediatric neurologist or neurodisability specialist.

  3. 03

    Assessing

    History and risk factors

    Pregnancy, prematurity, birth events, neonatal course and any early postnatal illness or injury to map likely aetiology.

  4. 04

    Confirming

    MRI brain

    Looks for periventricular leucomalacia, cortical malformation, hypoxic-ischaemic patterns, gliosis or a genetic malformation.

  5. 05

    Confirming

    Genetic and metabolic work-up

    Chromosomal microarray and whole exome sequencing when the cause is unclear or features look syndromic - yielding a diagnosis in around 10 to 30 per cent.

  6. 06

    Planning

    Associated-condition screen

    EEG for seizures, audiology, ophthalmology, speech and language, feeding and swallowing assessment, and hip and spine surveillance.

  7. 07

    Planning

    Function and equipment plan

    GMFCS level, gait analysis where relevant and a coordinated therapy, orthotics and equipment plan across the team.

Typical timeline: first concerns to a working MDT plan over the first two years of life.

Symptoms

What cerebral palsy can look like.

Cerebral palsy is a spectrum - from very mild motor differences to complex, multi-system needs. These are the features that most often prompt a referral.

  • Delayed motor milestones

    Late head control, rolling, sitting, standing or walking - often the first thing families and health visitors notice.

  • Abnormal tone

    Stiff (hypertonic) or floppy (hypotonic) muscles, or a mix that changes with position, effort or emotion.

  • Persistent primitive reflexes

    Reflexes that should have gone by six months persisting - a soft sign that the developing brain has been affected.

  • Asymmetric hand preference

    A strong right or left preference before 12 months can point to a hemiplegic pattern and deserves review.

  • Toe-walking and scissoring gait

    Walking on tiptoes with legs crossing at the knees is a classic sign of spastic diplegia.

  • Feeding and drooling

    Poor suck, slow feeds, coughing, chest infections and dribbling reflect oral-motor and swallow difficulty.

  • Associated conditions

    Epilepsy in around a third, learning and intellectual difficulties in around half, and vision, hearing and communication needs are common.

  • Red flag - regression

    Cerebral palsy itself is not progressive - clear loss of skills needs urgent review to rule out other conditions.

Treatment

How cerebral palsy is managed in the UK.

There is no cure. The goal is to maximise function, prevent complications and support the best possible quality of life - through a coordinated MDT.

  • Physiotherapy

    Motor learning, strength, balance, stretching and gait work - the daily foundation of function across every GMFCS level.

  • Occupational therapy

    Daily living skills, fine motor, seating, assistive technology and adapted equipment for home, school and play.

  • Speech and language therapy

    Communication (verbal and AAC), eating, drinking, swallowing and saliva control - often the highest-impact input over time.

  • Botulinum toxin injections

    Focal, evidence-based, repeatable injections into spastic muscles to reduce tone, ease care and slow contracture. See our botulinum toxin guide.

  • Intrathecal baclofen pump

    A specialist paediatric neurosurgical option for severe generalised spasticity or dystonia when oral medicines are not enough.

  • Selective dorsal rhizotomy

    A neurosurgical option in spastic diplegia GMFCS II to III, aged 3 to 10, at commissioned UK centres, to improve gait and function.

  • Orthopaedic surgery

    Orthotics, serial casting, single-event multilevel surgery, tendon releases, hip reconstruction and spinal fusion when indicated.

  • Education, equipment and support

    EHCP-led school support, wheelchair and walker provision, AAC devices, psychology and family and sibling support through UK charities.

Related interventions covered in more detail: botulinum toxin (medical and neurological), intrathecal baclofen pump, selective dorsal rhizotomy (SDR) and the orthopaedic surgery clinic.

What this guide is based on

The sources behind every claim on this page.

UK national guidance and specialist neurodisability standards, current at the time of last review.

Key references

Guidelines and standards we relied on.

A quiet reminder

This guide is for information, not medical advice.

Your child's paediatric neurodisability team knows their story and can tell you which parts apply. If in doubt, get seen.

  • NICE. Cerebral palsy in under 25s: assessment and management (NG62).

  • NICE. Cerebral palsy in adults (NG119).

  • Royal College of Paediatrics and Child Health (RCPCH). Neurodisability standards and cerebral palsy resources.

  • British Academy of Childhood Disability (BACD). Position statements on cerebral palsy care.

  • CanChild. Gross Motor Function Classification System (GMFCS) expanded and revised.

  • MOVE / UK Hip Surveillance in Cerebral Palsy programme guidance.

Red flags

When cerebral palsy needs urgent attention.

Most day-to-day care sits with the MDT. These are the situations where families and clinicians should escalate quickly.

  • Loss of previously acquired skills

    Cerebral palsy is not progressive - clear regression needs urgent paediatric neurology review for another cause.

  • New or worsening seizures

    Prolonged, frequent or new-onset seizures need same-day medical assessment and an urgent epilepsy review.

  • Hip pain, limp or asymmetry

    Hip subluxation and dislocation are silent and preventable - keep to the hip surveillance schedule and escalate any new pain.

  • Recurrent chest infections

    Repeated aspiration pneumonia points to unsafe swallow - request a specialist swallowing (SALT) and respiratory review.

  • Rapid scoliosis progression

    A curve that is changing quickly, or a new pelvic obliquity, needs a paediatric spinal opinion before it becomes fixed.

  • Feeding failure or weight loss

    Long feeds, distress, weight loss or dehydration deserve a dietetic and gastroenterology review, and a PEG discussion where appropriate.

  • Sudden increase in tone or dystonia

    A sharp change in spasticity or dystonic storms can be triggered by pain, infection, constipation or a device problem - seek review.

  • Mental-health decline

    Low mood, anxiety, self-harm thoughts or family exhaustion deserve a compassionate mental-health assessment and respite support.

  • Baclofen pump warning signs

    Suspected pump failure, withdrawal (itching, high tone, fever) or overdose (drowsiness, weak breathing) is a medical emergency.

Living with it

A lifelong condition, with a lifelong team.

Four things families tell us make the biggest difference - lean on the MDT, build small daily rhythms, keep surveillance in the diary, and plan the move to adult services early.

A quiet reminder

Small, consistent inputs, sustained for years.

Cerebral palsy care is a marathon. Charities such as Scope, Cerebra, Contact and CP Sport can carry some of the load alongside the clinical team.

  1. 01 Team

    Lean on the MDT

    One coordinated paediatric neurodisability team beats a scatter of separate appointments - use them as your anchor.

  2. 02 Rhythm

    Little and often

    Short daily therapy routines woven into play and school life outperform long, occasional sessions - and are easier to sustain.

  3. 03 Surveillance

    Keep the checks in the diary

    Hip, spine, vision, hearing, feeding and seizure reviews prevent avoidable harm - do not let them drift.

  4. 04 Transition

    Plan for adult services early

    Start transition planning in early teens - adult CP care is a known gap and deserves an active handover.

Frequently asked

Everything we get asked about cerebral palsy.

Quick answers on causes, diagnosis, GMFCS, spasticity treatments and adult care.

  • What is cerebral palsy?

    Cerebral palsy is a group of permanent, non-progressive disorders of movement and posture caused by a disturbance in the developing brain of a foetus or infant. It is the leading cause of physical disability in UK children and affects around two to three babies in every one thousand live births.

  • Is cerebral palsy progressive?

    No. The underlying brain injury does not get worse over time. However, the clinical picture can change as a child grows - spasticity, contractures, hip position and scoliosis can all evolve, which is why lifelong surveillance and specialist input matter.

  • What causes cerebral palsy?

    Around 70 to 80 per cent of causes are prenatal - brain malformations, intrauterine infections such as CMV, placental insufficiency, prematurity, multiple pregnancy and genetic factors. Around 10 to 20 per cent are perinatal, including hypoxic-ischaemic encephalopathy and neonatal stroke. Around 10 per cent are postnatal, from meningitis, encephalitis, head injury or severe illness in the first years of life.

  • How is cerebral palsy diagnosed?

    Diagnosis is clinical, made by a paediatric neurologist or neurodisability specialist using history, examination and tools such as the General Movements Assessment and Hammersmith Infant Neurological Examination. MRI brain looks for the underlying pattern, and genetic testing is offered where the cause is unclear or features look syndromic.

  • What treatments help spasticity?

    Physiotherapy is the foundation. Focal spasticity often responds to botulinum toxin injections. Severe generalised spasticity or dystonia may be treated with an intrathecal baclofen pump, and selected children with spastic diplegia (GMFCS II to III, aged 3 to 10) can benefit from selective dorsal rhizotomy at commissioned UK centres. Oral medicines such as baclofen, diazepam, gabapentin, tizanidine and trihexyphenidyl also have a role.

  • Can adults have cerebral palsy?

    Yes. Cerebral palsy is lifelong. Adults often experience new pain, fatigue, loss of function, contractures and mental-health needs, and NICE now has dedicated guidance for adult CP. Planned transition from paediatric to adult services and access to specialist adult CP clinics is important.

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