Cerebral palsy: what it is, symptoms, causes, diagnosis and support

The NHS describes cerebral palsy as the name for a group of lifelong conditions that affect movement and co-ordination, caused by a problem with the brain that develops before, during or soon after birth. NHS inform says it is caused by either damage to the brain or abnormal development of the brain, normally before birth or during a child's early development, and is not normally progressive in nature.

The NHS says cerebral palsy affects each person differently and the severity of symptoms can vary significantly. Some people only have minor problems, while others may be severely disabled.

NHS inform says cerebral palsy usually causes abnormal muscle tone and movement, and describes four main types.

The NHS says the symptoms of cerebral palsy are not usually obvious just after a baby is born and normally become noticeable from an early age. It lists the following. The NHS says to speak to your health visitor or a GP if you have any concerns about your child's health or development, noting that symptoms like these can have a number of different causes and are not necessarily a sign of anything serious.

• Delays in reaching development milestones, for example not sitting by 8 months or not walking by 18 months.

• Seeming too stiff or too floppy.

• Weak arms or legs.

• Fidgety, jerky or clumsy movements, or random, uncontrolled movements.

• Walking on tiptoes.

• Other problems such as swallowing problems, speaking problems, vision problems and learning disabilities.

NHS inform says symptoms vary from person to person and depend on the type of brain injury or abnormality. A person with cerebral palsy may struggle with movement and balance, may struggle to speak and need electronic aids, may have difficulties with eating, drinking and swallowing, vision problems, pain, fatigue, sleep problems, epilepsy, a learning disability, behavioural problems, bladder control problems, constipation or difficulty controlling saliva.

It adds that there can be secondary symptoms caused by the impact of the condition on the body, such as tightness in joints and muscles, dislocations, changes in physical abilities, changes in pain and increased fatigue. The NHS says that although the original problem with the brain does not get worse, the condition can put a lot of strain on the body and cause problems such as painful joints in later life.

The NHS says cerebral palsy can happen if a baby's brain does not develop normally in the womb, or is damaged during or soon after birth. Causes include bleeding in the baby's brain or reduced blood and oxygen supply to the brain, an infection caught during pregnancy, the brain temporarily not getting enough oxygen during a difficult birth, meningitis and a serious head injury. In many cases the exact cause is not clear.

NHS inform lists things that can increase the risk, including premature birth, neonatal encephalopathy, stroke or bleeding in the baby's brain, infection during or after pregnancy, meningitis and head injuries. It stresses that it is not always possible to tell why a child has developed cerebral palsy, that a child can develop it despite parents having done everything right during pregnancy and childbirth, and that the parents are not to blame.

NHS inform says there is not one single test that can diagnose cerebral palsy. A medical professional needs to see how the child develops over time and may use tests such as brain scans to confirm the diagnosis. They will examine the child's medical history and how well they can move, balance and react, and may use an MRI scan to look for signs of damage or abnormal development of the brain.

NHS inform says most children are diagnosed by two years old, and some are diagnosed earlier if they have spent time in medical settings, for example children born premature. The NHS says your child may be referred to specialists in child development who can do some checks and tests. NICE guideline NG62 covers diagnosing, assessing and managing cerebral palsy in children and young people from birth up to their 25th birthday.

NHS inform acknowledges that waiting for a diagnosis can be very stressful for parents and points to its mental wellbeing information and support.

The NHS says there is currently no cure, but treatments are available to help people be as active and independent as possible. A team of healthcare professionals will work with you to come up with a treatment plan that meets your or your child's needs.

The NHS says cerebral palsy affects each person differently and it can be difficult to predict the outlook. Generally speaking, most children live into adult life and some can live for many decades; the condition may limit activities and independence, although many people go on to lead full, independent lives; many children go to a mainstream school, but some may have special educational needs and benefit from a special school.

NHS inform says cerebral palsy is non-progressive but may not stay the same throughout life, with symptoms changing with age even in adulthood, and does not normally shorten life expectancy. The NHS also says daily challenges can be difficult to cope with and can lead to problems such as clinical depression in some people, so tell your care team if you are struggling.

The NHS names Scope as the main UK charity for people with cerebral palsy and their families, with an online community and helplines. Your care team may be able to provide details of support groups in your local area. NHS inform notes that online support groups for parents of children with cerebral palsy can help you feel less isolated.

Contact your GP practice if you or your child are experiencing a change in condition or symptoms that are getting worse, according to NHS inform.

On the NHS, a health visitor or GP can refer your child to child development specialists, and a team including physiotherapists, occupational therapists and speech and language therapists works with the family. Adults continue to receive support from their GP and specialist services.

Private assessments and therapies are available, but a coordinated plan across health, education and social care is usually led through NHS child development services. If you use private therapy, tell your NHS team so the plans fit together.