Cerebral palsy (CP) is the most common form of motor disability in children. CP refers to a group of non-progressive disorders of movement and posture that limit the child’s activity. CP is caused by a brain injury suffered during the development of the brain of a foetus or young child. This brain injury may occur during pregnancy, birth, or the early years of the child’s life. These motor disorders are often accompanied by sensory, perceptual, cognitive, and communication impairment and by epilepsy and secondary musculoskeletal problems.
The most common cause of CP is a lack of blood supply to a developing brain due to haemorrhages, inflammations, or strokes. Causes differ considerably, however, and they are unknown in many cases. (In 40% of cases, the cause of CP is unknown and may owe to deformities, brain injury suffered by the foetus because of infection or a lack of oxygen and blood supply, problems during childbirth, and postnatal secondary effects of meningitis, encephalitis, road traffic accidents, drowning, etc.).
By definition, the injury is stable (non-progressive), and the disorders are persistent yet change over time. Manifestations of CP depend on the extent and location of the brain injury and the brain’s capacity to adapt to the injury. Our constantly improving knowledge of neuroplasticity mechanisms suggests that neurodevelopment continues throughout our entire life. This knowledge also highlights the importance of intensive, specialized rehabilitation for patients with CP. In recent years, the prognosis for patients has improved because of new therapeutic tools and approaches.
- Disorders of postural fixation
- Failure to suppress primitive reflexes
- Paresis, paralysis, or disorders of the functional patterns of
- voluntary mobility
- Spasticity and other muscle tone disorders
- Involuntary movements
- Trouble developing control of balance and posture
- Trouble swallowing and irregularities in newborns’ oromotor abilities
- Lack of spontaneous movements at 2–4 months
- Lack of social smiling at 3 months
- Lack of eye tracking at 3 months
- Complete lack of head control at 3 months
- Serious hypotonia
- Serious spasms or rigidity
- Clear preference to move one part of the body
There are several classifications according to topography (the parts of the body affected at the motor level), neuropathology (the injured brain structures), and irregularities in tone and predominant movements (flaccid, spastic, dystonic, rigid, etc.). Currently, the aim of the classification is descriptive as well as being functional. In addition to motor disorder, all irregularities described here should be considered. Generally, classification takes place according to:
The part of the body affected: hemiplegia, diplegia, tetraplegia, monoplegia, triplegia
Irregularities in tone and/or movement: spastic (the most common: 80%), ataxic, dystonic, or mixed.