Severe Cerebral Palsy

Fact Checked

Severe cerebral palsy is the most serious form of the disorder, affecting movement, cognitive skills, and sensory skills. Although treatment options are available, the prognosis will depend on co-existing factors and the quality of care and quality of life that the child receives.

About Severe Cerebral Palsy

The functional disability of severe cerebral palsy, according to the U.S. National Institutes of Health (NIH), is broken up into three categories: cognitive, motor (mobility), and sensory. Each category is then divided into the “degrees of severity.” [1]

Severe cerebral palsy can also mean complete dependence on others for all activities, including mobility, eating, bathing, and dressing.

A study performed by Gregory S Liptak and numerous other physicians concluded that children with severe cerebral palsy also have numerous associated health problems. [2]

Children who were classified on the basis of mobility as having moderate to severe CP had multiple health-related problems. They used more medications than children without CP, and were shorter and lighter and had less body fat than children in the general population.”

Severe Motor Issues 

Severe motor issues for children with severe cerebral palsy typically means that they are likely on level four or five of the Gross Motor Function Classification System, or GMFCS, which describes five levels of mobility.

Children on level four of the GMFCS can be mobile with a self-operated wheelchair, meaning they can operate the wheelchair themselves. At level five, however, mobility is only possible in a wheelchair operated by another person.

Children with severe cerebral palsy often have motor issues in all four limbs, known as spastic quadriplegia or simple quadriplegia. [3]

Motor issues will affect all aspects of a child’s life. As mentioned earlier, children with severe cerebral palsy will need help eating, bathing themselves, and getting dressed. They’ll also need assistance with communication and socializing with other children.

Severe Cognitive Issues

Cognitive skills consist of remembering information, understanding communication, the ability to solve problems, analysis and synthesis of information, and decision-making abilities.

In other words, cognitive skills are the ability to understand, reason, and learn while using intellectual ability. Since brain damage is the primary cause of cerebral palsy, many children with the disorder will generally experience varying degrees of cognitive dysfunction.

Children with slight cognitive issues may only need help with syllables or paying attention. Children with severe cerebral palsy, however, will face the most cognitive issues, which can include lack of or difficulties with:

• Attention span
• Memory and learning
• Problem-solving
• Language skills
• Emotional processing
• Comprehension
• Speech

Severe cognitive issues also coming along with associated issues, including depression, anxiety, ADHD, sleeping problems, fatigue, temper outbursts, and difficulties making emotional connections with others.

Severe Sensory Issues 

Seeing things, smelling, and touching all play an important part in childhood. When brain damage occurs, these senses can be compromised, often leaving a child without the experiences that shape and define a part of being a young child.

Children with severe cerebral palsy will have abnormal sensory issues and sensory integrative dysfunction. Sensory integrative dysfunction affects the way a child walks due to issues with vestibular processing, which makes them appear clumsy and also affects their motor skills.

Other sensory issues for children with severe cerebral palsy include:

• Hearing
• Vision
• Taste
• Smell

Severe Cerebral Palsy Causes

Like most other cases of cerebral palsy, whether minor or severe, CP is generally caused by brain damage. [4] The severity of the brain damage will depend on how serious the cerebral palsy will be.

Brain damage can happen when:

• Environmental and genetic factors disturb an infant’s brain cell migration as the brain develops while the baby is in utero
• Maternal infections that can cause lesions on the baby’s brain
• Lack of oxygen during difficult childbirth; blood cells can also be ruptured during arduous labor and birth
• Inadequate insulation over developing nerve cells while in utero
• Severe, untreated jaundice and kernicterus

Severe Cerebral Palsy Treatment

It’s crucial to work with your child’s doctor and a team of healthcare professionals to come up with the most solid treatment plan to help your child. Keep in mind that each child’s needs are different, but typical treatment options consist of physical therapy, surgery, medications, integrated sensory therapy, a dietician, and occupational therapy.

Since children with cerebral palsy have issues with communication, assistive devices, such as computer-based communication machines, iPads, electronic communication boards, and eye-tracking devices are also forms of treatment for them. [5]

Surgery is usually reserved for those with the most serious cases of cerebral palsy. Surgery can assist in lengthening lengthen tightly-contracted and overly stiff muscles. It can also adjust a child’s abnormal spine and place the child’s limbs in better positioning.

In some instances, a surgeon will cut specific nerves in the body, in order to help the child with abnormal and spastic movements.

Medications for severe cerebral palsy can be given orally, but some children will need infusions into the fluid around the spinal cord. This is accomplished by a pump that is implanted near the spinal cord. Children with severe cerebral palsy may also need injections into their muscles.

Severe Cerebral Palsy Prognosis

While treatment options can go a long way in making a prognosis positive for a child with cerebral palsy, the seriousness of the disorder, in addition to any co-existing conditions (such as seizures), makes it difficult to estimate a life expectancy.

“Very few clinicians possess the actuarial skills and an appropriate database to give valid estimates of life expectancy,” the NIH study read.

The quality of life the child has at home, according to the study, will also affect prognosis. For example, a child with parents who ensure all medical appointments are kept and provide a nurturing caring home are promoting the child’s quality of life.

Quality of care is also important as well, meaning providing your child with the best medical care possible.

“Quality of life for a child with CP will inevitably be affected by quality of care. Although quality of care and its possible effect on survival has featured in legal cases, quality of life has not done so,” the study read.