Cerebral Palsy Symptoms

Page Medically Reviewed and Edited by Gina Jansheski, M.D.

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Cerebral palsy is a neurological disorder with several different forms. [1] While all forms of the disorder share a few similar symptoms, there are different manifestations, depending on which type of cerebral palsy the child has.

Spastic Cerebral Palsy Symptoms

Spastic cerebral palsy, a form of hypertonia, is the most common form of the disorder and is seen in more than 70% of all cases. It’s caused by damage to the brain’s motor cortex before, during, or shortly after birth. It can affect any muscle group in the baby’s body. [2]

Symptoms of spastic cerebral palsy may include:

• Failure to reach normal milestones for sitting up, crawling and walking
• Abnormal movements
• Stiff, spastic muscles
• Difficulties controlling and coordinating muscle movements
• Speech problems, such as slurred or poorly formed words
• Poor coordination of muscles of the tongue and mouth, which affect swallowing and make it difficult to eat and drink

Dyskinetic Cerebral Palsy Symptoms

Dyskinetic cerebral palsy is not as common as spastic cerebral palsy. It is marked by abnormal involuntary movements, but spasticity plays less of a role in the dysfunction. Muscle tone is varied and changes frequently.

Symptoms of dyskinetic cerebral palsy include:

• Repetitive, twisting motions (dystonia)
• Slow, writhing movements (athetosis)
• Unpredictable, irregular movements (chorea)
• Awkward posture and coordination
• Movements can range from slow to rapid and can be accompanied by pain

Ataxic Cerebral Palsy Symptoms

Ataxic cerebral palsy, affecting around 2.6% of people with the disorder, is similar to dyskinetic cerebral palsy in that babies and children exhibit irregular movements. It’s caused by damage to the cerebellum, the center of the brain responsible for balance and coordination. Ataxic cerebral palsy can affect any part of the body, including hands, legs, fingers, eye movements, and the muscles involved with swallowing.

Other symptoms may include:

• Tremors and shaky movements
• Unsteady balance
• Poor coordination
• “Scanning speech” – speaking in a breathy, monotone voice with abnormal pauses between words
• Slow eye movements and inability to target an object correctly

Mixed Cerebral Palsy Symptoms

Children with mixed cerebral palsy can have a combination of symptoms from the different types of the disorder, such as having exaggerated reflexes (spasticity) along with scanning speech (ataxic). Symptoms will depend upon what types of combined cerebral palsy the child has. Mixed cerebral palsy generally entails both spastic and non-spastic manifestations.

Associated Problems

Children with cerebral palsy many times experience problems that tend to be associated with the disorder. It is important to be aware of these and mention them to your child’s physician if they occur.

Delayed Development and Growth

Delays in growth and development are typically the first signs parents and physicians notice that indicate a baby may have potential problems. Although these types of delays aren’t always due to cerebral palsy, in many cases, babies and children with developmental delays will be behind their age group when learning to sit, grab objects, crawl, talk, walk, and more.

Babies and children with cerebral palsy also tend to be smaller and underweight for their age group. This can be due to difficulty eating, and associated nutritional deficiencies.

Their head size may be small to begin with (microcephaly) and grow more slowly than expected.

Muscle-Related Symptoms

Cerebral palsy generally forms after brain damage. When parts of the brain are damaged, abnormal signals are sent to the muscles, resulting in a number of of muscle-related disorders. Not all children will exhibit the same muscle-related symptoms. Some children may experience only a few minor abnormalities, whereas others may have a wide range of muscle-related symptoms.

The most common muscle-related symptoms associated with cerebral palsy include:

• Spastic movements [3]
• Shaky movements
• Poor muscle coordination
• Involuntary movements
• Dragging legs when trying to crawl
• Scissoring of legs
• Using one side of the body more than the other
• Difficulty grasping small objects
• Alternating between stiff and loose muscles
• Speech and swallowing problems
• Constipation and bladder incontinence
• Gastric reflux
• Scoliosis
• Joint contractures

Seizures

Around half of all people with cerebral palsy will have some form of seizure disorder. [4]

It’s important to note that seizures can range from mild to extremely severe. For instance, some cerebral palsy patients may have partial seizures, with the only signs being brief muscle twitches and/or passing confusion. [5]

Generalized seizures, however, are considered severe, marked by the child losing consciousness and experiencing tonic-clonic convulsions.

Gastrointestinal Problems

Many children with cerebral palsy, especially those with more severe cases, have difficulty with acid reflux. The stomach contents may make its way up the esophagus causing erosion of the mucous lining and pain. It can also lead to pneumonia if there is reflux all the way up to the trachea where it can enter the lungs. [7]

Constipation is a common issue due to spasticity and abnormal muscle coordination. It is important to ensure the regularity of bowel movements. Some children benefit from bowel programs in which combinations of medication and dietary measures are implemented with good results. [8]

Urinary Problems

Spasticity and poor coordination of muscles in the urinary tract may contribute to bladder incontinence when the child cannot control urination or has a buildup of urine in a spastic bladder. This can cause recurrent urinary tract infections and kidney complications. [9]

Cognitive and Behavioral Problems

Many children with cerebral palsy are bright, intelligent children who will go on to live productive, quality lives. A common misconception about cerebral palsy is that children are “slow” intellectually, but in most cases, this is completely untrue.

However, around 30% to 50% of all children with cerebral palsy have some sort of cognitive dysfunction, which can range from mild to severe. With proper management and treatment, these issues can be dealt with successfully. [#10]

The most common forms of cognitive or behavioral problems that children with cerebral palsy experience include:

• Short attention span
• Hyperactivity
• Learning and comprehension issues
• Memory problems
• Issues with problem-solving skills
• Emotional lability
• Intellectual disability

Hearing and Vision Problems

Children with cerebral palsy can be prone to difficulties with hearing and vision. [#11]

When children have vision problems, physicians may notice that one eye is weaker than the other, creating a cross-eyed look in some patients. This condition is known as strabismus and it can affect how people see objects and judge distances. They may experience double vision and may have trouble with the visual range in one or both eyes. [#12]

Hearing problems are more typical among people with cerebral palsy when compared to the general population. Hearing issues can range from mild to severe. Severe cases may require the use of hearing aids such as cochlear implants.

Children with hearing difficulties may have a hard time understanding what people say, even though they can hear the words. Speech issues may also develop due to hearing deficits. [#13]

Speech Problems

Problems with speech can be present due to poor coordination of muscles of the face and tongue. This can cause speech that is difficult to understand, even though the child has a normal intellectual ability. Hearing deficits and cognitive disabilities can also lead to speech delays. [#14]

If you ever have any questions or concerns about your child’s symptoms, regardless of how minor they may seem, be certain to consult with your child’s physician. Some symptoms may be indicative of other medical issues that accompany cerebral palsy.

Page Medically Reviewed and Edited by Gina Jansheski, M.D.

Gina Jansheski, M.D. is a Board Certified Pediatrician and a Fellow of the American Academy of Pediatrics. She has been a practicing pediatrician for over 20 years, working primarily with hospitalized patients and children with special needs.

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