Cerebral Palsy Symptoms

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Cerebral palsy symptoms vary depending on the type and severity as well as the individual child. Cerebral palsy is a neurological disorder with several different forms.[1] Signs of cerebral might be obvious right away or be too subtle to notice until a child grows and develops.

What Are the Early Signs of Cerebral Palsy?

Symptoms of cerebral palsy evolve as a baby develops into a toddler and young child. During the earliest period, signs might be hard to spot but include:

Unusual Muscle Tone

Too little or too much muscle tone is common in cerebral palsy. In a baby, undertoned muscles might look like floppy limbs or being unable to hold the head to any degree.

Overtoned muscles can cause stiffness in limbs and rigidness when held. A baby might arch its back or cross its legs when held.

Asymmetry

Some children with cerebral palsy are affected only on one side of the body or more on one side than the other. Imbalances or asymmetry in a baby can be an early sign. They might favor or use limbs on one side over the other.

Developmental Delays

All babies grow and develop at their own individual pace, but if there are noticeable deviations from expected milestones, these could indicate cerebral palsy. Some of the common milestones that are delayed in a baby with CP include:

• Rolling over
• Sitting
• Crawling
• Walking

At What Age Does Cerebral Palsy First Appear?

You might notice early signs of cerebral palsy in a baby within the first weeks or months. In children with milder cerebral palsy, noticeable symptoms might not appear until age two or three. Some of the signs of cerebral palsy in toddlers include:

• Delays in crawling and walking
• Delays in speech development
• Difficulty balancing to stand
• Scooting or knee walking instead of crawling or walking
• Lopsided crawling
• Muscle spasms
• Delays in fine motor skills, including holding objects or eating
• Vision or hearing problems

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 typical 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 of ataxic cerebral palsy are:

• 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 have a combination of symptoms from the different types of the disorder, such as having exaggerated reflexes (spasticity) and scanning speech (ataxic).

Symptoms will depend upon what types of combined cerebral palsy the child has. Mixed cerebral palsy often involves both spastic and non-spastic symptoms.

Associated Conditions and Symptoms

Children with cerebral palsy many times experience problems that tend to be associated with the disorder. It is essential 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 several 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:[3]

• Spastic movements
• 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 one-third of 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 or passing confusion.

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 their way up the esophagus, causing erosion of the mucous lining and pain. It can also lead to pneumonia if there is reflux up to the trachea, where it can enter the lungs.[5]

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.[6]

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.[7]

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 this is entirely untrue in most cases.

However, cerebral palsy does increase the risk of having cognitive dysfunction, ranging from mild to severe. With proper management and treatment, these issues can be dealt with successfully.[8]

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.[2]

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.[9]

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.[10]

Speech Problems

Problems with speech result from poor coordination of muscles of the face and tongue. This can cause speech that is difficult to understand, even though the child has an average intellectual ability. Hearing deficits and cognitive disabilities can also lead to speech delays.[11]

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