Cerebral Palsy (CP) | Diagnosis & Treatments

How is cerebral palsy diagnosed?

Clinicians typically diagnose cerebral palsy (CP) when a child is 6 to 24 months old, since this is the time when they start missing developmental milestones such as walking and controlling hand and head movements.

The process of diagnosing CP begins with a thorough history and physical examination. During the initial exam, a neurologist or pediatrician obtains a complete history of the mother's pregnancy and the child's birth and infancy.

Next, your child may have a variety of tests, including:

How is cerebral palsy treated?

Because CP affects children in different ways, your child's treatment plan will depend on several factors, including:

  • their age, overall health, and medical history
  • the type of cerebral palsy they have
  • the extent of symptoms
  • their tolerance for specific medications, procedures, or therapies
  • the expected course of their cerebral palsy
  • your family's preferences for treatment

Cerebral palsy is a lifelong condition that has no cure, so treatments are focused on:

  • preventing or minimizing physical deformities
  • improving mobility and motion to the greatest possible extent
  • optimizing health
  • maximizing your child's ability to succeed at home, at school, and in the community

Medications to help manage cerebral palsy

While medication can't treat or cure CP itself, it can be helpful in managing certain symptoms. Medications include:

  • antispasmodics: reduces muscle spasms and relaxes tightness in the muscles
  • anticonvulsants: treats seizures in children who have them
  • anticholingerics: helps children who have rigidity and uncontrollable drooling
  • botulinum toxin injections: helps reduce muscle tightness

Your clinician will determine if medication is safe and recommended for you child.

Therapy options for cerebral palsy

Your child’s doctor may recommend one or more types of therapy to treat symptoms. These may include:

Physical therapy (PT). PT can be very helpful in preventing muscle contractures by stretching your child's spastic muscles. Many children receive regular physical therapy to take part in stretches, strengthening exercises, and play activities that can help them improve their flexibility, endurance, and mobility. Physical therapy may be combined with orthotic devices like a brace or splint.

Occupational therapy (OT). OT is very helpful in giving children with CP independence, confidence, and essential life skills. The occupational therapist will use exercises, games, and training to help your child develop better fine motor skills, improve hand-eye coordination, and master basic skills, such as getting dressed or bathing.

Speech therapy. A speech therapist can work with your child to address concerns about communication, swallowing, and feeding. Speech therapy may include augmentative communication (using a computer system to help with communication) and feeding skill development, depending on the issue.

Nonsurgical treatments for cerebral palsy

Management of CP usually includes several nonsurgical aids, such as:

Seating and positioning aids. These are used to help your child sit, lie, or stand and may include wheelchairs, walkers, and ergonomic chairs that promote correct posture.

Orthotics. Orthotics are used to prevent deformity and to provide support or protection for your child’s limbs and torso. These devices can include braces and splints.

Special eating or writing utensils. Forks, spoons, knives, pens, and pencils can be designed for kids with fine motor skill difficulties.

Communication aids. Communication aids are used to help children who may have difficulty hearing, understanding, or communicating with others. These aids may include special picture books and posters, alphabet boards that can be used to spell out messages, and computers with adaptive programs and functions such as speech-recognition software.

Surgery for cerebral palsy

In some cases, surgery can be a helpful option for managing symptoms of cerebral palsy. These surgeries may include:

Orthopedic surgery. Orthopedic surgeons treat CP symptoms that affect the skeleton and muscles, such as spasticity and muscle contractures. Surgery may be recommended if your child's muscle spasms cause problems with movement, balance, and coordination. Surgery can also help reduce spasticity in the legs by elongating or releasing the contracted muscles and tendons that are too short. Surgical procedures are also used to treat scoliosis, hip dislocations, and ankle and foot deformities.

Neurosurgery. Some children with CP have pain and spasms severe enough to need neurosurgeryProcedures, including implant of a baclofen pump, can help control the pain and the spasms caused by CP. This is a small device placed under the skin of the belly to deliver the muscle relaxant baclofen directly into the spinal canal. Neurosurgeons may also perform selective dorsal rhizotomy, an operation that cuts certain nerves in the spine to reduce spasticity and improve your child's movement and posture.

What is the long-term outlook for cerebral palsy?

Although CP is a lifelong condition that can't be reversed, with proper medical and surgical treatment, children with cerebral palsy can lead rich, fulfilling lives.