Cerebral palsy refers to a group of disorders that affect a person's ability to move and to maintain balance and posture. It is due to a nonprogressive brain abnormality, which means that it does not get worse over time, though the exact symptoms can change over a person's lifetime.

People with cerebral palsy have damage to the part of the brain that controls muscle tone. Muscle tone is the amount of resistance to movement in a muscle. It is what lets you keep your body in a certain posture or position. For example, it lets you sit up straight and keep your head up. Changes in muscle tone let you move. For example, to bring your hand to your face, the tone in your biceps muscle at the front of your arm must increase while the tone in the triceps muscle at the back of your arm must decrease. The tone in different muscle groups must be balanced for you to move smoothly.

There are four main types of cerebral palsy - spastic, athetoid, ataxic, and mixed.

*Spastic: People with spastic cerebral palsy have increased muscle tone. Their muscles are stiff. Their movements can be awkward. Seventy to eighty percent of people with cerebral palsy have spasticity. Spastic cerebral palsy is usually described further by what parts of the body are affected. In spastic diplegia, the main effect is found in both legs. In spastic hemiplegia, one side of the person's body is affected. Spastic quadriplegia affects a person's whole body (face, trunk, legs, and arms).

*Athetoid or dyskinetic: People with athetoid cerebral palsy have slow, writhing movements that they cannot control. The movements usually affect a person's hands, arms, feet, and legs. Sometimes the face and tongue are affected and the person has a hard time talking. Muscle tone can change from day to day and can vary even during a single day. Ten to twenty percent of people with cerebral palsy have the athetoid form of the condition.

*Ataxic: People with ataxic cerebral palsy have problems with balance and depth perception. They might be unsteady when they walk. They might have a hard time with quick movements or movements that need a lot of control, like writing. They might have a hard time controlling their hands or arms when they reach for something. People with ataxic cerebral palsy can have increased or decreased muscle tone. Five to ten percent of people with cerebral palsy have ataxia.

*Mixed: Some people have more than one type of cerebral palsy. The most common pattern is spasticity plus athetoid movements.

The symptoms of cerebral palsy vary from person to person. Symptoms can also change over time. A person with severe cerebral palsy might not be able to walk and might need lifelong care. A person with mild cerebral palsy, on the other hand, might walk a little awkwardly, but might not need any special help.

People with cerebral palsy can have other disabilities as well. Examples of these conditions include seizure disorders, vision impairment, hearing loss, and mental retardation. [Read more about developmental disabilities]

You can learn more about the following questions about cerebral palsy below:

*How common is cerebral palsy?

*What causes cerebral palsy? Can it be prevented?

*What is the cost or economic impact associated with cerebral palsy?

*What resources are available for people with cerebral palsy and their families?

*How can we improve the health of people with cerebral palsy?

*How can kids learn about cerebral palsy?

*Where can I go to learn more about cerebral palsy?

We provide links to other Web pages if you want to learn even more about a topic. Some of these pages are within the CDC Web site and others are on outside Web sites. CDC has no control over the content on these outside sites. Links to such sites are included for information only. The views and opinions expressed there are not necessarily those of CDC, the U.S. Department of Health and Human Services (HHS), or the U.S. Public Health Service (PHS).

References:

Batshaw ML. Children with disabilities (4th edition). Baltimore, MD: Paul H. Brookes Publishing Co.; 1997.

Geralis E (Editor). Children with cerebral palsy: a parents' guide. Rockville, MD: Woodbine House; 1991.

National Institute of Neurological Disorders and Stroke. Cerebral palsy: hope through research.

How common is cerebral palsy?

CDC is tracking the number of children with cerebral palsy in a five-county area in metropolitan Atlanta (Georgia). This activity is part of the Metropolitan Atlanta Developmental Disabilities Surveillance Program (MADDSP). For 1991-1994, we found that, on average, 28 of every 10,000 children 3 through 10 years of age had cerebral palsy. [Read more about MADDSP]

CDC also studied how many children in metropolitan Atlanta had cerebral palsy in the mid-1980s. This project was done as part of the Metropolitan Atlanta Developmental Disabilities Study (MADDS), which studied how common certain disabilities were in 10-year-old children. We found that 23 of every 10,000 10-year-old children had cerebral palsy. Eighty-one percent of the children had spastic cerebral palsy. Seventy-five percent had one or more other disabilities (epilepsy, mental retardation, hearing loss, or vision impairment. [Read a summary of the article about cerebral palsy in MADDS] [Read more about MADDS]

In another study, CDC used data from the National Health Interview Survey - Child Health Supplement to find the number of children with cerebral palsy in the United States in 1988. The survey asked parents, or other adults, if children in the home had cerebral palsy. The study showed that 23 of every 10,000 children 17 years of age or younger had cerebral palsy. [Read a summary of the article on cerebral palsy in the United States]

References:

Boyle CA, Decoufle P, Yeargin-Allsopp M. Prevalence and health impact of developmental disabilities in US children. Pediatrics. 1994;93:399-403. [Read a summary of the Boyle et al article]

Murphy CC, Yeargin-Allsopp M, Decoufle P, Drews CD. Prevalence of cerebral palsy among ten-year-old children in metropolitan Atlanta, 1985 through 1987. Journal of Pediatrics 1993;123:S13-20. [Read a summary of the Murphy et al article]

What causes cerebral palsy? Can it be prevented?

Cerebral palsy is caused by brain damage that affects a child's ability to control his or her muscles. The part of the brain that is damaged determines what parts of the body are affected. There are many possible causes of the brain damage. Some causes affect how the child's brain develops during the first 6 months of pregnancy. These causes include genetic conditions and problems with the blood supply to the brain. Other causes of cerebral palsy happen after the brain has developed. These causes can occur during later pregnancy, delivery, or the first years of the child's life. They include bacterial meningitis and other infections, bleeding in the brain, lack of oxygen, severe jaundice, and head injury.

Children who are born prematurely or who are very low birth weight (less than 1,500 grams or about 3 1/3 pounds) are more likely to have problems that might lead to cerebral palsy. However, children who are full term and normal birth weight can also have cerebral palsy.

CDC funds the North Atlantic Neuro-Epidemiology Alliance (NANEA) to study factors that might make it more likely a child will develop cerebral palsy. These factors include infection, bleeding, and raised temperature during pregnancy. The studies are being done in Denmark. [Read more on the NANEA Web site - click on Research and then on Cerebral Palsy]

CDC has studied the causes of cerebral palsy among 3- to 10-year-old children in MADDSP in 1991. For 10% of the children, the cause of their cerebral palsy had happened after they were 30 days old. The most common causes in these children were meningitis, child abuse, stroke, and car crashes. [Read the MADDSP study of causes of cerebral palsy]

CDC also looked at the causes of cerebral palsy among 10-year-old children in MADDS in the mid 1980s. For 16% of the children, the cause of their cerebral palsy also had happened after they were 30 days old. The most common of these causes were infections, head injury, and stroke. [Read a summary of the MADDS study that looked at causes of cerebral palsy]

If you would like to learn more about a specific genetic condition that you think could cause cerebral palsy, you can go to the National Library of Medicine's Genetics Home Reference Web site. Information on each genetic condition includes symptoms, how common the condition is, related genes, treatments, and links to resources where you can learn more about the condition. The Genetics Home Reference Web site also can help you learn more about genetics, including about genetic testing, genetic counseling, and gene therapy. [Go to the Genetics Home Reference Web site]

Some causes of cerebral palsy can be prevented. For example, bike helmets and car seats can prevent head injuries that might result in cerebral palsy. Another cause that can be prevented is kernicterus, a kind of brain damage that happens when a newborn baby has too much jaundice. In some newborn babies, the liver makes too much yellow pigment, called bilirubin. If too much bilirubin builds up in a new baby's body, the skin and whites of the eyes turn yellow. This yellow coloring is called jaundice. A little jaundice is not a problem. It is actually very common in newborn babies and usually goes away by itself. Some babies, however, have too much jaundice. If not treated, these high levels of bilirubin can damage a baby's brain. Kernicterus most often causes cerebral palsy and hearing loss, but in some children it can also cause mental retardation. Kernicterus can be prevented by using special lights (phototherapy) to treat babies. [Read more about kernicterus]

Cerebral palsy cannot be cured. Treatment can, however, help a person take part in family, school, and work activities as much as possible. There are many treatments, including physical therapy, occupational therapy, medicine, operations, and braces.

References:

Batshaw ML. Children with disabilities (4th edition). Baltimore MD: Paul H. Brookes Publishing Co.;1997.

Centers for Disease Control and Prevention. Postnatal Causes of Developmental Disabilities in Children Aged 3-10 Years -- Atlanta, Georgia, 1991. Morbidity and Mortality Weekly Report. 1996;45:130-134. [Read the postnatal causes article]

Geralis E (Editor). Children with cerebral palsy: a parents' guide. Rockville, MD: Woodbine House; 1991.

Murphy CC, Yeargin-Allsopp M, Decoufle P, Drews CD. Prevalence of cerebral palsy among ten-year-old children in metropolitan Atlanta, 1985 through 1987. Journal of Pediatrics 1993;123:S13-20. [Read a summary of the Murphy et al article]

National Institute of Neurological Disorders and Stroke. Cerebral palsy: hope through research.

What is the cost or economic impact associated with cerebral palsy?

A recent study of the extra economic costs associated with cerebral palsy showed that the lifetime costs per person were about $800,000 (in 2000 dollars). This does not include important expenses, such as caregiver costs for children or adults with cerebral palsy, that might have to be borne by families.

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