Cerebral Palsy

A Guide for Parents

If your newborn infant was diagnosed with cerebral palsy, know that you are not alone.

In fact, cerebral palsy is the most common motor disability in childhood and currently affects 1 in 345 kids living in the United States. In far too many of these cases, the condition was avoidable and a direct result of a preventable birth injury.

What is Cerebral Palsy?

Cerebral palsy describes a group of permanent movement disorders that appear in early childhood, often shortly after birth or in infancy. The condition results from damage to the parts of the brain responsible for creating, coordinating and controlling movement and posture. While these brain abnormalities may develop during pregnancy, they are often caused by a birth injury that occurred during the labor and delivery or shortly after.

According to the U.S. Centers for Disease Control and Prevention (CDC), as of 2010:

Estimates of the worldwide prevalence of cerebral palsy ranged from 1 to nearly 4 per 1,000 live births or per 1,000 children.

58.9 percent of children with cerebral palsy could walk independently, 7.8 percent walked using a hand-held mobility device, and 33.3 percent had limited or no walking ability.
41 percent of children with cerebral palsy were limited in their ability to crawl, walk, run, or play, and 31 percent needed to use special equipment such as walkers or wheelchairs.
4 in 10 children with cerebral palsy also had epilepsy, while 7.5 percent were on the autism spectrum.

Other data suggests around 10 percent of children with cerebral palsy have impaired vision, and 5 percent have some level of hearing loss. About a quarter of those living with cerebral palsy also have a behavioral disorder.

Children with cerebral palsy may also experience delays in speech development, have trouble speaking, and experience difficulty with sucking, chewing, eating, drooling, and swallowing. Some of these kids will also experience delayed motor skills milestones, such as sitting up or crawling, and many will develop learning disabilities and intellectual disabilities. Cerebral palsy is also associated with delayed growth, resulting in a smaller size than would be expected for someone their age.

There is no cure for cerebral palsy. However, therapy, assistive devices, medications, and sometimes surgery can help ease symptoms and improve the quality of life for those afflicted. Newborns with cerebral palsy today have a life expectancy of 30-70 years, but that varies greatly depending on their access to medical care, therapy, and adaptive equipment.

Cerebral Palsy Types and Symptoms

Cerebral palsy is classified into one of four types according to the symptoms a child experiences.

Spastic Cerebral Palsy

The most common form, spastic cerebral palsy, results in stiff, tight muscles, awkward movements, and reduced range of motion. It usually manifests in one of three ways:

Spastic Hemiplegia/Hemiparesis: This form of cerebral palsy affects the arm and hand on one side of the body, but it can also affect the leg. Babies with spastic hemiplegia generally learn to walk later than their peers, and because they often have tight heel tendons, they may walk on their toes. It’s not unusual for the arm and leg on the affected side of their body to be shorter and thinner, and some will develop scoliosis. While many of these children are slow to develop speech, intelligence is usually unaffected.
Spastic Diplegia/Diparesis: Children with this type of cerebral palsy experience muscle stiffness that primarily impacts the legs, and, less severely, the arms and face. However, they may have reduced function in their hands. Tendon reflexes in their legs are hyperactive, and tightness in certain leg muscles causes their legs to move like the arms of a scissor. They may require a walker or leg braces.

Spastic Quadriplegia/Quadriparesis: This is the most severe form of cerebral palsy and is frequently accompanied by moderate-to-severe intellectual disability. These kids often have severe stiffness in the limbs but a floppy neck. They are rarely able to walk, have difficulty speaking, and may experience frequent,difficult-to-control seizures.

Dyskinetic Cerebral Palsy

Children with dyskinetic cerebral palsy experience variable, involuntary movements, including:

Dystonia: Dystonia describes slow twisting, repetitive movements and abnormal sustained posture triggered by attempts at mobility. It can be present in only one part of the body, known as focal dystonia, or throughout the entire body, known as generalized dystonia.
Athetosis: Athetosis is characterized by slow, continuous, involuntary, writhing movements that are present at rest and made worse by attempts to move. These kids experience fluctuations in muscle tone, alternating between being floppy (hypotonia) and extreme variable motion (hyperkinesias).

Chorea: Chorea involves brief, abrupt, irregular and unpredictable movements that may worsen with anxiety or attempts to move. Those with mild chorea may appear fidgety or clumsy, while kids with more severe forms may display wild, violent movements.

Ataxic Cerebral Palsy

Children with ataxic cerebral palsy experience problems with balance and coordination. They may walk with their legs farther apart than other kids, exhibit shakiness and tremors, and have difficulty with writing and other activities that require small hand movements. Some also have trouble with depth perception, meaning they cannot accurately discern how far away an object is. They frequently struggle with speech, are unable to bring their hands together, and have slow eye movements.

Mixed Type

Mixed types of cerebral palsy don’t fall into any of the previous categories, with children experiencing symptoms that correspond with multiple forms.

Complications of Cerebral Palsy

While the primary symptoms of cerebral palsy involve difficulties with movement and posture, other related complications may arise throughout a child’s lifetime. Some of the most common include:

Joint Dislocation or Deformities: Due to muscle imbalance and spasticity, kids with cerebral palsy are at increased risk of developing joint dislocations or deformities, particularly in the hips, knees, and ankles.
Chronic Pain: Chronic pain is a common complication of cerebral palsy, often arising from muscle stiffness, joint problems, or overuse injuries.
Swallowing and Feeding Difficulties: Some people with cerebral palsy experience difficulties with swallowing and feeding, known as dysphagia. This can increase the risk of aspiration (inhaling food or liquids into the lungs), malnutrition, and dehydration.
Respiratory Complications: Severe forms of cerebral palsy, particularly those with significant muscle involvement, such as spastic quadriplegia, can impact respiratory function, increasing the risk of infections, pneumonia, and other breathing problems.
Urinary and Bowel Issues: Dysfunction of the muscles involved in bladder and bowel control may lead to urinary or fecal incontinence or constipation. These issues can significantly impact quality of life and may require interventions such as medications, dietary modifications, toileting schedules, or surgical procedures.
Developmental Delays and Learning Disabilities: Many children with cerebral palsy experience developmental delays and learning disabilities, which can affect cognitive function, speech and language skills, and academic achievement.
Secondary Health Conditions: People with cerebral palsy are at increased risk of developing secondary health conditions such as osteoporosis, pressure sores, seizures, and vision or hearing impairments.
Emotional and Behavioral Problems: Living with cerebral palsy can be emotionally challenging, leading to feelings of frustration, low self-esteem, anxiety, or depression, especially as individuals navigate social and academic environments.

Causes of Cerebral Palsy

Some events or medical problems during pregnancy can increase the risk that a baby will be born with cerebral palsy, such as:

Preterm Birth: Babies born before 37 weeks gestation. The earlier the birth, the higher the risk.
Low Birth Weight: Infants weighing less than 5.5 pounds at birth, with risk increasing the less a baby weighs.
Multiple Births: Risk is greatest for a baby whose twin or triplet dies before or shortly after birth.
Infections: A newborn may develop brain damage if their mother has toxoplasmosis, rubella (German measles), cytomegalovirus, herpes, or other infections that cross the placenta during pregnancy.
Seizures. Infants who have seizures are more likely to be diagnosed with cerebral palsy later in childhood.

While the exact cause of cerebral palsy often remains unknown, adverse conditions and events that occur during labor and delivery and shortly after birth are often to blame:

Hypoxic-Ischemic Encephalopathy (HIE)

Hypoxic-ischemic encephalopathy (HIE) occurs when there is a lack of oxygen (hypoxia) and blood flow (ischemia) to the baby’s brain during labor and delivery, often due to complications such as umbilical cord compression, placental abruption, or prolonged labor.

Birth Trauma

Traumatic birth injuries, such as head trauma or skull fractures, may result from difficult or prolonged deliveries, improper use of delivery instruments (e.g., forceps or vacuum extractors), or excessive force exerted during delivery maneuvers. These traumatic events can lead to brain damage and neurological deficits that contribute to the development of cerebral palsy.

Infections

Maternal infections such as rubella, cytomegalovirus (CMV), toxoplasmosis, or untreated urinary tract infections can be transmitted to the fetus, leading to brain damage and developmental abnormalities. Infections acquired by the newborn during labor or shortly after birth, such as bacterial meningitis or sepsis, can also cause neurological damage and increase the risk of cerebral palsy if not promptly diagnosed and treated.

Maternal Health Conditions

Certain maternal health conditions, such as pre-eclampsia, gestational diabetes, thyroid disorders, or untreated maternal infections, can predispose an unborn baby to an increased risk of cerebral palsy. To safeguard the health of the mother and prevent the brain damage that results in cerebral palsy, such conditions must be appropriately managed during pregnancy.

Medication Errors

Errors in administering medications during labor and delivery can have serious consequences for both the mother and the baby. For example, incorrect dosage or administration of drugs such as Pitocin or anesthesia can lead to complications such as uterine hyperstimulation, placental abruption, or maternal hypotension, which in turn can result in oxygen deprivation and brain injury to the baby, increasing the risk of cerebral palsy.

Delayed or Inadequate Medical Care

Delayed or inadequate medical care during labor, delivery, or the immediate postnatal period can also contribute to the development of cerebral palsy. Failure to promptly recognize and respond to signs of fetal distress, umbilical cord prolapse, or other obstetric emergencies can result in prolonged oxygen deprivation and subsequent brain damage in the newborn.

Inadequate Monitoring

Inadequate or improper fetal monitoring, including failure to perform or interpret fetal heart rate monitoring accurately, can lead to delays in detecting and addressing fetal distress, increasing the risk of cerebral palsy and other birth injuries.

Improper Delivery Techniques

Improper techniques during delivery, such as excessive traction or improper positioning of delivery instruments, can cause trauma to the baby’s head or neck, leading to brain injury and neurological deficits characteristic of cerebral palsy.

Other Factors

While medical malpractice and errors during labor and delivery are significant contributors to cerebral palsy, the condition can also result from other factors such as genetic abnormalities, prenatal exposure to toxins, or congenital brain malformations.

Treatment of Cerebral Palsy

There is no cure for cerebral palsy. However, various treatments and therapies can improve quality of life, enhance functional abilities, and address the specific needs and challenges babies with cerebral palsy are likely to face during their lifetime. Early intervention is critical, and the best treatment approach involves a multidisciplinary team of healthcare professionals collaborating to provide comprehensive care tailored to the child’s unique needs.

Physical Therapy: Physical therapy plays a central role in managing cerebral palsy by improving mobility, strength, flexibility, balance, and motor skills.
Occupational Therapy: Occupational therapy addresses activities of daily living (ADLs) and fine motor skills to enhance functional independence and participation in daily activities.
Speech Therapy: Speech therapy focuses on improving communication skills, including speech, language, articulation, voice, and swallowing abilities.
Medications: Drugs may be prescribed to manage spasticity, dystonia, or other movement disorders and to treat symptoms such as seizures, pain, or gastrointestinal issues.
Orthopedic Surgery: Surgical procedures and other orthopedic interventions may be recommended to address musculoskeletal issues such as muscle contractures, joint deformities, or bone abnormalities associated with cerebral palsy.
Orthotics and Assistive Devices: Orthotic devices, such as braces, splints, or orthopedic footwear, are commonly used to provide support, stability, and alignment to affected limbs and joints, thereby improving mobility, preventing contractures, and enhancing functional independence. Assistive devices such as wheelchairs, walkers, or communication aids may also be necessary.
Adaptive Equipment and Environmental Modifications: Adaptive equipment and environmental modifications are essential for creating accessible and supportive environments tailored to a child’s needs.
Educational Support and Specialized Services: Children with cerebral palsy may require educational support and specialized services to address their learning needs, accommodate physical limitations, and promote academic success.
Daily Nursing Care: Children with cerebral palsy may require daily nursing care to assist with their medical and personal care needs. In the most severe cases, they may require the type of 24/7 care only available through an assisted care or skilled nursing facility.

Compensation for Cerebral Palsy

The financial and economic costs associated with cerebral palsy are staggering. In fact, the life-care plans we develop for our clients often reach $50 million or more.

If medical malpractice or a preventable medical error caused your baby’s cerebral palsy, your family should not have to bear this financial burden alone. Pursuing a legal claim against the responsible doctors, nurses, midwives, hospital, or birthing center may be the only way to secure the financial resources to ensure your child receives the care and support they’ll need for the rest of their lives.

If your claim is successful, you and your baby could be awarded compensation for:

Medical Expenses: Damages for past and future medical expenses, including doctor’s visits, hospitalizations, surgeries, therapies, medications, and assistive devices.
Rehabilitation Costs: Coverage for rehabilitation services such as physical, occupational, and speech therapy.
Pain and Suffering: Damages for the physical pain, emotional distress, and diminished quality of life experienced by your baby and your family.
Lost Income: Compensation for any lost income or earning capacity incurred due to your caregiving responsibilities or other limitations associated with your baby’s condition.
Educational Expenses: Coverage for special education services, tutoring, educational accommodations, and assistive technology tools necessary to support your child’s academic progress and development.

Home Modifications: Damages to cover the expenses of modifying your home to accommodate your baby’s mobility needs as they grow, such as installing ramps, widening doorways, or making other accessibility modifications.

844-NICU-Law Holds Negligent Healthcare Providers Accountable

If you’re worried that your child’s cerebral palsy was the result of a preventable birth injury, you deserve to know the truth.

Jeffrey Killino and his NICU Law Team have helped many families in similar situations, and they have the resources to retain the top medical experts in the nation to conduct a comprehensive analysis of your child’s birth records. If our review determines that your case merits legal action, they’ll dedicate all the resources necessary to achieve justice for your child.

Call 844-NICU-LAW or complete our online form to schedule your no-cost, confidential legal and medical review.

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Cerebral Palsy

A Guide for Parents

What is Cerebral Palsy?