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Cerebral palsy describes a group of neurological disorders that appear in early childhood. All stem from damage to certain areas of the brain in utero, at birth, or shortly after birth. They can manifest as movement disorders (including difficulty with speech even when intelligence is unaffected), seizure disorders or intellectual disorders. Each patient usually has a unique set of symptoms based on the underlying brain injury. In addition, although the disorders are clear early in childhood, the underlying brain damage does not get worse although the symptoms may do so. The condition has been known since antiquity, but was first systematized as a diagnosis by William Osler. Unfortunately, the name was somewhat misleading as, although "palsy" usually describes a form of paralysis, patients do not suffer from any form of nerve damage.
In most cases, the cause of the damage is clear, but in many cases, it is not clear what damage has led to the condition. The risk factors are higher for infants with low birth weight (particularly twins), exposure to certain Infections during pregnancy (most notably rubella), exposure to mercury, a difficult delivery, and head trauma. Some cases appear to have a genetic cause. Patients are generally classified by the main disorder they have, such as ataxia or spasms, rather than the underlying brain issue.
Cerebral palsy is the most common movement disorder in children. However, it is becoming less common due to routine vaccination and improved safety to prevent head injuries. Electronic fetal monitoring was often recommended as a preventative measure, but studies have shown it does not reduce the risk.
The condition must be carefully diagnosed to separate it from treatable conditions and conditions that are progressive (such as muscular dystrophy). It is usually diagnosed by a combination of a medical history and a physical examination.It can be properly diagnosed in children as young as four months of age. In all cases, the patient usually lags children of the same age in development.
There is no cure for the condition. Treatment is largely specific to the patient. Physiotherapy is common, as are the use of orthotic devices such as braces. Medication is often used to address the symptoms. Surgery is less common. In addition, patients are encouraged to perform everyday tasks such as chores and even leisure activities. Most patients require at least some assistance with routine physical tasks, but in some cases patients are able to live independently without personal assistance.