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What is Cerebral Palsy?

Cerebral Palsy is an umbrella term for a range of conditions which cause a child to have difficulty with movement and muscle control. It is caused by an early injury to the developing brain either before, during or immediately after birth.

Cerebral Palsy is classified according to the parts of the body most affected, e.g. it might affect the whole body (4 limb cerebral palsy - previously known as quadriplegia), one side of the body (hemiplegia) or just the legs (diplegia).

Cerebral Palsy may also be described in terms of the nature of the movement difficulties encountered, e.g. most commonly, spastic or spasticity meaning high muscle tone, dystonic, where muscles are held in stiff, awkward positions or dyskinetic representing a mixture of spastic and dystonic types. Because children continue to develop, their muscles and movement patterns may change over time. Each child is different and the difficulties may range from mild to severe.

Children with cerebral palsy often have difficulties in other areas of health and development ,e.g. epilepsy, feeding, speech, vision and learning.

Your child’s Cerebral Palsy is also classified according to their functional level, i.e. how well they move around and participate in all aspects of home, school and community life.

We may use some or all of the following classification systems to describe your child’s daily functioning:

Cerebral Palsy - classification - Please click on the headings below:

What you can do to help

There are lots of things that you can do.

The physiotherapists will advise about exercise, positioning and stretches, while an Occupational Therapist and Physiotherapist together will help with any equipment that might be needed and talk through how your child can participate in the activities they need and want to do at home, at school and at play.

You can support your child with exercise and stretching, making this fun and part of their daily life. Help support by giving your child lots of opportunities for exercise and play, just like any other child. “Use it or lose it” is particularly important in children with Cerebral Palsy. There is evidence to show that exercises improving muscle strength improve overall function and  we know that for every one, muscles tend to get weaker as you enter your twenties, being as strong as possible will help improve your function.

Speech and Language therapists will advise about communication and feeding. We know that exercise and strengthening is very helpful for all children with Cerebral Palsy, so we would advise that you keep your child as active as possible, making sure that they are not overweight, and  encouraging them to do as many things as possible e.g. joining sports clubs, just like any other child.

How we can help

You and your child will be seen initially by a Paediatrician who will confirm the diagnosis and think about any medical tests that are needed, some children may require blood tests or a brain scan.

All children will have a lead paediatrician  who has responsibility for overall care. Appointments will be arranged by the clinic co-ordinator.

After the age of 2 years children are seen every year in joint clinics with paediatricians and therapists working together (Multidisciplinary team or MDT clinics) to:

  • discuss your concerns
  • examine your child using the CPIP assessment tool (see below)
  • monitor their progress and
  • advise about what additional support, exercises or equipment may be needed both at home and at school.

Paediatricians will also assess for and treat other conditions such as epilepsy, feeding difficulties and bowel problems. Paediatric care continues up to the age of 16 years, or 19 years for those attending a Special School.

After each MDT clinic review a report is prepared which is shared with your GP, your child’s school and any other relevant health professionals, with your consent.

Hip and Spine monitoring through the Cerebral Palsy Integrated Pathway (CPIP. UK - What is it?

Children with cerebral palsy have increased muscle tone, often around the hips. Over time this can mean that the leg bone (femur) may be slowly pulled out of the hip socket, a process called subluxation or dislocation. This can be painful and eventually may need surgery. We follow the CPIP pathway which monitors the joint range of movement and posture. This is combined with x-rays to try to reduce this risk. The physiotherapists will take regular measurements of a child’s joint ranges and rate them on a traffic light system, i.e. green – no concern, yellow – mild concerns which may need adjustment to physiotherapy programme, or red – concern requiring intervention. The Physio will advise on targeted exercises, stretches and specialist equipment if needed. They may ask for tests and X-rays or a clinic appointment with the Doctors. A targeted exercise programme, physical activities and postural management, are the mainstay of treatment in preventing muscles becoming too tight, for children with cerebral palsy, and should be completed on a daily basis.

Treatment for Children with Cerebral Palsy

Children with Cerebral Palsy have muscles which are both weak and tight. There is no cure for Cerebral Palsy but there are helpful interventions to maximise your child's potential therapists will support you by developing exercise programmes with you.

Physiotherapists will support the children to maximise the level of physical functioning. They will also consider whether other supports are needed to improve positioning and movement - splints, standing frames, Lycra garments, walking frames etc.

Occupational therapists will support you to increase your child’s independence. They look at hand function and equipment to support sitting, bathing, using the toilet / toiletting and sleeping.  They can also help if your home or school needs adaptation to make it work better to support your child.  An OT and Physio can give advice on moving and handling both at school and at home.

Speech and language therapists help with communication skills and feeding.

Some children with cerebral palsy, but not all, will have additional medical needs, such as epilepsy, vision problems, learning difficulties etc.

Paediatricians will think about whether any additional tests are needed, they may think about using some drug treatments, and will help look after any other medical conditions associated with cerebral palsy such as epilepsy etc.

Medical and Surgical Interventions for Children with Cerebral Palsy with High Muscle Tone

Botox (Botulinum Toxin) injections for muscle tightness when only 1 or 2 muscles are involved, e.g. the calf muscles. Botox causes temporary relaxation of the muscles to allow for intensive physiotherapy input- https://www.scope.org.uk/advice-and-support/botox/.

Need more information?

Website links:

Cerebral Palsy overview 

Scope – advice and support 

Contact – Hemiplegia support 

Canchild – Cerebral Palsy diagnosis    

Cerebral Palsy Alliance

Local Links for support:

Additional information.

Orthotics - how to put on my AFO

Educational Support 
Further information about educational support for children with additional needs and disability.

Tree of life - this is a group run by the Cambridgeshire Community Services psychology team to support young people with cerebral palsy. It is an opportunity to meet other children with the same condition and to discuss what makes you “you”- this has proved a popular choice with our teenagers.

Cooking in the kitchen – supported by the occupational therapists, where a group of teenagers prepare and cook a meal which they eat at the end. Occupational therapists support the group and advise how to improve independence.

 

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