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How Do I Know If My Child Has It?

A definitive test for CP does not exist at this time. The diagnosis is made by reviewing the child's medical history and performing a physical exam. Diagnosis can be difficult because infants may have more than one type of CP and their symptoms may change during their first few years, making an exact diagnosis impossible. CP is easier to diagnose in more severely affected children. In these children, a diagnosis can often be made within the first months of life. About 43% of CP cases are diagnosed within this time frame; about 70% are diagnosed by the end of their first year. More mildly affected children may not have a confirmed diagnosis until as late as the age of 3 or 4.

Doctors diagnose CP by testing the infant's motor skills, looking for characteristic symptoms and considering the child's medical history. They also may use computed tomography (CT) scans or magnetic resonance imaging (MRI) scans to look for abnormalities in the infant's brain. Certain laboratory tests may help rule out various progressive biochemical disorders that involve the motor system, such as Tay-Sachs disease.

What Are the Treatments?

CP is a lifelong condition that cannot be cured. However, treatment can improve an affected person's capabilities, increasing motor function and independence. Many people who have CP enjoy near-normal lives. Depending on his or her symptoms, a person with CP may need the following:

• Surgery. Surgery is used to correct muscle contractures — bending at a joint due to muscles that are too short or are spastic. During such surgery, muscle is lengthened. In another type of surgery, certain spinal nerves may be severed to help reduce spasticity in the legs.
• Medications, which may be used to treat muscle problems and other symptoms. Drugs such as diazepam, baclofen and dantrolene are sometimes used to control muscle spasticity. Anticholinergic medications may be used to help control abnormal movements. Alcohol or Botox injections into muscle may be used to reduce spasticity for a short time so healthcare providers can work to lengthen a muscle. Baclofen infused into the spinal canal under control of an electronic pump may be used to control spasticity for long periods of time. Other medications may also be given to control seizures.
• Physical therapy, which consists of special exercises designed to increase and improve the child's movement and strength. In healthy children, normal daily activity stretches muscles, helping them grow faster in order to keep up with the child's growing bones. In children with CP, muscles don't stretch and grow normally. As the child ages, the difference between bone growth and muscle growth can interfere with motor abilities. Physical therapy helps combat this.
• Mechanical aids, which may help with a wide variety of functions — from orthotic braces that help stretch muscles by holding bones in certain positions to a computer equipped with special input devices and a speech synthesizer to help the person communicate.
• Occupational therapy, designed to help the child develop the fine motor skills needed to function day to day at home and school.
• Speech therapy to help the child overcome communication problems.
• Counseling, such as from a social worker or psychologist, to help the child and the child's family cope with the child's condition and obtain needed services.
• Specially designed educational programs for those who have learning disabilities or mental retardation.

Because of the range of treatments for cerebral palsy, a child typically receives care from a pediatrician, who coordinates all aspects of the child's treatment; an orthopedist, who specializes in surgery to treat muscular and skeletal problems; and a variety of other therapists and aides. The treatment that's right for someone with cerebral palsy depends not only on the person's symptoms but also on his or her life stage. The treatment should be geared to help the person develop skills appropriate for his or her age and prepare the person for future educational and occupational activities.

Many adults with cerebral palsy are able to live and care for themselves independently. Others may need assistance in caring for themselves, help with transportation and special employment arrangements geared to their abilities.