Cerebral palsy

Cerebral palsy (CP) describes a group of permanent but non-progressive neurological disorders caused by abnormal growth of — or damage to — the developing brain, typically before, during, or shortly after birth. The damage affects the brain areas controlling movement and posture, resulting in a lifelong condition of uncoordinated movement, muscle spasticity, or involuntary movements.

CP occurs in approximately 2–3 per 1,000 live births. In many cases the exact cause is unknown; identified risk factors include prematurity, very low birth weight (below 1,000 g), brain haemorrhage, oxygen deprivation during birth, viral infections, and chemical exposures during pregnancy.

**Types of CP**, classified by the pattern of motor involvement:

- **Spastic diplegia** — spasticity primarily affecting both legs (classical "scissors gait") - **Spastic quadriplegia** — spasticity in all four limbs; usually most severe - **Spastic hemiplegia** — spasticity on one side of the body (one arm and one leg) - **Athetoid/dyskinetic CP** — involuntary, purposeless, and jerky movements throughout the body

**Associated problems** children with CP often face: - Seizures - Visual, hearing, or speech impairments - Learning difficulties and behavioural challenges - Intellectual disability (in some types) - Respiratory problems - Bladder and bowel dysfunction - Bone deformities including scoliosis

Children with CP are typically slow to reach motor developmental milestones (rolling, sitting, crawling, walking). Some retain primitive reflexes that normally disappear in infancy.

Since CP is lifelong and cannot be cured, management focuses on preventing or minimising deformities, reducing spasticity, and maximising the child's ability to function independently at home and in the community. Best outcomes result from multidisciplinary care involving neurology, physiotherapy, occupational therapy, orthopaedic surgery, and speech therapy — started as early as possible and maintained throughout development.