What is Cerebral Palsy?

“Globally, cerebral palsy (CP) remains an important cause of motor disability. It has a reported prevalence of more than 4 per 1000 live births in low-and middle-income countries.” (Katangwe et al, 2024)

In South Africa, CP is one of the major causes of disability in children and highlights the need for a holistic approach towards the prevention, identification and treatment of the disorder. CP is a non-progressive neurological-motor disorder that affects the development of a child’s movement and posture. The disorder is non-progressive, meaning it does not get better or worse, but the child may develop secondary conditions that can affect their functional skills, such as epilepsy. To put it more plainly, CP a lifelong condition caused by a brain injury to a child during pregnancy or up until about two years old that results in various movement disorders.

Ce-re-bral Palsy

of the cerebrum of the brain lack of muscle control

Effects of Cerebral Palsy

Although CP is mainly known for affecting movement, it can influence multiple areas in the child’s life.

• Communication, drooling, eating and drinking: the change in muscle tone and muscle coordination can affect a child’s ability effectively use the muscle in their face and mouth.

• Bladder and bowel movements: a decrease in muscle control and pelvic strength can affect a child’s ability to control their bladder. The decrease in mobility can also increase the risk of constipation.

• Sensory: sensory processing can be common in children with CP. In children with decreased mobility and movement, they may lack the sensory input received from their joints to guide movement.

Children with CP can develop secondary conditions resulting in further complications. Such as learning disabilities, visual impairments, hearing difficulties and sleep disorders. Children with CP can also be more prone to infections such as aspiration pneumonia.

Types of Cerebral Palsy

CP is a very broad term used to define a complex condition that affects movement. The type of CP that a child is diagnosed with depends on the area of the brain affected. These are the different types of CP:

Type of Cerebral Palsy	Characteristics
Spastic	The most common type. Damage to the motor cortex. Increased muscle tone that can lead to stiff muscles and contractures. Jerky, exaggerated movements and reflexes. Diplegia: muscle stiffness affecting mainly the lower limbs. Hemiplegia/hemiparesis: affects one side of the body. Quadriplegia/quadriparesis: affects all 4 limbs.
Athetoid/Dyskinetic	Damage to the basal ganglia. Fluctuating muscle tone that results in uncontrollable movements. Floppiness in the limbs. Posture challenges.
Ataxic	Damage to the cerebellum. Balance and co-ordination issues. Movements can appear unsteady or uncoordinated. Hypotonic - Difficulty with quick or precise movements.
Hypotonic	Low muscle tone resulting in a floppy body. Mixed - Instability in the joints due to increased flexibility.
Mixed	When a child presents with 2 or more types of CP.

How to help a child with CP

Once a child is formally diagnosed its is easier to determine the help that they need. Many children will be under the care of a specialist physician, such as a paediatrician or neurologist, where the right medication will be prescribed as needed. The Dr will determine if the child needs to go for specific procedures to help manage the motor fall outs of their type of CP.

Physiotherapy, occupational therapy and speech therapy play a vital role to help the child get stronger and work towards improving their functional abilities. The rehabilitation team will educate the family on how best to help the child’s progress at home to allow the child to be more independent. The various members will prescribe mobility aids as needed.

A dietician can help ensure the child is getting the right nutrients in to promote their growth. They will also help determine what the child’s dietary requirements to ensure adequate nutrition.