Incidence and prevalence:

The incidence is about 1.5 to 4 per 1000 live births. This amounts to approximately 5,000-10,000 babies born with cerebral palsy each year in the United States. Each year, around 1,500 preschoolers are diagnosed with the disorder. In around 70% of all cases, cerebral palsy is found with some other disorder, the most common being mental retardation.

Overall, advances in care of pregnant mothers and their babies has not resulted in a noticeable decrease in cerebral palsy. Only the introduction of quality medical care to locations with less than adequate medical care has shown any decreases. The incidence increases with premature or very low-weight babies regardless of the quality of care. Twins are also four times more likely to develop cerebral palsy than single births, and triplets are more likely still to develop it.

Despite medical advances, the incidence and severity of cerebral palsy has actually increased over time. This may be attributed to medical advances in areas related to premature babies or the increased usage of artificial fertilization techniques.

Types:

Based on the group of muscles involved (typically only used to further describe spastic CP):

• Tetraplegia or Quadriplegia : Involvement of the four limbs, the trunk and the head. The great majority of these individuals will not be able to stand up or walk.
• Diplegia: The four limbs are affected, but lower limbs are more involved than upper limbs. Some of the people with diplegia will be able to walk alone, with orthosis, or by the use such as crutches or walkers.
• Hemiplegia: Only the right side or the left side of the body is involved. People with hemiplegia are the most likely to walk, even though people with the above two types can often walk without assistance, if severity allows.

NOTE: These are not the only 3 types of spastic CP. Occasionally, terms such as monoplegia, paraplegia, triplegia and pentaplegia may be used.

• Ataxia: Persons with ataxia have damage to their cerebellum which results in problems with balance, especially while walking. It is the most rare type, occurring in at most 10% of all cases.
• Athetoid or dyskinetic: Persons with this type generally have involuntary body movements. The damage occurs to the extrapyramidal motor system and/or pyramidal tract and to the basal ganglia. It occurs in ~20% of all cases.
• Spastic: Persons with this type have damage to the corticospinal tract, motor cortex, or pyramidal tract. It occurs in ~70% of all cases.

These three types may be found together. In 30% of all cases of cerebral palsy, the spastic form is found with the one of the other types. There are a number of other minor types of cerebral palsy, but these are the most common.

Presentation (signs and symptoms):

All types of cerebral palsy are characterized by abnormal muscle tone, posture, reflexes, or motor development and coordination. The classical symptoms are spasticity, paralysis, seizures, unsteady gait, and dysarthria. While mental retardation and cerebral palsy do not cause each other, the two disorders are found together in approximately 20%-30% of all persons with cerebral palsy. CP symptomology is as diverse as the individuals who have it. Secondary symptoms can include rigidity of limbs, bladder control issues, and impaired tongue movement.

Prognosis:

Cerebral Palsy is not a progressive disorder. A person with the disorder may improve somewhat during childhood, if they receive extensive care from specialists. Some individuals with the disorder will need to stay under the immediate care of another person for their entire lives, while others have a mild enough case to pursue fully independent lives.

Treatment:

There is no cure for cerebral palsy, but various forms of therapy can help a person with the disorder to function more effectively. Nevertheless, there is only some benefit from life-long care. The treatment is usually symptomatic and focuses on helping the person to develop as many motor skills as possible or to learn how to compensate for the lack of them. The disorder does not affect the expected length of life so treatment focuses on quality of life issues. Non-speaking people with cerebral palsy are often successful availing of Augmentative and Alternative Communication systems such as Blissymbols.

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