When delivering a baby, complications can happen. Unfortunately, some of these complications might lead to a medical condition called cerebral palsy, or CP. It is suspected that the majority of cerebral palsy cases are the result of some sort of brain injury sustained during the process of childbirth.
What is Cerebral Palsy?
Cerebral palsy is a type of muscle disorder that is caused by abnormal brain development or damage. The most common time of incidence for cerebral palsy is either before or during delivery. These cases are referred to as congenital cerebral palsy and they account for up to 90 percent of CP cases.
Risk factors for developing cerebral palsy are wide reaching. First, if the infant is premature or has a low birth weight, they may have a higher risk of having CP. Additionally, if assistive reproductive technology infertility treatments are used, cerebral palsy could be more likely due to either preterm delivery or multiple births. Lastly, if an infection was sustained during pregnancy, CP risk might be higher. This is due to the higher presence of cytokines, which are a type of protein, that cause inflammation which can lead to brain damage in newborns1.
Cerebral palsy is not a single disorder, but rather a grouping of disorders, that can affect a person’s ability to move, maintain balance, and keep an upright posture.
Types of Cerebral Palsy
There are four common types of cerebral palsy: spastic, dyskinetic, ataxic, and mixed. Each have their own characteristics2.
Spastic
Spastic cerebral palsy is the most common form of cerebral palsy. It occurs in about 80 percent of diagnosed cases. People who have spastic cerebral palsy have an increased muscle tone. This causes intense muscle stiffness which results in agitated and improper muscle movement. Spastic cerebral palsy is often further categorized depending on what area of the body it affects most.
Spastic diparesis means that there is significant muscle stiffness within the lower appendages with the arms being less or unaffected.
Spastic hemiparesis refers to when cerebral palsy affects one entire side of the person’s body with the upper limb more affected than the lower limb.
Lastly, spastic quadriplegia is the most severe form of spastic CP and affects the entire body, including both appendicular and axial areas.
Dyskinetic
Dyskinetic cerebral palsy is a type of CP where a person has difficulty controlling appendicular movements. This includes the areas like the arms, hands, legs, and feet. This can make it difficult for them to sit and walk. Muscle tone can change drastically in dyskinetic CP meaning one day a person could have a tight tone while the next day could be loose.
Ataxic
Ataxic cerebral palsy is characterized by having difficulty with balance and coordination. This displays as unsteadiness while walking or being unable to make quick movements. Additionally, actions that require a lot of control, like writing, may be difficult.
Mixed
Mixed cerebral palsy, as the name suggests, indicates that symptoms from multiple types of CP are recognized. For example, a common mixed type of CP is spastic-dyskinetic cerebral palsy. For patients with spastic-dyskinetic CP, they would display an increased muscle tone, difficulty with proper movements, and appendicular control issues.
Symptoms of Cerebral Palsy
In newborns, it can often be difficult to recognize cerebral palsy unless specifically tested for. Even then, though, cases can be difficult to detect until specific milestones are missed. In babies under six months old, parents may recognize their baby’s head falling backward when lifted. Alternatively, their muscle tone could feel either stiff or floppy, which is inconsistent with the typical muscle tone of a young baby.
After six months old but before ten months old, a baby might display difficulty rolling or coordinating movements. For example, moving the hands to the mouth or bringing both hands together could be delayed.
When ten months and older, babies with cerebral palsy might push off a single leg when crawling. Additionally, they may not crawl normally at all, such as scooting or hopping on the knees instead of on all fours. Failing to stand without support after the one-year milestone is reached may be a sign of cerebral palsy, too2.
It’s important to recognize that the signs and symptoms of cerebral palsy vary significantly, so if you’re concerned about your child’s development it’s important to speak to a physician.
Causes of Cerebral Palsy in Newborns
There are many possible causes of cerebral palsy in childbirth. Physicians and researchers used to believe that asphyxia, or the lack of oxygen during delivery, was the main source of CP. However, further research indicated that this is not the only cause of cerebral palsy incidence.
Another cause of cerebral palsy could be fetal stroke or brain bleeds. When the blood supply to the brain is limited, brain bleeds can occur due to improper oxygenation and blood supply. This could ultimately lead to brain damage associated with cerebral palsy.
During delivery, if fetal stress isn’t monitored properly or responded to promptly, permanent damage can occur2.
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