What Age Does Cerebral Palsy Appear?

While cerebral palsy (CP) is usually apparent from birth (congenital) in 85 to 90 percent of cases, the condition develops early in life while the brain is still developing in some cases.

Cerebral palsy (CP) is a disorder that affects a person’s movement, balance, and posture and people with CP have problems using their muscles. 

Cerebral palsy is apparent from birth (congenital) in 85 to 90 percent of cases, though in a small number of cases, the condition develops early in life while the brain is still developing.

Symptoms of cerebral palsy vary widely from mild impairment to severe disability. 

Symptoms of cerebral palsy involve movement disorders including:

• Stiff muscles (spasticity)
• Uncontrollable movements (dyskinesia)
• Poor balance and coordination (ataxia)

There are four main types of CP and symptoms depend on the type of CP that is present.

• Spastic cerebral palsy
  • Causes increased muscle tone (stiff muscles)
  • Awkward movements
    • Spastic diplegia/diparesis
      • Muscle stiffness is mainly in the legs and patients may have difficulty walking because tight hip and leg muscles cause their legs to pull together, turn inward, and cross at the knees (“scissoring”)
    • Spastic hemiplegia/hemiparesis
      • Only one side of a person’s body, usually the arm more than the leg
    • Spastic quadriplegia/quadriparesis
      • The most severe form of spastic CP 
      • Inability to walk and along with developmental disabilities such as intellectual disability; seizures; or problems with vision, hearing, or speech.
• Dyskinetic cerebral palsy (also includes athetoid, choreoathetoid, and dystonic cerebral palsies)
  • Muscle tone can change (from too tight to too loose) 
  • Causes problems controlling the movement of hands, arms, feet, and legs, making it difficult to sit and walk
  • Movements are uncontrollable and can be slow and writhing or rapid and jerky
  • Face and tongue may be affected and the person has a hard time sucking, swallowing, and talking
• Ataxic cerebral palsy
  • Problems with balance and coordination.
  • Unsteadiness when walking
  • Difficulty with quick movements or movements that need a lot of control
  • Difficulty controlling hands or arms when reaching for things
• Mixed cerebral palsy
  • Symptoms of more than one type
  • The most common type of mixed CP is spastic-dyskinetic CP

Children with cerebral palsy may also have other symptoms, including:

• Problems drinking or eating 
• Acid reflux 
• Lung infections
• Difficulty thinking and learning
• Problems hearing and speaking
• Vision problems
• Scoliosis
• Bladder control problems 
• Constipation 
• Seizures
• Dislocation of the hip joints
• Pain, which may be related to muscle stiffness, problems with the hip joints, or constipation

Risk factors for congenital cerebral palsy that is apparent at birth include:

• Low birth weight (less than 5-1/2 pounds at birth)
• Premature birth before the 37th week of pregnancy
• Multiple birth (twins, triplets, and other multiple births)
• Children conceived using assisted reproductive technology (ART) infertility treatments
• Viral infections during pregnancy, such as chickenpox, rubella (German measles), and cytomegalovirus (CMV)
• Bacterial infections during pregnancy, such as infections of the placenta or fetal membranes, or maternal pelvic infections
• Maternal medical conditions such as thyroid problems, intellectual disability, or seizures 
• Jaundice and kernicterus
• Birth complications such as detached placenta, uterine rupture, or problems with the umbilical cord during birth 

Causes of acquired cerebral palsy, which is caused by brain damage that occurs more than 28 days after include:

• Brain injuries, such as head injuries caused by motor vehicle crashes or child abuse
• Infection, including brain infections such as meningitis or encephalitis during infancy
• Problems with blood flow to the brain, such as stroke or bleeding in the brain associated with a blood clotting problem, blood vessels that didn’t form properly, a heart defect that was present at birth, or sickle cell disease

Treatment for cerebral palsy usually involves an “early intervention” program to teach parents and caretakers how to help a child perform daily activities such as eating, speaking, walking, and learning. 

Treatments for CP are individualized based on a child’s symptoms and may include:

• Medications to help treat symptoms such as stiff muscles, unusual body movements, or seizures
• Equipment which may include devices such as leg braces, walkers, or a wheelchair to help a child get around
• Physical, occupational, and speech therapy
• Nutrition 
  • Special diets 
  • Gastrostomy tube (g-tube) to bring nutrition directly into the stomach
• Surgery 
  • For very severe symptoms, surgery may be needed to put the child's legs or arms into the correct position