Because the severity and side effects of cerebral palsy (CP) can vary so greatly, there is no single way to determine if a child has it. Common signs of cerebral palsy in newborn babies include muscular stiffness, limpness, difficulty feeding, seizures, and more. In some cases, medical personnel recognize these clinical signs and diagnose cerebral palsy within the first few months of life. In other cases, cerebral palsy isn’t detected or diagnosed until the child misses important developmental milestones around the age of four or five. Cerebral palsy can be caused by complications during pregnancy, labor, and delivery, or shortly thereafter. Many times medical errors cause cerebral palsy. Throughout this FAQ page, our team will discuss the common signs and symptoms that help parents, caregivers, and medical professionals determine if a child has cerebral palsy.
The importance of early diagnosis and intervention
Although cerebral palsy (CP) can be difficult to identify before the child reaches an age in which physical development and/or cognitive capacities begin maturing, it is critical that it be diagnosed as soon as possible. Early diagnosis gives patients the ability to begin treatment earlier. Physical therapy and other interventions increase a child’s physical and mental capacities, and the earlier these interventions are initiated, the better the outlook for the child with cerebral palsy.
Risk factors for cerebral palsy
Babies are at increased risk of cerebral palsy if any of the following are true:
- They were born to a mother who had a high-risk or complicated pregnancy
- They had heart rate abnormalities during labor and delivery or there were other signs of fetal distress
- They experienced fetal oxygen deprivation/birth asphyxia
- They had a traumatic birth
Medical professionals must closely monitor at-risk newborns.
Diagnosis of cerebral palsy
Cerebral palsy diagnoses are often not made on a single abnormality. Instead, they are often based on multiple signs and findings, which can include the following:
- Motor delays, which are delays in muscle function and movement milestones (such as crawling and walking)
- Neurological signs, which include excessive irritability or excessive docility (baby is overly compliant)
- Abnormal postural reactions, such as a posture wherein the head and neck are thrust backward and held in that position
- Persistence of primitive reflexes, which are early reflexes in a baby.
Early diagnosis and intervention are crucial with all types of cerebral palsy (CP). For this reason, head imaging (such as a CT scan or MRI) should be performed shortly after birth when a brain injury is suspected, and the baby must be closely observed. Head imaging is also performed at regular intervals after that, so physicians can see the progression of the brain injury. When the brain is injured due to oxygen deprivation and hypoxic-ischemic encephalopathy (HIE), for example, there can be a progression of the injury that causes cerebral palsy. Sometimes the brain damage does not progress to cerebral palsy, but the child nonetheless experiences certain developmental delays.
Generally, if HIE is suspected, the baby should be given therapeutic hypothermia as soon as possible after the brain insult. Current guidelines state that this must be done within six hours of life (1). Research shows that this treatment can slow the spread of brain injury, and prevent or minimize the extent of cerebral palsy and other permanent disabilities. Of course, clinical signs of cerebral palsy (CP) evolve as the baby’s brain and nervous system mature, which is why continuous observation and serial examinations of the baby are imperative. All children should have a detailed history taken by the physician, as well as a thorough physical exam. It is especially important to determine that the condition is a non-progressive one (characteristic of cerebral palsy) rather than one that is progressive or degenerative.
What types of delays and abnormal behaviors are seen in children with cerebral palsy?
Signs of cerebral palsy typically appear in the early months of life, although the condition sometimes is not noticed until later when the child begins to show signs of delayed developmental milestones. Listed below are signs and behaviors that may indicate a child has cerebral palsy (2, 3, 4). For more information on early indications of cerebral palsy, please click here.
Signs of cerebral palsy in infants younger than six months
- When the baby is picked up while lying on their back, they cannot hold their head up.
- While being held, the baby may also overextend their back and neck as though they are pulling away.
- The baby feels stiff (hypertonic) or floppy (hypotonic).
- When the baby is picked up, the legs get stiff or cross/scissor.
- The baby has cortical thumbs
Signs of cerebral palsy in babies older than six months
In addition to the signs already mentioned for children under six months of age, babies over six months may exhibit the following early indications of cerebral palsy:
- The baby doesn’t roll over in either direction.
- The baby develops right or left “handedness” earlier than normal (e.g. they reach out with one hand only while keeping the other one in a fist).
- The baby struggles to bring their hands together.
- The baby struggles to lift their hands to their mouth.
Signs of cerebral palsy in babies older than ten months
In addition to the aforementioned signs, babies older than ten months may exhibit the following:
- Lopsided crawling (the baby pushes off with one hand and leg while dragging the opposite hand and leg).
- Inability to crawl on all fours (the baby may instead scoot around on their buttocks or hop on their knees).
- Inability to stand on their own, even when holding onto support.
Causes of cerebral palsy (CP)
There are many different injuries and complications that can cause cerebral palsy. Below are some of the many causes of cerebral palsy:
- Oxygen deprivation
- Hypoxic-ischemic encephalopathy (HIE)
- Brain bleeds
- Infections in the mother that cause infection in the baby’s brain (chorioamnionitis, group B strep, urinary tract infections, bacterial vaginosis, herpes simplex virus, and others)
If you have questions about your child’s development, it is wise to consult with your pediatrician and other medical specialists as soon as possible. If you believe that your child’s cerebral palsy was due to a medical error, you should also seek the assistance of an experienced birth injury attorney.
Cerebral palsy lawyers
If you are seeking legal help for a loved one with cerebral palsy, it is critical that you choose a lawyer and firm that focus solely on birth injury cases. Here at ABC Law Centers, we have exclusively been helping children with birth injuries since 1997. Our team of award-winning birth injury attorneys works closely with our in-house nursing staff, top medical experts, forensic specialists, and care-planning professionals to fight for birth injured children and their families. We work together to understand the causes of our clients’ injuries, the areas of medical negligence, and the long-term care needs of our clients. Our exclusive focus on birth trauma and birth injury allows our attorneys to extend exceptional legal service to our clients.
If your child was diagnosed with a birth injury from medical malpractice, such as cerebral palsy, hypoxic-ischemic encephalopathy (HIE), or a seizure disorder, the birth injury lawyers at ABC Law Centers can help. We have helped children throughout the country obtain compensation for lifelong treatment, therapy, and a secure future, and we give personal attention to each child and family we represent. Our birth injury firm has numerous multi-million dollar verdicts and settlements that attest to our success, and no fees are ever paid to our firm until we win your case. We encourage you to reach out to our team in any of the following ways:
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Related reading on cerebral palsy
- Early Signs of Cerebral Palsy
- About Cerebral Palsy
- Legal Help for Cerebral Palsy
- About ABC Law Centers
- Verdicts & Settlements
Video: Michigan cerebral palsy lawyers discuss birth injuries
- The Academica Medical Center Patient Safety Organization (AMC PSO) Neonatal Encephalopathy Task Force. (2016). Therapeutic Hypothermia in Neonates: Recommendations of the Neonatal Encephalopathy Task Force[Pamphlet].
- Cerebral Palsy (CP). (2018, March 09). Retrieved January 17, 2019, from https://www.cdc.gov/ncbddd/cp/diagnosis.html
- What are the early signs of cerebral palsy? (n.d.). Retrieved January 17, 2019, from https://www.nichd.nih.gov/health/topics/cerebral-palsy/conditioninfo/signs
- Sarnat, H. B., & Sarnat, M. S. (1976). Neonatal encephalopathy following fetal distress: a clinical and electroencephalographic study. Archives of neurology, 33(10), 696-705.