A: 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 cerebral palsy. 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.
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.
Babies who experienced a traumatic or risky delivery or who had heart rate abnormalities (nonreassuring heart tones) during labor and delivery are at an increased risk of developing cerebral palsy (CP), as are babies whose mothers had abnormal pregnancies. Medical professionals must closely monitor at-risk newborns. Clues that a baby may have cerebral palsy include abnormal behavior, delay in physical and emotional reactions, and abnormal mouth and eye activity (i.e., the baby cannot control mouth and facial muscles and drools excessively). In addition, babies who have normal functional development and behavior, but who appear to have mildly limp muscles (mild hypertonia) or muscles that are too stiff or flexed (hyperreflexia) should be very closely observed for signs of cerebral palsy. If these particular abnormalities are the only ones present, they often will resolve after the child reaches nine months of age.
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 backwards and held in that position
- Persistence of primitive reflexes, which are early reflexes in a baby.
Early diagnosis and intervention is crucial with all types of cerebral palsy (CP). Research shows that cerebral palsy diagnoses are often missed at one month of age. For this reason, head imaging (usually by magnetic resonance imaging) 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 the initial MRI, so that 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, however, the brain damage does not progress to cerebral palsy, but the child nonetheless experiences developmental delays and learning disabilities.
If a brain injury is suspected – whether or not any signs of brain injury are present – the baby should be given hypothermia treatment (brain cooling) as soon as possible after the brain insult. Research shows that when a baby experiences oxygen deprivation that can damage the brain, the chances of cerebral palsy (CP) are reduced when a baby’s brain is cooled for about 72 hours, beginning shortly after the insult. For best results, the hypothermia treatment should be started within six hours of the oxygen-depriving insult. Often, babies are deprived of oxygen during the labor and delivery period, and when this occurs, hypothermia treatment should be initiated soon after birth.
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 the child is two years of age or older. Babies with cerebral palsy frequently have developmental delays and are thus slow to reach development milestones. Decreased muscle tone can make babies appear overly relaxed and floppy (hypotonic), while increased muscle tone (hypertonia) makes other babies appear stiff or rigid. In some cases, the baby may have hypotonia that progresses to hypertonia after the first two to three months of life. Babies and children with cerebral palsy may have unusual posture or favor one side of their body when reaching, crawling, or moving.
Listed below are signs and behaviors that may indicate a child has cerebral palsy. Not all signs occur in babies with the condition, but the presence of three or more abnormal signs/behaviors in a baby at eight months of age is highly predictive of cerebral palsy.
Signs of Cerebral Palsy in Babies and Young Children
- The baby or child is stiff and has increased tendon reflexes and clonus, which is involuntary, rhythmic, muscular contractions and relaxations.
- The baby’s primitive reflexes, such as rooting, may be asymmetric or they may continue well past the age in which they should stop.
- The postural reactions may be delayed. Postural reactions are motor skills that develop during the first year of life and form the basis of functional motor skills. These reactions automatically maintain the body in an upright position through changes in muscle tone, in response to the position of the body and its parts.
- The tone in the baby’s extremities may be normal or increased (stiff muscles).
- The baby has abnormal mouth and tongue patterns, such as retracting and thrusting the tongue, biting hard and not letting go (tonic bite), an overly-sensitive mouth, or frequent grimacing.
Signs of Cerebral Palsy in Babies Younger Than Six Months
- When the baby is picked up while lying on his or her back, the head lags. However, increased tone in the neck muscles may make head control seem more normal than it actually is.
- The baby feels either very stiff or floppy or has shaky arms and legs.
- When the baby is picked up, the legs get stiff and cross or scissor.
- The baby is irritable, has difficulty feeding and sleeping, vomits frequently, is difficult to handle and cuddle, has poor visual attention, and may be overly docile (the body doesn’t appropriately tense or stiffen).
Signs of Cerebral Palsy in Babies Older Than Six Months
- The baby doesn’t roll over in either direction.
- Poor head control.
- The baby reaches out with one hand only while keeping the other one in a fist.
- Holding the hands in fists continuously.
- Inability to bring the hands together.
- Inability to push up with the hands while lying on the stomach.
- Difficulty bringing the hands to the mouth.
- Frequent vomiting
- The baby is difficult to handle and cuddle
- Poor visual attention
- Extreme docility (the body doesn’t appropriately tense)
Signs of Cerebral Palsy in Babies Older Than Ten Months
- The child’s crawling is lopsided; the baby pushes off with one hand and leg while dragging the opposite hand and leg
- Inability to sit independently
- Inability to stand without 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 Representing Victims of Medical Malpractice
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 Reiter & Walsh 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 Erb’s palsy, cerebral palsy, a seizure disorder, or hypoxic-ischemic encephalopathy (HIE), the birth injury lawyers at Reiter & Walsh, P.C. 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:
Free Case Review | Available 24/7 | No Fee Until We Win
Related Reading on Cerebral Palsy
- Early Signs of Cerebral Palsy
- About Cerebral Palsy
- Birth Injury and Cerebral Palsy
- Cerebral Palsy Resources
- Legal Help for Cerebral Palsy
- About Reiter & Walsh, P.C.
- Verdicts & Settlements
Video: Michigan Cerebral Palsy Lawyers Discuss Birth Injuries
View our video library to see Michigan cerebral palsy lawyers Jesse Reiter and Rebecca Walsh discuss causes of and treatments for cerebral palsy and other birth injuries.
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