Spastic cerebral palsy is a motor disorder that can cause a child to struggle with balance, coordination, and movement due to increased tone (tension) in their muscles. Normally, muscles have enough tone to maintain posture or movement against the force of gravity, while at the same time providing flexibility and speed of movement. When a person’s body tenses, the message goes to the spinal cord via nerves from the muscle itself. Since these nerves tell the spinal cord just how much tone the muscle has, they are called “sensory nerve fibers.” The command to be flexible, or reduce muscle tone, comes to the spinal cord from nerves in the brain. These two commands must be well coordinated in the spinal cord for muscles to work smoothly and easily while maintaining strength. People with cerebral palsy have an injury to the brain, usually in the area that controls muscle tone and movement of the arms and legs, resulting in muscles that are too tense (spastic). Patients with cerebral palsy do not typically have spasticity of the extremities at birth, but develop them over time. Spastic cerebral palsy is caused by events that take place around the time of labor and delivery. Trauma to the baby’s head during labor, lack of oxygen in the baby’s brain (which can be caused by a lack of oxygen in the blood or a diminished blood flow in the brain), infection, or toxins in the baby’s brain are conditions that can cause spastic cerebral palsy. A lack of oxygen in the blood is called hypoxemia or hypoxia.
Approximately 70 – 90 out of 100 people with cerebral palsy have varying degrees of spasticity. Spasticity can be associated with diplegic, quadriplegic, or hemiplegic cerebral palsy. Spasticity can be evident during the first year of life in many cases, but it is most often detected later in life. It is important to note that once spasticity has developed with cerebral palsy, it never improves spontaneously. Intense treatment and therapy is required, and many people with spastic cerebral palsy undergo surgery, such as selective dorsal rhizotomy (SDR).
Spasticity adversely affects the muscles and joints of the extremities, causing abnormal movements, and it is especially harmful in growing children. The known effects of spasticity include:
- Inhibition of movement
- Inhibition of longitudinal muscle growth
- Inhibition of protein synthesis in muscle cells
- Limited stretching of muscles in daily activities
Development of muscle and joint deformities
Causes of Spastic Cerebral Palsy
- Umbilical Cord Prolapse and Compression
- Jaundice, Hyperbilirubinemia, and Kernicterus
- Pregnancy Infections
- Misuse of Forceps and Vacuum Extractors
- Strong Contractions and Hyperstimulation
- Breech Births
- Placental Abruption
- Post-Term Pregnancy
- Placenta Previa
- Nuchal Cord
- Uterine Rupture
- Cephalopelvic Disproportion (CPD)
- Premature Rupture of Membranes (PROM)
- Intracranial Hemorrhages and Brain Bleeds
Umbilical Cord Prolapse and Compression
The umbilical cord is the baby’s lifeline. Through the umbilical cord, oxygenated blood is transported from the placenta to the baby. Any disruption in normal blood flow and gas exchange through the umbilical cord can lead to potentially devastating and traumatic injuries to the baby, including severe oxygen deprivation and spastic cerebral palsy.
Umbilical cord prolapse refers to a condition in which the umbilical cord descends or falls ahead of the part of the baby that is being delivered, often referred to as the “presenting part.” Umbilical cord prolapse can result in a sudden and potentially devastating reduction in the supply of oxygenated blood to the baby.
Umbilical cord prolapse is frequently associated with malpresentation of the baby. Instead of being in the vertex position, where the head of the baby is at or near the pelvic inlet, some other part of the baby, such as the buttocks or feet, present at or near the mother’s pelvic inlet instead. Accordingly, whenever a baby is assessed as being in a breech or transverse lie presentation, the physician should be alert to the potential trauma and grave risks associated with prolapse.
Umbilical cord prolapse is also frequently associated with the artificial rupture of the maternal membranes, also known as amniotomy. In many cases, maternal membranes are artificially ruptured by the phsyician before the baby’s head is secure in the pelvic inlet. When this happens, umbilical cord prolapse often occurs. Because of the increased risk of umbilical cord prolapse associated with amniotomy, the physician should always determine that the fetal head is secure in the maternal pelvic inlet before artificially rupturing membranes.
A prolapsed umbilical cord represents an obstetrical emergency, which can quickly result in permanent brain damage and spastic cerebral palsy. Accordingly, the prompt assessment of umbilical cord prolapse is critical to the implementation of appropriate medical interventions, which often include emergency C-section delivery.
Jaundice, Hyperbilirubinemia and Kernicterus
Jaundice is yellowing of the skin caused by too much bilirubin, which is a product of the breakdown of red blood cells. Everyone has bilirubin in their blood, but babies can have a difficult time getting rid of it, which is why they are so susceptible to jaundice. When the level of bilirubin in a baby’s blood rises to an unsafe level, it can enter the brain tissue. Bilirubin is toxic to brain tissue, and when it enters the tissue, permanent brain injury can result. This brain damage is called kernicterus, and it can cause spastic cerebral palsy, although kernicterus more frequently causes other types of cerebral palsy.
Excessive bilirubin in the blood is easily diagnosed with simple blood tests. It also is easily treatable with phototherapy (the baby is placed under special lights that decrease bilirubin levels), a fiberoptic phototherapy blanket, and a blood exchange transfusion. The underlying condition that is causing the excessive bilirubin also should be treated, if possible.
When a baby shows signs of kernicterus, permanent brain damage is likely happening. Immediate treatment should be done to prevent further damage.
Group B Streptococcus (GBS) is type of bacterium found in the genital tract and gut that can cause illness in people of all ages, including babies. Also known as baby strep, GBS is extremely dangerous when a pregnant woman has the infection. If GBS is left untreated or treated improperly, it can cause life-threatening problems in the baby, such as pneumonia, sepsis, meningitis, and spastic cerebral palsy. The test for GBS is very easy; the physician takes a swab (Q-tip) and collects a sample from the rectum and vagina. Since GBS can cause severe injury in a baby, and since 25% of all pregnant women have GBS infection, the Centers for Disease Control (CDC) recommends that all pregnant women be tested for GBS at weeks 35 – 37 of pregnancy.
Chorioamnionitis is an infection of the amniotic fluid (the fluid that surrounds the baby) as well as an infection of the membranes that surround the fetus. It is caused by a bacterial infection, such as GBS, that starts in the mother’s vagina or anus and then moves up to the uterus (womb). When the infection enters the womb, there is a fetal inflammatory response, and this inflammation can cause brain damage and spastic cerebral palsy in the baby.
A urinary tract infection (UTI) is an infection in the mother’s urinary system, which includes the kidneys, the bladder, and the urethra (the short tube that carries urine from the bladder to outside the body). A UTI can be either a bladder infection or a kidney infection. If a bladder infection goes untreated or is treated incorrectly, it can lead to a kidney infection or preterm delivery. Pregnant women are at increased risk for UTIs starting in week 6 through week 24.
Bacterial vaginosis (BV) is an infection of the vagina caused by bacteria. Specifically, it is caused by an imbalance of naturally-occurring bacterial flora. BV is the most common vaginal infection in women of childbearing age. Approximately 1 in 5 women have this infection at some point during pregnancy.
BV and UTI’s must be timely diagnosed and correctly treated in pregnant women because the infection can travel to the womb and infect the baby. The infections are associated with increased risk of premature rupture of the membranes (which can lead to chorioamnionitis), and preterm birth, which can lead to spastic cerebral palsy, if not properly managed. UTIs are sometimes asymptomatic. Due to the potential for serious complications, it is standard practice for physicians to screen all pregnant women for the infection. On the other hand, research shows no benefit to screening all pregnant women for BV, but many specialists screen women with a history of preterm birth.
Misuse of Forceps and Vacuum Extractors
Inappropriate use of vacuum extractors and forceps can cause brain damage through several mechanisms. These include brain bleeds, cerebral contusions, stretching and tearing of blood vessels and brain tissue, compression of the brain with changes in blood flow, and/or skull fractures. When a baby is in distress during delivery, forceps, which resemble large salad tongs, are placed on either side of the baby’s head. As each contraction occurs, the physician guides the baby’s head downward and out of the birth canal. A vacuum extractor uses a small, soft cup that is applied to the top and back of the baby’s head. A tube runs from the cup to a vacuum pump that provides suction. During a contraction, the physician pulls or applies gentle traction to the baby’s head while suction from the vacuum assists in pulling the baby’s head out of the birth canal. If forceps and vacuum extractors are used improperly, the damage can be extensive and permanent. If they are applied unevenly to the baby’s head, the strain could cause compression of the head as well as brain bleeds and hemorrhages, which can cause spastic cerebral palsy.
Strong Contractions and Hyperstimulation
Trauma causing brain injury can also occur from the cumulative effect of prolonged periods of contractions and pushing, forcing the baby’s head and brain repeatedly against the mother’s pelvis in a setting where the baby is a very tight fit for the particular pelvis, which can happen in cases of cephalopelvic disproportion (CPD) and macrosomia. The labor-enhancing drugs Cytotec and Pitocin (synthetic oxytocin) often are misused in this scenario.
Excessive Pitocin and Cytotec can cause excessive uterine activity (contractions), thereby reducing the ability of the placenta to replenish its oxygen supply. Excessive frequency, strength, or duration of contractions is called hyperstimulation. When hyperstimulation prevents replenishment of oxygen in the placenta, the baby’s brain may be deprived of oxygen, which can cause spastic cerebral palsy.
Uterine rupture occurs when the excessive contractions associated with hyperstimulation cause the uterus to tear, either partially or completely. The baby then must be delivered by an emergency C-section in an attempt to avoid hypoxia, ischemia, trauma, and spastic cerebral palsy. Cytotec and Pitocin also have been associated with increased incidence of hemorrhaging, amniotic fluid embolism, meconium stained amniotic fluid, and increased assistive device deliveries (forceps or vacuum extractors), all of which can cause injury to a baby and resultant spastic cerebral palsy.
A breech birth is when the baby enters the birth canal with the buttocks or feet first, as opposed to the normal head first presentation. Breech presentation presents some hazards to the baby during the process of birth, including the mode of delivery (vaginal versus C-section). Though labor and vaginal birth are possible for the breech baby, certain fetal and maternal factors influence the safety of vaginal breech birth. The majority of breech babies should be delivered by C-section. At the beginning of labor, the baby is generally facing either the right or left side of the mother’s back. Delay in descent is a cardinal sign of possible problems with the delivery of the head. Umbilical cord prolapse may occur, particularly in the complete, footling, or kneeling breech. This is caused by the lowermost parts of the baby not completely filling the space of the dilated cervix. When the waters break, it is possible for the umbilical cord to drop down and become compressed. This complication severely diminishes oxygen flow to the baby and the baby must be delivered immediately (usually by C-section) so that he or she can breathe. If there is a delay in delivery, the brain can be damaged and spastic cerebral palsy may occur. Also, injury to the brain and skull may occur due to the rapid passage of the baby’s head through the mother’s pelvis. Squeezing the baby’s abdomen can damage internal organs. Positioning the baby incorrectly while using forceps to deliver the aftercoming head can damage the brain and cause spastic cerebral palsy.
Placental abruption occurs when the placenta separates from the uterus before the fetus is delivered. The placenta delivers oxygen-rich blood to the baby through the umbilical cord. A placental abruption can cause extreme bleeding in the mother, which can severely deprive the baby of oxygen-rich blood, and this can cause brain damage and spastic cerebral palsy, or even kill the baby.
The baby’s heart rate should be electronically monitored during labor and delivery, but this is especially important if abruption is suspected. When a baby is being deprived of oxygen, there will be an abnormal heart rate on the fetal monitor, and this is called fetal distress. Typically, to protect the baby from brain damage and spastic cerebral palsy, a C-section is the best option when abruption occurs. Indeed, physicians should watch for this condition, and they typically should deliver the baby before fetal distress is evident.
When a baby remains in the womb beyond the natural due date, usually beyond 41 or 42 weeks, there is great potential for brain injuries. In general, the longer a pregnancy continues after 40 weeks, the more risks there are to the baby, including spastic cerebral palsy. Research suggests that due to the increase in fetal death and injury at 42 weeks and beyond, it is much safer to induce labor by about 40 or 41 weeks than to allow the pregnancy to continue.
There are numerous problems that may occur to the baby and mother if a pregnancy continues beyond the normal gestation period. While some problems resolve on their own, others are more serious and can result in lifelong disabilities, such as spastic cerebral palsy. These include:
Postmaturity Syndrome: Occurring in roughly 20% of post-date pregnancies, this syndrome develops due to a placenta that is no longer working properly. This causes long term fetal distress and hypoxia in the baby, which can cause spastic cerebral palsy. Postmaturity syndrome features a number of disorders:
- Uteroplacental insufficiency. The major risk to a baby comes from the fact that the placenta reaches its maximum size and surface area around 37 weeks. After 37 weeks, its surface area and function gradually deteriorate. This usually means that the placenta is less able to supply sufficient oxygen-rich blood to the baby. When the placenta is unable to supply sufficient oxygen, it poses an increased risk for spastic cerebral palsy.
- Fetal Distress/Nonreassuring Fetal Assessment. If a baby is not responding well and is not being adequately oxygenated during delivery, fetal monitoring will be nonreassuring, indicating fetal distress. In post-term pregnancies, there is increased risk of fetal distress and trauma due to the higher incidence of cord compression. It is crucial that physicians pay close attention to fetal monitoring devices.
- Meconium aspiration/asphyxiation. Sometimes fetal stress and an older gestational age may induce a bowel movement by the baby while in the womb. In some cases, the baby will actually inhale the amniotic fluid mixed with stool into his or her lungs. This may cause trauma to the airway, irritation, airway obstruction, infection, problems with normal lung expansion, HIE, and spastic cerebral palsy.
- Macrosomia. A baby can become very large when a pregnancy is post-term. This can make it traumatic to deliver vaginally due to shoulder dystocia or cephalopelvic disproportion. This may prompt a physician to use forceps or a vacuum extractor for delivery assistance, which may increase the likelihood of head trauma, brain bleeds, and spastic cerebral palsy. Macrosomia also increases the chances of prolonged labor, which in turn increases the likelihood of brain injury and spastic cerebral palsy.
- Oligohydramnios. Amniotic fluid is a liquid that surrounds and protects the baby in the amniotic sac during pregnancy. Initially, the fluid consists of water. Around 20 weeks, fetal urine becomes the primary substance. The baby swallows and sometimes inhales amniotic fluid, which aids in lung maturation. When there is an unexpected decrease in the amount of amniotic fluid, it is called oligohydramnios. Oligohydramnios can cause complications in the baby, such as cord compression and spastic cerebral palsy.
Preeclampsia is a pregnancy complication in which the mother develops high blood pressure. Preeclampsia causes problems with the vessels in the placenta, and it is generally classified as being mild, moderate, or severe. In many cases, a mother with even mild preeclampsia can rapidly progress to a more severe form of the disease. Undiagnosed or untreated preeclampsia can also lead to eclampsia, a potentially deadly consequence associated with significant maternal mortality and potentially permanent brain injuries in the baby, including oxygen deprivation and spastic cerebral palsy.
In cases where preeclampsia is undiagnosed or untreated, there usually is a decrease in the blood flow from the mother’s placenta to the baby, thereby reducing the amount of oxygen-rich blood going to the baby. In cases of moderate to severe preeclampsia, there can be reductions in the amniotic fluid (oligohydramnios), intrauterine growth restriction (in which the baby does not grow normally), or placental abruption, all of which can cause spastic cerebral palsy.
Placenta previa is a condition in which the placenta either partially or totally covers the cervical opening (the “cervical os”). A placenta previa is characterized as either: 1.) a complete placenta previa – where the placental tissue completely covers the cervical opening; or, 2.) a partial or marginal placenta previa, in which the placenta only partially covers the cervical opening.
Hemorrhagic placenta previa is characterized by painless third trimester bleeding. Often, bleeding occurs with the cervical changes and related uterine contractions that naturally occur as the pregnancy advances through the third trimester. As a result, when the cervical opening becomes wider and/or uterine activity occurs, the placenta previa can become hemorrhagic, causing the mother – and sometimes the baby – to hemorrhage (bleed suddenly and profusely). Because of this, the physician must closely monitor a mother diagnosed with complete placenta previa and the physician usually must deliver the baby by C-section well before the time when any uterine activity or related cervical changes are likely to occur.
Since a complete placenta previa covers the cervical opening, vaginal delivery can never be safely attempted. It has long been recognized that placenta previa may cause life-threatening hemorrhage in less than fifteen minutes, and that the amount or extent of hemorrhage associated with placenta previa is often unpredictable. Furthermore, because a baby’s circulating blood volume is so low, fetal hemorrhage associated with placenta previa is particularly dangerous, and may lead to the baby’s death or HIE and spastic cerebral palsy if not properly managed.
When the umbilical cord wraps around a baby’s neck, it is called a nuchal cord. In many cases, the nuchal cord causes ischemia, hypoxia, decreased fetal development and movement, complicated delivery and spastic cerebral palsy. Nuchal cord deprives the baby of oxygen due to the following reasons: 1.) the tightness around the neck restricts blood flow from the neck artery to the head; 2.) the blood from the veins gets backed up; and 3.) the vessels in the cord get compressed themselves due to the cord being tightly compressed against itself or the baby’s neck.
Nuchal cords have been associated with fetal demise, impaired fetal growth, meconium stained amniotic fluid, and an increased rate of intrapartum fetal heart rate abnormalities leading to an increased rate of operative delivery, and umbilical artery acidemia. They have also been associated with a long-term risk of neurodevelopmental abnormalities and spastic cerebral palsy.
A uterine rupture is a potentially life threatening condition for both mother and baby, which typically occurs when the forces and stresses of uterine contractions associated with attempted vaginal delivery cause the uterus to tear open, potentially expelling the unborn baby into the mother’s abdomen. In such cases, maternal or fetal death or fetal oxygen deprivation with associated long-term brain damage and spastic cerebral palsy are common consequences, particularly in those cases where the physician fails to appreciate the risk of uterine rupture, or fails to act quickly when uterine rupture occurs.
Although a uterine rupture may sometimes develop as a result of pre-existing injury or trauma, it is generally recognized that the most common cause of uterine rupture is the separation of a previous C-section scar during labor. Thus, it has been recognized that the induction or augmentation of labor in patients who previously had a C-section, called a “VBAC” delivery, is associated with an increased risk of uterine rupture. Medical studies have indicated that when prostaglandin agents, such as Cervidil or Prepidil, are utilized to induce labor in a patient who had a previous C-section delivery, there is also an associated increased risk of uterine rupture.
Because of the risk of uterine rupture, many physicians will not use any medications such as Pitocin or prostaglandins to either induce or augment the labor of a patient who has had a prior C-section. A uterine rupture, or the separation of a surgical scar from a prior C-section, can result in massive maternal hemorrhage and oxygen deprivation in the baby.
If uterine rupture occurs, maternal hemorrhage must be promptly controlled and the baby must be delivered as expeditiously as possible to avoid hypoxia, ischemia, trauma, and spastic cerebral palsy.
Cephalopelvic Disproportion (CPD)
CPD occurs when the baby’s head is too large to pass through the mother’s pelvis. Initially, physicians will have information about the mother’s pelvis type and size by x-ray and examination. Ultrasounds also give the physician an idea of the baby’s head measurements. Another important factor is how the baby’s head is positioned in the pelvis – some parts of the baby’s head can mold to conform to the mother’s pelvis. Physicians should identify any risk factors for CPD before the start of labor. Risk factors include:
- Small or abnormal pelvis
- Large head measurement of baby
- Mother with diabetes or gestational diabetes
- Post-term pregnancy
- Mother over age 35
The treatment for CPD is surgical delivery or C-section. Sometimes it may be necessary to plan to deliver the baby early. When CPD is present, attempts to deliver the baby vaginally will cause trauma, which can lead to spastic cerebral palsy.
Some trauma-inducing mistakes made by physicians when CPD is present include the following:
- Pitocin/Oxytocin: Physicians may react to CPD by administering Pitocin, which can cause excessive and traumatic contractions, leading to hypoxia, ischemia, and resultant spastic cerebral palsy.
- Prolonged Labor: Physicians may allow labor to progress for too long. Labor is stressful and traumatic for babies, and when prolonged, it can cause hypoxia and ischemia, which can lead to spastic cerebral palsy.
- Shoulder Dystocia: When CPD is a problem, babies are more likely to have shoulder dystocia, which can cause hypoxia and resultant spastic cerebral palsy.
- Prolapsed Umbilical Cord: When there is less room in the uterus, either because of a large baby or a small pelvis, a prolapsed umbilical cord is more likely, and this puts the baby at risk for hypoxic injuries and spastic cerebral palsy.
Premature Rupture of Membranes (PROM)
Premature rupture of the fetal membranes (PROM) is a dangerous condition, leading to fetal distress and other complications before labor or near the end of the third trimester. Without the sterile, protective amniotic fluid, an unborn baby is prone to bacterial infections, premature birth and other traumatic complications that cause spastic cerebral palsy. Complications from PROM can include:
- Prolapsed umbilical cord
- Inflammation and infection of the fetal membranes (chorioamnionitis)
- Infections such as GBS, UTI and BV, and HSV
- Premature birth and hypoxia
Intracranial Hemorrhages and Brain Bleeds
Sometimes during labor and delivery, trauma to the baby’s head occurs, causing brain bleeds (hemorrhages). Sometimes, the hemorrhages are very serious and result in spastic cerebral palsy.
Many brain bleeds are the result of mismanaged labor and delivery. Intracranial hemorrhage refers to any bleeding within the skull or brain. There are several types of brain bleeds that can cause spastic cerebral palsy, and they are listed below.
- Cerebral hemorrhage. This is a form of stroke in which bleeding occurs within the brain itself.
- Subarachnoid hemorrhage. This occurs when there is bleeding in the subarachnoid space, which is the area between the innermost two membranes that cover the brain. This type of hemorrhage usually occurs in full term babies and produces seizure activity, lethargy, and periods of breathing cessation.
- Intraventricular hemorrhage. This is bleeding into the brain’s ventricular system, where spinal fluid is produced. It is the most serious type of intracranial bleeding and is usually seen in premature infants and infants with low birth weight. This is because blood vessels in the brain of premature infants are not fully developed and are very weak. Intraventricular hemorrhages can result from physical trauma during birth.
- Subdural hemorrhage or subdural hematoma. This occurs when there is a rupture of one or more blood vessels that are in the subdural space – the area between the surface of the brain and the thin layer of tissue that separates the brain from the skull. These ruptures are usually caused from difficult deliveries. Seizures, high levels of bilirubin in the blood, a rapidly enlarging head, a poor Moro reflex, or extensive eye bleeds sometimes occur with these kinds of hemorrhages.
- Cephalohematoma (cephalhematoma). This is bleeding that occurs between the skull and its covering, starting as a raised bump on the baby’s head. It occurs a few hours after birth and lasts anywhere from 2 weeks to a few months.
Causes of Intracranial Bleeding
There are a number of things that can lead to brain bleeds and resultant spastic cerebral palsy. They include:
- Baby is large for gestational age (macrosomic)
- Mother has small pelvis or the baby’s head does not easily fit through the pelvis (cephalopelvic disproportion)
- Abnormal presentation (such breech or face presentation)
- Trauma from prolonged labor
- Abnormal changes in blood pressure
- HIE (blood and oxygen supply to the brain is reduced)
As discussed above, severe head and brain trauma to newborns can occur from medical intervention during labor and delivery. Improper use of forceps and vacuum extractors are well-documented causes of intracranial bleeding. In addition, improper delivery techniques (excessive twisting or pulling of the infant’s head) can cause intracranial hemorrhages and spastic cerebral palsy.
Reiter & Walsh, P.C. | Trusted Birth Injury and Cerebral Palsy Attorneys
There are many complications that can cause spastic cerebral palsy. It is crucial for the physician to monitor the mother and baby very closely during pregnancy and around the time of delivery, and prevent or treat conditions that can lead to spastic cerebral palsy. Failure to properly monitor and treat the mother and baby is negligence. Failure to follow standards of care and guidelines, and to act skillfully and expediently, also constitutes negligence. If this negligence leads to cerebral palsy, it is medical malpractice.
Birth injury lawyer Jesse Reiter, president of ABC Law Centers, has been focusing solely on birth injury cases for over 28 years, and most of his cases involve hypoxic-ischemic encephalopathy (HIE) and cerebral palsy. Partners Jesse Reiter and Rebecca Walsh are currently recognized as two of the best medical malpractice lawyers in America by U.S. News and World Report 2015, which also recognized ABC Law Centers as one of the best medical malpractice law firms in the nation. The cerebral palsy lawyers at ABC Law Centers have won numerous awards for their advocacy of children and are members of the Birth Trauma Litigation Group (BTLG) and the Michigan Association for Justice (MAJ).
If your child was diagnosed with a birth injury, such as cerebral palsy, a seizure disorder or hypoxic-ischemic encephalopathy (HIE), the award-winning 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.
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Related Resources: Spastic Cerebral Palsy
Video: Jesse Reiter Discusses the Causes of Spastic Cerebral Palsy
In this video, Jesse Reiter discusses causes of and treatments for spastic cerebral palsy.