Signs and Symptoms of Cerebral Palsy

Cerebral Palsy (CP) is a broad medical term used to describe a disorder that affects motor control. CP is the result of a brain injury that occurs during birth or shortly after your child is born and can be caused by a medical error. Children with cerebral palsy have a neurological disorder that affects their motor function. Common signs include walking, speaking, hearing, and vision problems.

How do I Know if my Child Has Cerebral Palsy?

Most of the time, parents who seek our services already know that their child has cerebral palsy. They received the diagnosis from a doctor shortly after birth or by about 7-9 months of age, which is the most common time to be diagnosed with this disorder. Cerebral palsy is a complicated condition with various levels of severity and many different side effects and impairments. This can make CP difficult to diagnose and treat.

Signs of Cerebral Palsy

A sign of any medical condition is something that can be seen or observed by others. Signs of cerebral palsy include things like seizures, tremors, and muscle stiffness. Loss of coordination or balance may also be signs of CP. Prior to your child being able to communicate with words, we can only look for signs of cerebral palsy. Symptoms (discussed below) must await the child’s ability to speak or in some other way effectively communicate.

Ever wonder why your pediatrician does certain tests, like having your baby grab the doctor’s fingers and sit up? Well, that is a test to see if your baby has the strength and muscle coordination needed to complete the task. If they can do it, great. But if not, and if your baby is missing other developmental “milestones,” further testing may be needed. Missing key milestones is a potential indication of cerebral palsy.

Symptoms of Cerebral Palsy

A symptom is something your child can tell us or communicate to us about how they are feeling. They can let us know about their muscle pain, if their legs hurt, or if they are having trouble swallowing. As your child grows and learns to communicate, their symptoms can help form the basis for a diagnosis of cerebral palsy, too.

It is important to know what to look for as a sign or symptom of cerebral palsy. Your doctor will know to look for these, but as a parent or caregiver, if you notice any abnormality, you should bring it to your doctor’s attention. Here are some specific items to notice (or not notice) in your child’s development:

Signs of Cerebral Palsy: Developmental or Motor Milestones

In a newborn

• She has very low APGAR scores

• She does not cry after delivery

• She does not breathe right away after delivery

• She has seizures

In a baby under six months

• He feels stiff

• He feels floppy

• His head lags when you pick him up

• His legs get stiff or cross like a scissors when you pick him up

• He overextends his back and neck when you cradle him, like he is trying to push you away

• He does not roll over

• He does not blink at loud sounds

• He does not open and shut his hands

In a baby six months to ten months

• She reaches out with only one hand while keeping the other in a fist

• She cannot sit up independently

• She does not begin to crawl

• She does not pull up to a standing position

In a baby over ten months

• He crawls in a lopsided manner

• He pushes off with one hand and leg while dragging the other side behind him

• He does not speak by 12 months

• He does not walk by 18 months

• He cannot hold his head up while sitting or reclining

• He does not point to things he wants

Signs of Cerebral Palsy: Retention of Primitive Reflex Responses

All primitive reflexes (including the Moro reflex, rooting reflex, Spinal Galant and others not listed here), if retained, play a significant role in decreasing the brain’s ability to process sensory information. As higher, more sophisticated centers of the brain begin to develop and mature, these primitive reflexes should disappear, so that proper neurological organization of the brain can develop. Children with cerebral palsy often retain multiple primitive reflexes, including:

• Asymmetrical or Symmetrical Tonic Reflex. This is also known as the “fencing reflex” because of the way the infant’s arm and head are positioned, which resemble a classically trained fencer. This primitive reflex should not be noticeable beyond six months because it can cause problems for the growing child. It can be disruptive to rolling over and bringing hands to mouth. Joint and bone damage can also occur. Retaining this reflex can even cause scoliosis.

• Systemic Tonic Neck Reflex. This primitive reflex is also known as the Crawling reflex and should be not be present in children older than three. This reflex is a bridge reflex and important developmentally because it is necessary for a baby to transition from lying on the floor to crawling. In order for the baby to be successful, the baby needs to unlink the automatic movement of the head from the automatic movement of the arms and legs. If this reflex is retained, children will most likely have poor posture or an ape-like walk, poor hand-eye coordination, and eye tracking issues. In recent research, this reflex also has been tied to bedwetting.

• Tonic Labyrinthine Reflex. This primitive reflex should not be present beyond six months of age. With this reflex, while the baby is on its back, the head tilts backwards, causing the back to stiffen and even arch backwards. This position causes the legs to straighten, stiffen, and push together. The toes even point. The child’s arms bend at the elbows and wrists, and the hands become fisted or fingers curl. This is also referred to as abnormal extension pattern or extensor tone. If this reflex still exists past six months, the baby will have trouble meeting developmental milestones.

• Palmer Grasp Reflex – This primitive reflex should be visible through four months of age. When an object is placed in an infant’s hand and the palm is stroked, the fingers will close reflexively and the infant will hold the item. The reverse is true if you stroke the outside of the infant’s hand. The grip is strong but unpredictable. If this reflex exists past four months, it can delay the infant’s ability to hold other items voluntarily or release objects from their hands voluntarily.

• Babinski Reflex – This reflex is normal in children up to two years old. When the bottom of a baby’s foot is stroked, the big toes moves up, and the other toes fan out. This reflex is not seen in heathy adults. It is believed that this reflex helps with walking.

Signs of Cerebral Palsy: Coordination and Control

• Spastic movements

• Walking with wide gait

• Walking with toes pointed inward or outward

• Dragging one leg while walking

• Scissor gait

• Balance impairments

• Waddling when walking

• Dyskinetic (involuntary) movement

Signs of Cerebral Palsy: Oral Motor Problems

• Difficulty communicating orally

• Difficulty breathing

• Difficulty sucking

• Difficulty eating and chewing

• Difficulty closing the mouth

• Difficulty swallowing

• Abnormal mouth and tongue patterns such as tonic bite – biting hard and not opening up – and thrusting tongue

Signs of Cerebral Palsy: Muscle Tone

• Hypotonia – low muscle tone

• Hypertonia – high muscle tone

• Tremors – involuntary movements

• Athetosis – writhing movements

• Stiffness or muscle spasms

• Poor muscle control

• Clonus – involuntary muscle contractions of the ankles, feet, or wrists

Additional Signs of Cerebral Palsy

• Hearing impairments

• Visual impairments

• Sensory abnormalities

Caring for A Child with Cerebral Palsy

Caring for a child with cerebral palsy can be very expensive. The good news is that there are multiple therapies, including occupation, physical, and speech therapy that may help your child improve his condition. There are also various assistive devices, accommodations, and other treatments that can help your child compensate for the various signs and symptoms of cerebral palsy. Cerebral palsy affects each person differently, so the care given to each child will be unique. One constant in all cerebral palsy cases is that the care is over a lifetime, and it can be very expensive.

Cerebral Palsy Law Firm

Your child’s cerebral palsy might have been caused by a medical professional’s negligence. The birth injury attorneys at The Eisen Law Firm can assist you. We handle only medical malpractice cases and have decades of experience representing families like yours in birth injury cases. Contact our office today at 216-687-0900 for a free consultation. We know the medicine, we know the law.