Wondering what some of the most common complications of cerebral palsy are?
It’s important to be aware of potential complications so that you can keep an eye out for symptoms and prevent them from progressing.
This article will not only go over direct complications of cerebral palsy but also some associative conditions that commonly co-occur.
Direct Complications of Cerebral Palsy
Cerebral palsy always results in impaired motor control but depending on the location, severity, and type of cerebral palsy, experiences will vary.
For example, spastic cerebral palsy is characterized by high muscle tone, meaning that the muscles are constantly contracted and movements are stiff or jerky.
It can occur in the legs, half the body, or throughout the entire body.
In contrast, dyskinetic cerebral palsy is characterized by fluctuations of stiff and floppy muscles which causes uncontrollable movements.
Ataxic cerebral palsy results in poor balance and coordination.
You can even have a mix of various types of cerebral palsy, so the combination of motor impairments can range quite a bit.
Let’s go over different types of motor impairment!
1. Gross Motor Impairment
Gross motor functions involve the muscles necessary to make large movements like walking.
People with cerebral palsy may need mobility aids like crutches, walkers, or wheelchairs to get around.
Many individuals with CP walk with an abnormal gait because of spasticity.
The constantly contracted muscles result in an uneven muscle pull.
This is why you may see people with cerebral palsy drag their feet, walk on their toes, or walk without straightening their knees.
2. Fine Motor Impairment
Fine motor functions generally refer to the muscles necessary to perform smaller or more precise movements such as writing, using utensils, and picking up tiny objects.
People with fine motor impairments in their hands will likely find it difficult to move their fingers and will benefit from hand therapy exercises.
3. Oral Motor Impairment
Cerebral palsy can affect all areas of the body, even the facial muscles.
If children with cerebral palsy experience oral motor impairment, they will have difficulties controlling the muscles necessary to chew and swallow.
This can cause malnutrition from insufficient calorie intake. To prevent this, children may need to use a feeding tube.
Oral motor impairment can also affect speech and breathing.
Children will need to go to speech therapy to strengthen their oral muscles and improve articulation.
Associative Complications of Cerebral Palsy
Associative complications are conditions that commonly occur in individuals with cerebral palsy but are not directly caused by CP.
Generally, children with more severe cerebral palsy are more likely to have disabilities in other areas.
Some of the most common associative complications of cerebral palsy include:
- Intellectual disabilities. People with intellectual disabilities have an IQ below 70 and will have difficulties understanding social interactions, be prone to emotional outbursts, have delayed responses, poor memory, and difficulties problem-solving.
- Learning problems. A person with a learning disability will have an average or above-average IQ. They may struggle in a school setting because it is difficult for them to follow directions, read, write, and count.
- Behavior problems. Behavior problems in children with cerebral palsy are usually a result of frustration from not being able to communicate effectively.
- Mental health disorders. Generally, mental health disorders develop as a result of feeling different, misunderstood, and unaccepted rather than the severity of CP itself.
- Autism spectrum disorders. Autism is a cognitive disorder that affects communication skills and behavior.
- Sleep disorders. Children that are in pain, have respiratory complications, or have high levels of stress may develop sleeping difficulties that stunt growth, cognition performance, and emotional stability.
- Vision impairments. With cortical vision impairments, the problem isn’t with the eyes themselves, but rather the way the brain processes what the eyes are looking at.
- Hearing impairments. Hearing impairments can be caused by damage to the inner ear nerve pathways or from problems that block sound at the middle or outer ear.
- Epilepsy. Nearly 30-40% of CP patients will also experience epilepsy.
- Chronic pain. Nearly 75% of people with cerebral palsy experience chronic pain. Pain can result from severely contracted muscles, scoliosis, joint stress, and digestion problems.
- Skeletal Issues. Children are constantly growing and uneven muscle pull can cause scoliosis or hip displacement.
- Gastroesophageal reflux disease (GERD). GERD is a digestive disorder where stomach acid travels up the esophagus which causes heartburn or vomiting. There is a higher prevalence of GERD in people with cerebral palsy (75%). This can further contribute to feeding problems.
Managing Complications of Cerebral Palsy
The brain damage that causes cerebral palsy is not reversible, but it also won’t get worse over time.
However, complications of cerebral palsy can progress, so early intervention is ideal.
Let’s go over some effective management options.
Depending on the type and severity of your cerebral palsy, different rehabilitation therapies may be recommended.
Physical therapy can help people with CP strengthen their gross motor skills through exercise.
Occupational therapy will help develop fine motor skills by encouraging CP patients to perform everyday tasks.
Speech therapy helps develop oral muscles for speech, chewing, and swallowing.
Behavior therapy helps teach CP patients better ways to cope with frustration and how to communicate more effectively.
Especially for children who are starting to walk with an abnormal gait, a brace can help promote proper form and combat the negative effects of spasticity.
They mold around the limb and hold it in place to prevent compromising form.
Generally, muscles can only lengthen during stretching or exercise. However, because braces resist the movement of spastic muscles, they can help lengthen muscles even when you’re being sedentary.
Medications can definitely help relieve direct and associative complications of cerebral palsy.
A wide variety of medications may be prescribed depending on each of your complications.
For example, muscle relaxants may be used for spasticity, anticonvulsants may be used for seizures, and antidepressants may be used for mental health disorders.
Not all medications mix well together, so be sure to inform your doctor of all medications you are taking to prevent harmful side effects.
Usually, surgeries will only be recommended as a last resort because they are invasive and costly.
The patient’s age and how much the condition interferes with their quality of life are major considerations that affect recommendations for surgery.
Surgeries for complications of cerebral palsy include:
- Selective dorsal rhizotomy involves selectively cutting sensory nerve fibers to permanently reduce spasticity.
- Spinal fusion uses rods and screws to realign the spine and prevent further curving for children with scoliosis.
- Intrathecal baclofen pump surgery is when a baclofen pump is implanted on the side of the abdomen to deliver a steady, constant flow of baclofen to reduce spasticity.
- Cochlear implant surgery is for severe sensorineural hearing loss. It works by directly stimulating the auditory nerve.
- Gastrostomy involves inserting a feeding tube to directly deliver nutrients to the stomach.
That’s a Wrap!
Cerebral palsy is solely a physical condition that impairs motor function.
But as you now know, there are a lot of psychological, cognitive, and sensory complications that commonly co-occur.
Everyone will experience cerebral palsy and it’s associative conditions a little bit differently, so it’s important to approach each complication individually.
Now that you now have a better understanding of the various conditions people with CP may experience, be sure to stay alert for symptoms and seek early intervention.