Cerebral Palsy

Overview

Cerebral palsy (often called CP) is a condition that affects muscle movement, posture, and balance. It happens when the brain doesn't send the right signals to the muscles, often because of damage to the brain before, during, or shortly after birth. It is not a disease and does not get worse over time.

Cerebral palsy is one of the most common physical disabilities in children, affecting about 1 in every 400 children in the UK.

CP can affect anyone, but it is more common in babies born early, with low birth weight, or with certain infections during pregnancy. It is also more common in twins or multiple births.

Symptoms

Common symptoms

• Stiff or tight muscles (spasticity)
• Weak muscles or floppy limbs
• Difficulty with balance and coordination
• Unusual walking — like toe-walking or a scissor-like walk
• Tremors or uncontrollable movements
• Difficulty with fine motor skills, like holding a pencil

Symptoms in children

• Delays in reaching milestones like rolling over, sitting, crawling, or walking
• Persistent fisting of hands or using one hand more than the other
• Difficulty feeding, swallowing, or speaking
• Seizures (fits) or fits of uncontrollable movements

Symptoms in older adults

• As people with CP age, they may notice increased joint pain, stiffness, or fatigue
• Higher risk of developing arthritis, osteoporosis, or pressure sores from reduced mobility
• Changes in balance or even falls as strong muscles get tighter with age

Causes

Main causes

• Damage to the developing brain before birth (most common), due to infection (like rubella), poor oxygen supply, or stroke in the womb
• Brain damage during birth, for example from severe jaundice, a difficult delivery, or lack of oxygen
• Brain damage in the first few years of life from infection (like meningitis), head injury, or other illness

Risk factors

• Being born prematurely (before 37 weeks)
• Low birth weight (under 2.5 kg)
• Multiple birth (twins or triplets)
• Maternal infection during pregnancy (such as rubella or cytomegalovirus)
• Complications during labour and delivery

When to see a doctor

See a doctor urgently if:

• If your child is not reaching movement milestones (like sitting, standing, or walking) by the usual age
• If your child has seizures or fits, especially if they last for more than a few minutes
• If you notice a sudden change in movement, balance, or swallowing

Book a routine appointment if:

• If you have any concerns about your child's development, even if they are mild
• If you have CP and notice increasing pain, stiffness, or difficulty managing daily tasks

Diagnosis

A doctor will usually suspect CP after looking at a child's development and doing a physical exam. They will ask about your child's medical history and how they move, and they may check muscle tone, reflexes, and balance. No single test can confirm CP, so doctors often rely on a combination of observations and tests.

Tests that may be done

• Blood and urine tests to look for other causes
• MRI scan of the brain to show any areas of damage or abnormal development
• Ultrasound of the brain (in young babies)
• Hearing and vision tests

What to expect at your appointment

Don't expect an instant diagnosis. CP is often diagnosed in the first or second year of life, but sometimes later if symptoms are mild. The doctor may refer you to a child development specialist or a team of therapists. It's okay to take a notebook and ask questions at every visit.

Treatment

There is no cure for CP, but treatment helps manage symptoms, improve movement, and treat any related conditions. The goal is to support each person to be as independent and comfortable as possible. Treatment usually involves a team of professionals working together.

Self-care at home

• Gentle stretching every day to help keep muscles flexible
• Keeping a routine for meals, medications, and exercises so it's easier to manage symptoms
• Staying active in a way that's safe and comfortable — like swimming, adapted cycling, or walking with support
• Using special cushions or seating to make sitting and sleeping more comfortable

Medical treatments

Medical treatment for CP is individualised. It may include medicines to relax tight muscles or reduce drooling, injected treatments that help specific muscles relax, and treatments for conditions that can appear with CP, such as seizures or sleep problems. Always discuss options with your child's specialist, and never change medicines without medical advice.

When is surgery considered?

Surgery may be recommended if contractures (tight, fixed joints) develop, if there is a dislocation in the hip, or if movement is very stiff. Procedures can lengthen muscles, straighten bones, or improve sitting balance. Surgery is not the first step, but it can greatly improve comfort and function in some cases.

Living with this condition

Living with CP is very individual. Many people with CP live independently, work, and raise families. For others, daily life may include support from carers, therapists, and family members. It helps to focus on abilities, not limitations, and to build a strong network of people who understand the condition.

Lifestyle tips

• Create a safe, clutter-free home with grab bars if needed
• Use assistive devices like wheelchairs, walkers, or communication tools as needed
• Break tasks into small steps to avoid fatigue
• Keep up with regular appointments with your GP, physiotherapist, or occupational therapist

Diet and exercise

A balanced diet becomes even more important because poor mobility can make it easy to gain weight, and strong bones need good nutrition. Aim for lots of fruits, vegetables, whole grains, and enough protein. For exercise, talk to your physiotherapist about safe activities that keep joints and muscles moving without causing pain. If swallowing is difficult, work with a speech and language therapist for safe eating strategies.

Mental health and emotional wellbeing

Living with a lifetime physical condition can be exhausting, and it's common to feel anxious, sad, or isolated. But you don't have to cope alone. Talking to a counsellor, joining a support group, or simply connecting with others who understand can make a huge difference. It's okay to ask for help. And if you or someone close to you is having thoughts of harming themselves, please call your local emergency number or a mental health crisis line right away.

Prevention

Not all cerebral palsy can be prevented, because sometimes the cause is completely unknown. But there are important ways to reduce risk: keeping up with childhood vaccinations, getting early treatment for infections in pregnancy, and avoiding alcohol and drugs during pregnancy. If you are pregnant, talk to your midwife about any concerns.

Vaccines

Vaccinations against rubella (German measles) and other infections help protect mothers and baby from illnesses that can cause brain damage. Also, routine childhood vaccines reduce the risk of infections like meningitis, which can lead to CP.

Screening programmes

There is no routine screening test for cerebral palsy before birth. But during pregnancy, ultrasound scans and blood tests can spot some risk factors. After birth, doctors routinely check a newborn's development and growth, so early signs can be caught early.

Complications

If left untreated

• Tight muscles can become permanently fixed in one position (contractures), which is painful and hard to treat
• Difficulty swallowing can lead to poor nutrition, choking, or chest infections from inhaling food
• Reduced mobility raises the risk of osteoporosis (weak bones), pressure sores, and infections
• Without support, daily activities and mental health can become harder to manage

Long-term outlook

Living with cerebral palsy is a lifelong journey, but with the right support, most people with CP enjoy meaningful, fulfilling lives. The condition does not get worse over time, and many adults with CP live independently, work, raise families, and contribute to their communities. Medical advances are also helping to improve movement and comfort. Focus on what you can do — and don't be afraid to dream big.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.