Clinical Review

Managing common symptoms of cerebral palsy in children

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g5474 (Published 25 September 2014) Cite this as: BMJ 2014;349:g5474
  1. Mathew D Sewell, paediatric spinal fellow1,
  2. Deborah M Eastwood, paediatric orthopaedic consultant1,
  3. Neil Wimalasundera, consultant in paediatric neurodisability2
  1. 1Royal National Orthopaedic Hospital, Catterall Unit, Stanmore, UK
  2. 2Wolfson Neurodisability Service, Great Ormond Street, London, UK
  1. Correspondence to M D Sewell matbuzz1@hotmail.com

Summary points

  • Cerebral palsy is a disorder of movement and posture secondary to abnormal muscle tone, spasticity being the most common abnormality of tone

  • The majority of cerebral palsy is not related to birth asphyxia

  • Cerebral palsy is most reliably diagnosed by assessing general movements and neurological examination

  • The management of spasticity includes physiotherapy, orthotics, botulinum toxin injections, oral drugs, and surgery (orthopaedic and neurosurgical)

  • Cerebral palsy is often accompanied by disturbances in sensation, cognition, communication, behaviour, and epilepsy, which should be looked for continuously, as these problems may be more functionally disabling than the motor problems

  • Cerebral palsy is a chronic condition with no cure and as such the overall goal of treatment is to improve quality of life and participation in life situations

  • Pain is a common problem and is increasingly recognised as a major determinant of quality of life

  • Most children with cerebral palsy have the potential to gain a similar quality of life to their peers and this should guide social and educational policy to ensure that children with disability participate fully in society

Cerebral palsy describes a heterogeneous group of permanent disorders of movement and posture which are attributed to non-progressive disturbances in the developing fetal or infant brain and cause limitations in activity. The motor disorders of cerebral palsy are often accompanied by disturbances of sensation, perception, cognition, communication, and behavior; epilepsy; and secondary musculoskeletal problems.1 Worldwide, cerebral palsy is the commonest cause of motor disability in childhood, with an incidence of 2-3 per 1000 live births,2 3 4 increasing to 40-100 per 1000 live births in premature babies and those of very low or low birth weight.5 As cerebral palsy is a permanent disabling condition it is a major consumer of healthcare resources in developed countries. The motor disorder results from centrally …

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