Cerebral palsy is a term used to describe permanent motor damage. Cerebral palsy does not always indicate intellectual impairment, although two-thirds of people with CP have some mental disability, according to the National Institute of Neurological Disorders and Stroke. CP affects 15 percent of premature infants, according to the Merck Manual, and it is difficult to diagnose in early infancy. Causes of cerebral palsy include problems before birth, birth injury, or lack of oxygen after birth.
Neurological Signs
Because prematurity by itself causes symptoms similar to those of cerebral palsy, it's not always easy to diagnose CP in the premature infant. Some possible neurological signs related to CP in premature infants, according to "Pediatric Nursing" by Jane Ball and Ruth Bindler, include frequent apneic episodes (where the baby forgets to breathe and needs stimulation) and episodes of bradycardia (a slow heart rate). These symptoms are also common in premature infants without CP. Other possible neurologic signs of CP include a high-pitched cry, jitteriness and seizures. The baby may also be irritable or lethargic.
Motor Signs
Cerebral palsy causes alterations in muscle tone. Babies with CP may be hypotonic, which means that they have decreased muscle tone. They may have scissoring in their lower limbs, meaning that their legs cross when they're lifted up. Cerebral palsy often causes diplegia, which is an increased spasticity of the lower limbs, with the upper limbs less affected. According to infant development specialist Sheena Carter, Ph.D., the most common type of CP in premature infants in spastic diplegia.
Babies with athetosis are stiff, or hypertonic, with muscles that make involuntary movements known as athetosis. This type of CP is less common in premature infants, according to Dr. Carter. Other signs of muscle tone damage related to CP include retention of normal infant reflexes, like the Moro, or startle reflex, past the age of six months. The infant may have fisted hands, where the thumb is kept inside rather than outside the fist. Some babies with CP have fluctuating muscle tone, which changes from hypotonic to hypertonic depending on the stimuli given, or are affected by muscle tone abnormalities on only one side of the body.
Feeding Signs
Feeding problems can be one of the first signs of cerebral palsy noted in premature infants. According to "Pediatric Nursing," possible signs of cerebral palsy in premature infants include poor feeding, poor suck and the inability to coordinate suck and swallow reflexes.
