Cerebral palsy (CP) is caused by brain damage during development and results in problems with muscle tone, balance and motor skills. The location and extent of the brain damage can result in a wide range of different symptoms. There is no surefire way to diagnose CP in infancy, but certain symptoms suggest the presence of CP in babies.
Delay in Reaching Developmental Milestones
The earliest indicator that a child has CP is a substantial delay in achieving standard developmental milestones. Most children begin to smile by around 6 weeks of age, roll over by 4 months, sit independently by 5 months and crawl by 7 months of age. It should be noted, however, that there are many potential causes for developmental delays, including the simple fact that different normally developing babies progress at widely varying rates. According to the Merck Medical Manual, CP affects only 2 to 4 out of every 1,000 children born in the United States. Regardless, parents may wish to consult a pediatrician if their child misses these milestones by more than several months.
Abnormal Muscle Tone
CP is strongly associated with problems in maintaining appropriate muscle tension. CP infants often exhibit these muscle tone problems even in their first few months. Excessively low muscle tone, known as hypotonia, renders infants overly relaxed and floppy. Excessively high muscle tone, known as hypertonia, renders infants overly stiff and rigid. According to the National Institute of Neurological Disorders and Stroke, infants may switch from hypotonia to hypertonia around 2 or 3 months of age.
Favoring One Side While Crawling
Children with CP typically crawl later than unaffected children. When children with spastic hemiplegia--a type of CP that affects one side of the body--do crawl, they often favor one side, avoiding use of the arm and leg with which they have problems.
Poor Manual Coordination
In addition to problems with gross motor function, children with CP tend to have difficulty controlling their arms and hands. Performing actions that require precise motor control, such as picking up small objects with the fingers, is very difficult. For some children with CP, this difficulty is present for only one arm and hand; for others it affects both sides.
Lack of Facial Control / Drooling
Children with CP often exhibit uncontrollable, spastic contractions of the facial muscles, producing a grimace. The control of the lips and tongue can also be problematic, resulting in excessive drooling. All babies drool, however, so this, by itself should not be taken as a clear indicator of a problem.
Seizures
For children with the severe forms of CP, seizures are common. The severity and duration are highly variable. Some children may make convulsive motions of the arms and legs accompanied by unconsciousness. Others may simply exhibit uncontrolled twitching and chewing movements accompanied by confusion. Seizures during early infancy are an early indicator that a child may have CP.
Difficulty During Childbirth
In the late 1800s, when this disorder was first identified, it was presumed that all CP was caused by trauma suffered during childbirth. Birth difficulties are associated with CP, and birth trauma can cause brain damage and lead to CP. According to the Merck Medical Manual, birth trauma causes less than 20 percent of cases. There are many different causes of brain damage that can lead to CP, including genetic mutations, maternal infections and bleeding.
Physical Trauma in Early Infancy
In rare cases, CP is acquired after birth due to physical trauma. Adults should never shake an infant, for any reason, as this can cause damage to the developing brain that can lead to CP or even death.
