Cerebral palsy (CP) is a set of disorders caused by brain damage suffered either before, during or shortly after birth. Children with CP typically have problems with muscle tone, balance and motor skills. There is no sure way to diagnose CP in infancy, but there are several symptoms that suggest CP, many of which are first seen by the child's parents.
Extremely High or Low Muscle Tone
The brain injuries associated with CP vary in their location and extent, which can result in a wide variation of symptoms. One of the most common, however, is a problem with the infant's level of muscle tone. Extremely low muscle tone---called hypotonia---can make an infant seem overly relaxed or floppy. Extremely high muscle tone---called hypertonia---can make an infant seem overly tense and rigid. Either or both of these symptoms can be present during early infancy. According to the National Institute of Neurological Disorders and Stroke, infants with CP often switch from hypotonia to hypertonia at around 2 or 3 months of age.
Delays in Achieving Standard Developmental Milestones
The other most commonly identified symptom of CP in infancy is a delay in reaching standard milestones of physical and motor development. Most children will smile by 6 weeks of age, roll from their front to their back around 4 months, sit independently at around 5 months and crawl by around 7 months of age. If a child has CP, however, he is very likely to reach these milestones several months later than the ages stated here. It is important to point out, however, that children vary a great deal in when they reach these milestones, even when they do not have CP or any other disorder. According to the Merck Medical Manual (www.merck.com), only about two to four out of every 1,000 children born in the United States have CP, so motor delays are far more commonly associated with something other than CP than with CP. If, however, a child exhibits more than a month of delay for several of these milestones, parents may wish to consult a physician.
Favoring One Side While Crawling
CP is actually an umbrella term that describes a range of different disorders. For several of those disorders, including one called spastic hemiplegia, the problems only affect one side of the body. For these children, crawling will be delayed. When a child with CP does begin to crawl, she will favor the affected side, avoiding the use of the arm and/or leg that gives her difficulty.
Fine Motor Difficulties
Fine motor control refers to tasks that require precise positioning of the hands and fingers, for instance, picking up very small objects. These tasks are very difficult for children with CP. For some children with CP, the problems will be present with one arm and hand; for others, it affects both sides.
Facial Spasms and Drooling
CP often affects the muscles of the face and tongue. This can cause periodic spasms of the facial muscles, resulting in a characteristic grimace expression. Problems with the control of the lips and tongue can also produce excessive drooling. Of course, all infants drool, so drooling by itself is not a very diagnostic symptom of CP.
Seizures
In cases of severe CP, affected children may experience seizures. The frequency and duration of these seizures varies a great deal from child to child. Any seizures during early infancy are an early symptom of CP.
Childbirth Complications
CP was originally identified in the 1860s as a disorder caused by problems during childbirth. It is now very clear, however, that birth complication is only one of many causes of the brain damage associated with CP. According to the Merck Medical Manual (www.merck.com), birth trauma causes fewer than 20 percent of CP cases. Genetic mutations, maternal infections and bleeding are more likely causes. That said, complications during childbirth such as asphyxia can cause CP. It is also true that difficulties during childbirth are associated with CP, even if the associated brain damage has occurred well before the childbirth itself.
Physical Trauma in Early Infancy
In rare cases, CP can be caused by brain damage suffered shortly after childbirth---for instance, by the physical trauma associated with the shaking of an infant. 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.
