Cerebral Palsy: Symptoms, Causes, Diagnosis, and Treatment Explained
Updated: 3 days ago
Medically reviewed by *Dr. Baraa Alnahhal, MD* · Last reviewed: October 2026
Quick Answer
Cerebral palsy is a group of conditions affecting movement, balance and posture, caused by damage to a baby's brain, most often before birth. Symptoms appear in infancy or the preschool years, and spasticity is the most common movement problem. There is no cure, but physical therapy, medicines and surgery can improve function, and early intervention can improve outcomes.
What the research says
Cerebral palsy affects roughly 1.6 in every 1,000 live births in high-income countries. A systematic analysis of registers and population-based studies from 41 regions in 27 countries found a birth prevalence of 1.6 per 1,000 live births (95% CI 1.5 to 1.7) in high-income countries, with pre- and perinatal cases declining in most European and Australian regions. Estimates from low- and middle-income countries were markedly higher, reaching 3.4 per 1,000 (95% CI 3.0 to 3.9) for pre- and perinatal cerebral palsy (PubMed: McIntyre et al., Dev Med Child Neurol, 2022) [4].
The earlier and smaller the baby, the higher the risk. A systematic review and meta-analysis of 49 population-based studies found a pooled overall prevalence of 2.11 per 1,000 live births (95% CI 1.98 to 2.25). Prevalence was highest in babies born before 28 weeks' gestation, at 111.80 per 1,000 live births (95% CI 69.53 to 179.78) (PubMed: Oskoui et al., Dev Med Child Neurol, 2013) [5].
Several pregnancy and birth factors are linked to cerebral palsy. A meta-analysis of 13 case-control and cohort studies (2,489 children with cerebral palsy and 4,782 children without) identified gestational hypertension, preterm birth, premature rupture of membranes, and emergency cesarean section as risk factors, with no heterogeneity or publication bias detected (PubMed: Chen et al., Transl Pediatr, 2022) [6].
What Is Cerebral Palsy?
Cerebral palsy is a group of conditions that affect movement, balance, and posture. It is caused by damage to a baby's brain. In most cases, that damage happens before birth, though it can also occur at birth or during early infancy.
Symptoms appear during infancy or the preschool years. They may include exaggerated reflexes, floppy or stiff muscles, changes in posture and movement, difficulty swallowing, or trouble focusing the eyes. Most children with cerebral palsy show a combination of these symptoms.
The effects on how a person functions vary greatly. Some people can walk. Others need assistance. Some people have intellectual disabilities, while others do not. Some people may have epilepsy, blindness, or deafness.
An important point for parents: there is no cure for cerebral palsy, but treatments can help improve function. In most cases the condition itself generally stays the same over time, meaning the brain damage does not get worse.
Key Fact | What It Means |
What it is | A group of conditions affecting movement, balance, and posture |
Cause | Damage to a baby's brain, most often before birth |
When symptoms appear | Infancy or preschool years |
Can it be cured? | No, but treatments improve function |
Does it worsen? | The condition generally stays the same over time |
Function | Varies greatly; some can walk, others need assistance |
What Are the Symptoms of Cerebral Palsy?
Symptoms vary greatly from person to person. They can affect the whole body or just one limb, two limbs, or one side of the body. The general areas affected are movement and coordination, speech and eating, and overall development.
Movement and Coordination
The most common movement condition is spasticity: stiff muscles and exaggerated reflexes. Other movement problems include changes in muscle tone (too stiff or too floppy), rigidity, ataxia (lack of balance and muscle coordination), tremors, and slow, writhing movements.
Many children favor one side of the body, reaching with only one hand or dragging a leg while crawling. Trouble walking shows up in several ways, including toe-walking, crouching, a scissors-like walk where the knees cross, or a wide and unsteady walk. Fine motor skills can also be affected, making tasks like buttoning clothes or picking up utensils difficult.
Speech and Eating
Children with cerebral palsy may have delays in speech development or trouble speaking. Eating challenges include trouble sucking, chewing, and eating, as well as drooling and trouble swallowing.
Development
Developmental symptoms include delays in motor skills such as sitting up or crawling. Some children have learning disabilities or intellectual disabilities. Delayed growth can also occur, making a child appear smaller for their age than expected.
Other Possible Symptoms
Cerebral palsy can also come with seizures (epilepsy), trouble hearing, vision trouble or eye movement changes, pain or trouble feeling touch, bladder and bowel issues such as constipation or urinary incontinence, and mental health conditions including emotional conditions and behavior issues.
Symptom Area | What It Can Look Like |
Muscle tone | Stiff muscles (spasticity), too floppy muscles, rigidity, tremors, slow writhing movements |
Balance | Ataxia (lack of balance and coordination), unsteady wide walk |
Walking | Toe-walking, crouching, scissors-like gait, favoring one side |
Fine motor | Trouble buttoning clothes, picking up utensils |
Speech and eating | Speech delays, trouble speaking, trouble sucking, chewing, or swallowing, drooling |
Development | Delayed milestones (sitting, crawling), learning or intellectual disabilities, smaller size for age |
Other | Seizures, hearing trouble, vision trouble, pain, bladder and bowel issues, mental health conditions |
A key point about how symptoms behave: the brain condition doesn't change with time, and symptoms usually don't worsen with age. They may become easier to notice as the child grows. However, muscle shortening and muscle rigidity can worsen if not treated aggressively.
When should you see a doctor about cerebral palsy?
If your child has any symptoms of a movement condition or developmental delays, contact a healthcare professional promptly. Also seek care for any of the following signs:
Warning Sign | Description |
Episodes of loss of awareness | Unexplained lapses of awareness |
Changes in movement or posture | Unusual body movements or postures |
Trouble swallowing | Difficulty eating or swallowing |
Poor coordination | Clumsiness or coordination difficulties |
Eye muscle changes | Changes in eye muscle balance |
Developmental issues | Missed milestones or delays in growth and learning |
If you notice any combination of these signs, don't wait. A diagnosis may take months to a year after birth in some cases, and early evaluation helps start supportive treatment sooner.
What Causes Cerebral Palsy?
Cerebral palsy is caused by unusual brain development or damage to the developing brain. The damage usually happens before birth, but it can occur at birth or during the early months of life. In many cases, the exact cause isn't known.
Cause | What Happens |
Gene changes | Genetic conditions or differences in brain development |
Maternal infections | Infections during pregnancy affect the fetus |
Stroke | Interrupts blood supply to the developing brain |
Bleeding into the brain | Occurs in the womb or when the baby is a newborn |
Infant infections | Cause swelling in or around the brain |
Traumatic head injury | From a car accident, a fall, or other physical trauma in infancy |
Lack of oxygen during delivery | Happens during hard labor and delivery, and is less common than previously thought |
What are the risk factors for cerebral palsy?
Several factors raise the risk of cerebral palsy. The strongest risks come from health during pregnancy and serious infant illnesses, while pregnancy and birth circumstances play a more limited role.
Health During Pregnancy
Infections, fever, or inflammation during pregnancy can damage the developing brain. Several specific infections raise the risk:
Infection | How It Spreads or Occurs |
Cytomegalovirus | A first active infection during pregnancy can cause birth defects |
Rubella (German measles) | A vaccine-preventable viral infection |
Herpes | Can pass to the unborn baby, affecting the womb and placenta |
Syphilis | A bacterial infection, usually spread sexually |
Toxoplasmosis | Caused by a parasite found in contaminated food, soil, or infected cat stool |
Zika virus | A mosquito-borne virus that affects the brain before birth |
Intrauterine infections affecting the placenta or fetal membranes, toxin exposure (such as methyl mercury), and other maternal conditions such as thyroid conditions, preeclampsia, or seizures also increase risk.
Infant Illness
Serious illnesses in early life can damage the developing brain. These include bacterial meningitis and viral encephalitis (which cause brain inflammation), serious or untreated jaundice (when bilirubin byproducts are not filtered), and bleeding into the brain, commonly from a stroke in the womb or early infancy.
Pregnancy and Birth Circumstances
The contribution of delivery itself is limited, but several circumstances raise risk:
Circumstance | Why Risk Rises |
Low birth weight | Under 5.5 lb (2.5 kg); risk rises as weight drops lower |
Premature birth | The earlier the birth, the greater the risk. [5] [6] Read more about premature birth. |
Multiple babies | Risk relates to prematurity and low weight; if one baby dies, survivors' risk rises |
Delivery complications | Certain complications during delivery increase risk |
What complications can cerebral palsy cause?
Without careful management, cerebral palsy can lead to several complications over time.
Contracture is muscle shortening and tightness caused by spasticity. It can slow bone growth, bend bones, and cause joint changes or dislocation, including a dislocated hip or a curved spine.
Malnutrition can result from swallowing or feeding trouble. A feeding tube is sometimes needed. Poor nutrition affects growth and weakens bones.
Mental health conditions such as depression can develop from social isolation and the challenges of coping with the condition. Behavior issues may also occur.
Complication | What Happens |
Contracture | Stiff spastic muscles shorten; can bend bones, dislocate joints, curve the spine |
Malnutrition | Feeding trouble limits nutrition; a feeding tube may be needed; weakens bones |
Heart and lung disease | Includes aspiration pneumonia when food, drink, saliva, or vomit enters the lungs |
Osteoarthritis | Joint pressure and misalignment from spasticity damage joints |
Osteoporosis | Low bone density leads to fractures, worsened by immobility, poor nutrition, or some antiseizure medicines |
Mental health | Depression and behavior issues from social isolation and coping challenges |
Other | Sleep conditions (see pediatric sleep apnea), chronic pain, skin breakdown, intestinal issues, oral health issues |
Can Cerebral Palsy Be Prevented?
Cerebral palsy often can't be prevented, but if you are pregnant or planning to become pregnant, several steps can reduce the risk:
Prevention Step | How It Helps |
Get vaccinated | Vaccination (such as rubella), ideally completed before pregnancy |
Take care of yourself | Being healthier before pregnancy makes infections less likely |
Get early, continuous prenatal care | Reduces the risk of premature birth, low birth weight, and infections |
Avoid alcohol, tobacco, and illegal drugs | These are linked to increased cerebral palsy risk |
Cerebral palsy is rarely caused by brain damage in childhood. To reduce that small risk, practice general child safety: use a car seat, have your child wear a bicycle helmet, use bed safety rails, and supervise young children to prevent head injuries.
How Is Cerebral Palsy Diagnosed?
Because symptoms become easier to see over time, a diagnosis may not be made until months to a year after birth. Children with mild symptoms may be diagnosed later.
Diagnosis begins with an evaluation of symptoms and medical history, a physical exam, and monitoring the child's growth and development over successive appointments. Healthcare professionals often refer families to pediatric neurologists, pediatric physical medicine and rehabilitation specialists, and child development specialists.
Test | What It Does |
MRI | Uses radio waves and a magnetic field to produce detailed 3D and cross-sectional brain images; painless but noisy and may take up to an hour; children often receive a sedative or general anesthesia |
Cranial ultrasound | Used during infancy; high-frequency sound waves give a quick, valuable preliminary exam, though less detailed |
EEG (electroencephalogram) | Used when seizures are suspected; electrodes on the scalp record the brain's electrical activity |
Laboratory tests | Blood, urine, or skin tests screen for genetic or metabolic conditions |
Additional tests | Assess vision, hearing, speech, intellect, development, movement, and other medical conditions |
Types of Cerebral Palsy
Types are determined by the main movement condition, and more than one type can occur in the same person:
Type | Hallmark |
Spastic cerebral palsy | Most common; stiff muscles and exaggerated reflexes |
Dyskinetic cerebral palsy | Hard to control voluntary muscles |
Ataxic cerebral palsy | Trouble with balance and coordination |
Doctors also use the Gross Motor Function Classification System (GMFCS), a rating scale that measures a child's function, mobility, posture, and balance. This helps the care team select the right treatments.
How Is Cerebral Palsy Treated?
There is no cure for cerebral palsy, and treatment may require lifelong care from a healthcare team. Care is typically overseen by a healthcare professional and a physical medicine and rehabilitation specialist, and may include a pediatric neurologist, therapists, and mental health specialists. Treatment selection depends on the child's specific symptoms and needs, which may change over time. Early intervention can improve outcomes.
Medicines
Medicines are used to lessen muscle tightness, treat pain, and manage complications:
Medicine Type | Details |
Muscle or nerve injections | OnabotulinumtoxinA (Botox) or another medicine injected into a specific tightening muscle; repeated about every 3 months; side effects include injection-site pain and mild flu-like symptoms, and it can cause trouble breathing or swallowing |
Oral muscle relaxants | Baclofen, tizanidine, diazepam, and dantrolene taken by mouth |
Intrathecal baclofen | Baclofen pumped directly into the spinal cord through a tube; the pump is surgically implanted under the skin of the stomach |
Drooling treatment | OnabotulinumtoxinA injected into the salivary glands |
Always talk with the healthcare professional about the benefits and risks of any medicine.
Therapies
Therapy is the foundation of daily care:
Therapy | What It Involves |
Physical therapy | Muscle training and exercises for strength, flexibility, balance, movement, and mobility; teaches safe at-home care such as bathing and feeding; early years focus on head and trunk control, rolling, and grasping; braces, splints, and supportive devices may help walking. Learn more about physical therapy. |
Occupational therapy | Builds independence in daily activities at home, school, and in the community; may include adaptive equipment such as walkers, wide-based canes, standing and seating systems, or electric wheelchairs |
Speech and language therapy | Helps with speaking clearly, sign language, and communication devices such as computers or voice synthesizers; also treats eating and swallowing difficulties |
Recreational therapy | Adaptive sports such as therapeutic horseback riding and skiing; improves motor skills, speech, and emotional well-being |
Surgical Procedures
Orthopedic surgery addresses contractures. Surgery on the bones and joints places the arms, spine, hips, and legs in correct positions and lengthens muscles and tendons. It lessens pain, improves mobility, and makes using a walker, braces, or crutches easier.
Selective dorsal rhizotomy, which involves cutting nerve fibers, is an option for painful walking or moving when other treatments have failed. Surgeons cut the nerves serving specific spastic muscles, which relaxes the leg muscles and reduces pain. It can cause numbness.
Other Treatments
Additional medicines and treatments address the conditions that often accompany cerebral palsy, including seizures, pain, osteoporosis, and mental health conditions, as well as sleep problems, oral health, feeding and nutrition, bladder incontinence, vision, and hearing.
How does cerebral palsy affect adults?
Adults with cerebral palsy need ongoing care, including general screenings and management of related conditions. They require the same general health screenings as all adults, such as cholesterol checks, plus ongoing management of conditions that are more common in this population:
Ongoing Need | Details |
Vision and hearing | Trouble with vision and hearing is more common |
Muscle tone | Maintenance of muscle tone needs monitoring |
Seizures | Ongoing seizure management may be needed |
Pain and fatigue | Common concerns requiring attention |
Dental and orthopedic | Dental issues plus contractures, arthritis, and osteoporosis |
Heart and lung | Higher risk of heart and lung disease |
Mental health | Depression is more common and warrants attention |
What About Alternative Medicine?
Some children and teenagers with cerebral palsy use complementary and alternative medicine. It is important to know that alternative therapies have not been proved to work and have not been adopted into routine clinical practice. Talk with the healthcare professional about potential risks and benefits before trying any alternative therapy.
How can families cope with cerebral palsy and find support?
Foster your child's independence. Encourage your child's effort no matter how small. Engagement in social, educational, recreational, and community activities, and later work, has a positive effect on quality of life.
Be an advocate. Speak up. Ask questions of healthcare professionals, therapists, and teachers.
Find support. The circle of support around your family matters. Parents may feel grief and guilt. The care team can help locate support groups, organizations, and counseling services. The child may benefit from family support programs, school programs, and counseling. Reputable starting points include United Cerebral Palsy, Cerebral Palsy Alliance, the National Institute of Neurological Disorders and Stroke, and the American Academy of Pediatrics' HealthyChildren.org.
Access services. In the United States, early intervention and special education services for children under age 21 are available through the Individuals with Disabilities Education Act (IDEA). Adult disability services are also available. Talk with the healthcare team about programs in your area. Community resources for adults may cover guardianship, living arrangements, social and recreational participation, work, and financial support.
How should you prepare for a cerebral palsy appointment?
To prepare for a cerebral palsy appointment, expect questions about your child's symptoms, when they started and any risk factors during pregnancy or delivery. Before the appointment, make a list of:
Symptoms that concern you and when they began
All medicines, vitamins, and supplements your child takes, with doses
Your child's medical history, including other conditions
Information about your pregnancy and delivery
Questions you want to ask
Bring a family member or friend to help remember information. Questions worth asking include:
Question to Ask | Why It Helps |
What tests will my child need? | Clarifies the diagnostic path |
When will we know test results? | Sets expectations |
What specialists will we need to see? | Identifies the care team |
How will you monitor my child's health and development? | Clarifies the follow-up plan |
Can you suggest educational materials and local support services? | Connects you to resources |
Can my child be seen by specialists in a cerebral palsy clinic? | Explores coordinated specialist care |
Expect your doctor to ask about your concerns regarding your child's growth and development, how well your child eats, how your child responds to touch, whether your child favors one side of the body, and whether your child is reaching milestones such as rolling over, pushing up, sitting up, crawling, walking, and speaking. Don't hesitate to ask your own questions.
Conclusion
Cerebral palsy is a lifelong group of conditions affecting movement, balance, and posture, caused by brain damage that occurs most often before birth. While there is no cure and the underlying condition does not worsen over time, the range of outcomes is wide, and early intervention makes a real difference. Therapies build independence, medicines manage stiffness and pain, and surgery corrects contractures. The best first step is a prompt, honest conversation with a healthcare professional at the first sign of movement or developmental concerns, followed by a coordinated care team that supports your child from infancy through adulthood.
Your next step: If you've noticed any movement symptoms or developmental delays in your child, contact a healthcare professional promptly. Bring this guide's appointment questions with you, and ask about early intervention services in your area.
Frequently Asked Questions
1. What is cerebral palsy?
Cerebral palsy is a group of conditions that affect movement, balance, and posture. It is caused by damage to a baby's brain, most often before birth. Symptoms appear during infancy or the preschool years. There is no cure, but treatments can improve function.
2. Does cerebral palsy get worse over time?
No. The brain condition doesn't change with time, and symptoms usually don't worsen with age, though they may become easier to notice as a child grows. However, muscle shortening and rigidity can worsen if not treated aggressively.
3. What are the most common symptoms of cerebral palsy?
The most common movement condition is spasticity: stiff muscles and exaggerated reflexes. Other symptoms include floppy or rigid muscles, tremors, poor balance, toe-walking or a scissors gait, speech delays, trouble swallowing, drooling, delayed milestones, and in some cases seizures, hearing trouble, or vision trouble.
4. Can cerebral palsy affect only one side of the body?
Yes. Symptoms can affect the whole body or just one limb, two limbs, or one side of the body. A child may favor one side, such as reaching with only one hand or dragging one leg while crawling.
5. What are the three types of cerebral palsy?
The types are determined by the main movement condition: spastic cerebral palsy (stiff muscles and exaggerated reflexes, the most common), dyskinetic cerebral palsy (hard to control voluntary muscles), and ataxic cerebral palsy (trouble with balance and coordination). More than one type can occur in the same person.
6. What causes cerebral palsy?
Cerebral palsy is caused by unusual brain development or damage to the developing brain, usually before birth but sometimes at birth or in early infancy. Causes include gene changes, maternal infections, stroke, brain bleeding, infant infections, traumatic head injury, and, less commonly than previously thought, lack of oxygen during delivery. Often the cause is not known.
7. Does a difficult delivery cause most cases of cerebral palsy?
No. Lack of oxygen to the brain during hard labor and delivery is less common than previously thought. The strongest risk factors are low birth weight, premature birth, maternal infections during pregnancy, and serious infant illnesses such as meningitis or untreated jaundice.
8. Can cerebral palsy be prevented?
Cerebral palsy often can't be prevented, but risks can be reduced. Steps include getting vaccinated (such as rubella, ideally before pregnancy), staying healthy before pregnancy, getting early and continuous prenatal care, and avoiding alcohol, tobacco, and illegal drugs during pregnancy.
9. What tests are used to diagnose cerebral palsy?
Diagnosis includes reviewing symptoms and history, a physical exam, and monitoring growth over time. Tests may include MRI (detailed brain images), cranial ultrasound (during infancy), EEG (if seizures are suspected), and blood, urine, or skin laboratory tests that screen for genetic or metabolic conditions.
10. How is cerebral palsy treated?
There is no cure, so treatment focuses on improving function through a team approach: medicines (muscle injections like Botox, oral muscle relaxants, intrathecal baclofen pumps), therapies (physical, occupational, speech and language, recreational), surgery (orthopedic surgery for contractures, selective dorsal rhizotomy), and treatments for seizures, pain, osteoporosis, and mental health conditions.
11. Is alternative medicine effective for cerebral palsy?
Alternative therapies have not been proved to work and have not been adopted into routine clinical practice. Some children and teenagers use complementary and alternative medicine, but parents should discuss potential risks and benefits with their healthcare professional before trying any of them.
Related Reading
Selective Dorsal Rhizotomy (SDR): Surgery for Cerebral Palsy explains selective dorsal rhizotomy.
Physical Therapy for Cerebral Palsy: Goals, Exercises and Benefits explains physical therapy for children with cerebral palsy.
References
Mayo Clinic Staff. Cerebral palsy: Symptoms and causes. Mayo Clinic. May 1, 2026. https://www.mayoclinic.org/diseases-conditions/cerebral-palsy/symptoms-causes/syc-20353999
Mayo Clinic Staff. Cerebral palsy: Diagnosis and treatment. Mayo Clinic. May 1, 2026. https://www.mayoclinic.org/diseases-conditions/cerebral-palsy/diagnosis-treatment/drc-20354005
National Institute of Neurological Disorders and Stroke. Cerebral Palsy. NINDS. Last reviewed March 13, 2026. https://www.ninds.nih.gov/health-information/disorders/cerebral-palsy
McIntyre S, Goldsmith S, Webb A, et al. Global prevalence of cerebral palsy: a systematic analysis. Dev Med Child Neurol. 2022;64(12):1494-1506. PMID 35952356. https://doi.org/10.1111/dmcn.15346
Oskoui M, Coutinho F, Dykeman J, Jetté N, Pringsheim T. An update on the prevalence of cerebral palsy: a systematic review and meta-analysis. Dev Med Child Neurol. 2013;55(6):509-519. PMID 23346889. https://doi.org/10.1111/dmcn.12080
Chen D, Huang M, Yin Y, et al. Risk factors of cerebral palsy in children: a systematic review and meta-analysis. Transl Pediatr. 2022;11(4):556-564. PMID 35558974. https://doi.org/10.21037/tp-22-78
Medical Disclaimer
This article is for informational purposes only and does not constitute medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read here.
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