Treatment Overview

Cerebral palsy (CP) cannot be cured. But a variety of treatments can help people with CP to maximize their abilities and physical strength, prevent complications, and improve their quality of life. The brain injury or problem that causes CP does not get worse over time. But new symptoms can appear or become worse over time because of how a child grows and develops.

Specific treatment varies by individual and changes as needed if new issues develop. In general, treatment focuses on ways to maintain or improve a person's quality of life and overall health.

Initial treatment

Physical therapy is an important treatment that begins soon after a child is diagnosed and often continues throughout his or her life. This therapy also may begin before a definite diagnosis is made, depending on the child's symptoms.

Medicines can help control some of the symptoms of CP and prevent complications. For example, injectable antispasmodics help relax tight muscles and improve range of motion. Anticholinergics help manage uncontrollable body movements or frequent drooling. Other medicines may be used for common problems related to cerebral palsy, such as anticonvulsant medicines for seizures.

In some cases, a child with severe problems may need orthopedic surgery (for muscles, tendons, and joints) or selective dorsal rhizotomy (cutting nerves of affected limbs) for contracture or other mobility problems.

It is common to have a fear of the unknown. Learning about CP can help you to understand the condition and be familiar with some of the challenges and joys of raising a child with cerebral palsy. Being informed can help give you a sense of control about how best to help your child. For more information, talk to your doctor or see the Other Places to Get Help section of this topic.

Ongoing treatment

Ongoing treatment for cerebral palsy (CP) focuses on continuing and adjusting existing treatments and adding new treatments as necessary. Although the brain injury that causes CP does not get worse over time, some of its effects can appear for the first time, change, or become more severe as a child gets older.

Regular visits with your child's doctor and specialists are important for monitoring your child's condition. These visits may include tests, such as questionnaires to evaluate whether new developmental milestones are being achieved as expected, or periodic blood tests to find out about the effects of medicine your child may be taking. Your child should also have regular eye, hearing, and speech evaluations.

Other tests may be done to find out whether common problems related to cerebral palsy have developed. These problems can then be treated as they appear.

Ongoing treatment for cerebral palsy may include:

• Physical therapy, which can help your child become as mobile as possible. It may also help prevent the need for surgery. If a child has surgery, intense physical therapy may be needed for 6 months or more.
• Monitoring of any medicines being taken, to help control symptoms and prevent complications.
• Orthopedic surgery (for muscles, tendons, and joints) or selective dorsal rhizotomy (cutting nerves of affected limbs) to try to prevent problems with bones and related muscles, ligaments, and tendons.
• Special devices and equipment, such as braces, casts, and splints. The specific types used depend on a child's needs. For example, a child may get a cast after surgery or as a means to restrict movement in one area to strengthen muscles and tendons in another part of the body.
• Pain management. For more information, see the topics Pain Management and Chronic Pain.

Behavioral therapy, in which a counselor helps a child learn better ways to communicate, may be a part of ongoing treatment. It is most often used to help school-age children with CP learn better ways to interact with others, especially their peers.

Working with others involved with your child's care, understanding your child's needs and rights, and taking care of yourself and other family members are all important parts of ongoing treatment for people with cerebral palsy. These strategies include:

• Researching and understanding your child's educational rights. In the United States, children with special needs can get free public school services and some free treatments. You have the right to be fully informed about educational decisions concerning your child. Contact your state and local education departments for detailed information about these accommodations. Also, vocational training can help some teens and young adults.
• Working with your child's teachers, school administrators, special learning consultants, and school boards to develop the best educational plan for your child. A cooperative team approach helps your child realize his or her potential.
• Supporting your child emotionally. Your child's needs will change over time. As children grow and become more aware of their physical limitations, they need to be able to talk about their feelings and how they are treated. It is sometimes easier for them to talk with someone who is not a family member. Ask your doctor about whether emotional counseling might benefit your child. Also, involve your child as much as possible when making decisions about his or her health care.
• Getting proper rest, eating well, exercising, and learning ways to cope with the challenges of raising a child with CP. You will be better equipped to help your child when you have physical energy and emotional strength.
• Working together as a family. The entire family is affected when one member has CP. Helping family members cope with this situation is important, especially for siblings. You can help prevent other children from having unrealistic fears and concerns, feeling left out, or becoming overwhelmed.

Most children with cerebral palsy live to adulthood and have a somewhat shorter than normal life span. But a lot depends on the type of CP and how it affects your child's health.

Many adults get jobs if they have good support from their family and community. You can enroll your teen in occupational therapy as part of a gradual preparation for independent living. Helping your child be independent requires patience and resourcefulness on your part. Expect some frustrating setbacks or obstacles. Your child may need extra help and encouragement to prepare for added expectations and responsibilities.

Treatment if the condition gets worse

Although the brain injury that causes cerebral palsy (CP) does not get worse over time, some of its effects can appear for the first time, change, or become more severe as a child's nervous system grows and develops.

Common problems related to cerebral palsy may develop, become more severe, or lead to complications. Treatment varies by the individual and type of problem but generally can include medicine, surgery, specialized therapies, and orthopedic equipment.

Surgery

Types of surgery include:

• Orthopedic surgery to loosen tight muscles, tendons, and joints, particularly on the hips, knees, and ankles.
• Selective dorsal rhizotomy to cut nerves on the limbs that are most affected by movements and spasms, to allow more flexibility and control.

A doctor evaluates symptoms, age, and the person's general state of health when considering whether to recommend surgery. A thorough checkup is needed to help the doctor determine which muscles and nerves are affected and what type of surgery would best treat the condition. A gait analysis may be done to check your child's walking patterns.

Physical therapy

Physical therapy is often used as part of ongoing treatment. But its focus may change after surgery or for problems that are new or getting worse. After surgery, specialized physical therapy may be needed for 6 months or longer. Biofeedback may be useful as part of physical therapy or on its own. During biofeedback sessions, people with CP learn ways to control their affected muscles. Although biofeedback does not help everyone with CP, some people who use the technique learn how to control their affected muscles or reduce muscle tension.

Special devices and equipment

Many people with CP benefit from using something to maintain or improve joint mobility, help strengthen muscles and relax overactive (spastic) muscles, and assist with daily activities. Such devices and equipment may include orthotics, casts, standers, special seats, walkers, wheelchairs, special shoes, and other individualized methods to help with specific problems.

Individualized therapies

Other therapies may also be needed depending on the specific need that develops.

• Occupational therapy helps teens and adults adapt to their limitations and live as independently as possible.
• Speech therapy helps control the mouth muscles. This therapy can be of great benefit to children with speech or eating problems. Speech therapy often starts before the child begins school and continues throughout the school years.
• Nutritional counseling may help when dietary needs are not met because of problems with eating certain foods.
• Both massage therapy and hatha yoga are designed to help relax tense muscles, strengthen muscles, and keep joints flexible. Hatha yoga breathing exercises are sometimes used to try to prevent lung infections. More research is needed to determine the health benefits of these therapies for people with CP.
• Therapies to stimulate learning and sensory development may benefit babies and young children. Some also help people of other ages. These therapies cannot repair damaged parts of the brain. But they may be able to stimulate undamaged parts of the brain.
• Behavioral therapy helps some school-age children with CP learn better ways to communicate with others.

You may hear about a wide range of controversial treatments, some of which may cause harm. Do not be afraid to talk to your doctor about any type of treatment you are considering for your child.