Cerebral Palsy (cont.)

Outlook

With proper therapy, many people with cerebral palsy can lead near-normal lives. Even those with very severe disabilities can improve their condition significantly, although they will never be able to live independently.

Approximately 25% of children with cerebral palsy have mild involvement with few or no limitations in walking, self-care, and other activities. Approximately half are moderately impaired to the extent that complete independence is unlikely but function is satisfactory. Only 25% are so severely disabled that they require extensive care and are unable to walk.

Of the 75% of children with cerebral palsy who are eventually able to walk, many rely on assistive equipment. The ability to sit unsupported may be a good predictor of whether a child will walk. Many children who can sit unsupported by age 2 years eventually will be able to walk, while those who cannot sit unsupported by age 4 years probably will not walk. These children will use wheelchairs to move around.

The likelihood of medical complications of cerebral palsy is related to the severity of the condition. Generally, the more severe the CP, the more likely are related conditions such as seizures and mental retardation. Individuals with quadriplegia are much more likely than those with diplegia or hemiplegia to have these related conditions.

• Seizure disorders occur in about one third of people with cerebral palsy.
  
  
• Mental retardation occurs in about 30-50% of people with cerebral palsy. Standardized tests that evaluate primarily verbal skills may underestimate a child’s intelligence level.
  
  
• Obesity is a common problem in children who are confined to a wheelchair or are unable to move freely.

Life expectancy in people with cerebral palsy also is related to the severity of their condition. People with milder forms of cerebral palsy have the same life expectancy as the general population. Those with severe forms of cerebral palsy typically have a shorter life span, especially if they have many medical complications.

Some studies have found that abnormalities of muscle tone or movement in the first several weeks or months after birth may gradually improve over the first years of life. In one study, almost 50% of very young infants thought to have cerebral palsy and 66% of those thought to have spastic diplegia “outgrew” these signs of cerebral palsy by age 7 years. Many children do not manifest full motor signs that are suggestive of cerebral palsy until aged 1-2 years. Thus, some propose that the diagnosis of cerebral palsy should be deferred until the child is aged 2 years.

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