When their child is diagnosed with cerebral palsy, parents often have a host of questions. One of the most common concerns is whether or not cerebral palsy can be considered a progressive condition.

The reasons for this question are understandable - after all, children with cerebral palsy will often experience a wide range of debilitating long-term symptoms, and parents will want to know whether to expect these to get worse. As such, it should be reassuring to know that cerebral palsy is not considered a progressive disorder by the medical definition. However, while the condition itself is not progressive, cerebral palsy symptoms can still evolve and change throughout an individual's lifetime.

As such, if your child should develop cerebral palsy, it is important to understand what this means in order to make sure your family is able to manage the condition effectively and maintain the highest possible quality of life for your loved one.

Why cerebral palsy is not a progressive disorder

To understand what a cerebral palsy diagnosis might mean for your child, it is important to understand the basics of what the condition is, and how it develops.

One of the most important aspects of cerebral palsy to bear in mind is that the term does not refer to a single disorder - instead, cerebral palsy encompasses a group of neurological conditions that appear in infancy or early childhood as a result of a brain injury, or abnormal development of the parts of the brain that control muscle movement. When this happens, it has a lifelong impact on the patient's body movement, muscle coordination and balance.

In addition to brain injury, cerebral palsy can also be caused by an abnormality or disruption in brain development, most often before a child is born. No matter what the specific cause may be, cerebral palsy always stems from damage sustained to an infant's developing brain, either before, during or shortly after birth.

You can find out more about the basics of cerebral palsy from the NHS website.

Because cerebral palsy is caused by brain injuries, it should be considered a condition rather than a disease, and it does not spread from person to person. This is also why the condition is non-progressive - the brain damage that causes cerebral palsy is a one-time event that occurs while the brain is still developing, and the damage does not continue to happen after the initial episode.

The long-term symptoms of cerebral palsy

As a result, the symptoms of cerebral palsy are likely to remain relatively consistent throughout an individual's life. However, this is not to diminish their seriousness, or the impact they can have on a person's health and wellbeing.

Cerebral palsy affects each individual differently, and the specific symptoms can vary widely. Most commonly, individuals with cerebral palsy exhibit difficulties with movement and coordination. They may have stiff muscles, involuntary movements, disturbances in gait or mobility, or difficulty with precise tasks due to motor disability. Some may experience difficulties with communication, while others may have associated conditions like learning disabilities, epilepsy, or issues with hearing and vision.

There are four main types of cerebral palsy, each with distinct characteristics:

• Spastic cerebral palsy - the most common type of cerebral palsy, characterised by stiff and tight muscles, and awkward movements
• Dyskinetic cerebral palsy (also known as athetoid cerebral palsy - characterised by uncontrolled, slow, writhing movements affecting the hands, feet, arms or legs, or in some cases, the muscles of the face and tongue, creating swallowing difficulties
• Ataxic cerebral palsy - affects balance and depth perception, leading to problems with movements that require a high degree of control, like writing
• Mixed cerebral palsy - a combination of symptoms of more than one type of cerebral palsy, with the most common mix being spastic and dyskinetic cerebral palsy

The degree to which these symptoms affect an individual can vary widely. Some people with cerebral palsy can move around without assistance, while others may need the use of assistive devices such as walkers or wheelchairs; in some cases, the condition can have a significant effect on mental health and cognitive capacity.

Even though these symptoms may not worsen over time due to cerebral palsy itself, they still represent a significant burden for those experiencing them, which is why a comprehensive treatment plan needs to be developed to help the individual lead as independent life as possible.

Can cerebral palsy symptoms still change and become worse over time?

While cerebral palsy is not progressive and the brain damage that causes it does not worsen, there are a number of factors that may still result in the symptoms of cerebral palsy evolving over time. This is not because the condition is deteriorating, but rather because our bodies naturally change and age. As the body develops and grows, certain issues related to cerebral palsy can become more noticeable or difficult to manage.

Here are a few examples:

• Spasticity is one of the most common symptoms associated with cerebral palsy, causing the muscles to involuntarily contract and movements to become stiff. If this is not properly managed over a child’s lifetime, it can lead to uneven muscle tone and improper development, as well as place excessive pressure on the joints. This will affect the individual’s posture, growth, and walking patterns over time.
• As a knock-on effect of the movement and muscle abnormalities caused by cerebral palsy, these individuals are more susceptible to various musculoskeletal problems over their lifetimes, including scoliosis (sideways curvature of the spine), osteoarthritis, osteoporosis and hip dislocation.
• Individuals with cerebral palsy experience fatigue more frequently due to their motor impairments, and this is likely to get worse over time as the person gets older
• Many people with cerebral palsy experience chronic pain, as spasticity, poor posture and irregular movements lead to musculoskeletal abnormalities. If this is not treated properly, then this pain will continue to get worse.
• The mental health effects of poorly managed cerebral palsy are likely to get worse over time, affecting the development of communication skills and making it difficult to develop a healthy social life, resulting in isolation.

These changing symptoms are not a sign that the underlying cerebral palsy is progressing. Instead, they should be seen as a response to the body’s growth and ageing process in the presence of cerebral palsy, and the impact that cerebral palsy symptoms can have on the body if they are not properly addressed.

What treatments can help control cerebral palsy symptoms?

As such, even though cerebral palsy is a non-progressive condition, the need for ongoing medical and therapeutic intervention is necessary to address evolving symptoms and potentially related health issues.

Although it is not possible to cure cerebral palsy, that does not mean that nothing can be done to improve the quality of life for someone with this condition, or prevent symptoms from getting worse. This is why the most important priority is to get the symptoms of cerebral palsy diagnosed and confirmed as soon as possible, so that the correct treatment pathway can be determined by a medical professional.

Treatment for cerebral palsy is highly individualised and is usually delivered by a team of healthcare providers. It may include a combination of physiotherapy, occupational therapy and speech and language therapy to help improve mobility, enhance strength and overcome communication difficulties. Assistive devices like orthotics, walkers or wheelchairs can also be used to enhance independence and mobility.

In some cases, medications might be used to manage symptoms such as muscle spasticity or associated conditions like epilepsy. Surgery might also be recommended in some instances to alleviate pain, correct deformities, or improve mobility.

Moreover, pain management becomes crucial, especially in adulthood when musculoskeletal issues tend to become more prominent. Regular check-ups with healthcare professionals can help monitor and proactively address any emerging issues to prevent exacerbation of symptoms.

Find out more

The key message for parents learning about cerebral palsy should be that while the condition is non-progressive, it nevertheless requires ongoing management to ensure the best possible quality of life. Understanding the nature of the condition and how symptoms can evolve is an essential part of this process; this will help your family to get the regular assessments and personalised treatment plan that children with cerebral palsy will need to navigate the challenges that they will face.

You can learn more about the impact of cerebral palsy and the best methods of treating the condition by visiting JMW's Cerebral Palsy Hub. If your child's cerebral palsy was caused by medical negligence, visit our cerebral palsy claims page to find out how you can make a claim for compensation.