Cerebral palsy (CP) is a condition that results from abnormal brain development or injury to the brain during or after birth. Understanding what causes cerebral palsy can be very helpful for families in managing this life-altering condition, both emotionally and practically.

Cerebral palsy causes can vary, but they generally fall into three categories: prenatal, perinatal, and postnatal factors. In this blog post, the medical negligence experts at JMW Solicitors will explain the various factors that can affect the development of this condition and explore what steps families affected by cerebral palsy should take to get the support they need.

Prenatal Causes

Prenatal causes of cerebral palsy are those that occur before the child’s birth, and relate to various factors that can interfere with normal brain development. These include:

Infections During Pregnancy

Certain infections contracted by the mother during pregnancy can increase the risk of cerebral palsy in the unborn child. For example, infections such as rubella (German measles), cytomegalovirus (CMV) and toxoplasmosis can lead to inflammation in the developing brain, causing damage that may result in cerebral palsy. Maternal infections that cause high fevers can also disrupt the brain development of the foetus.

Exposure to Toxic Substances

Prenatal exposure to harmful substances such as alcohol, tobacco or drugs can negatively affect brain development. Alcohol, in particular, is known to cause a spectrum of disorders, including foetal alcohol syndrome, which can be associated with cerebral palsy. Similarly, drug use and smoking during pregnancy can lead to low birth weight and premature birth, both of which are risk factors for cerebral palsy.

Complications in the Womb

Conditions such as placental insufficiency, where the placenta fails to provide enough oxygen and nutrients to the foetus, can lead to brain damage. Abnormalities in the development of the brain, such as malformations in the brain’s structure, can also contribute to the condition. Abnormal development during crucial stages can result in varying types of cerebral palsy.

Genetic Factors

In some cases, cerebral palsy may be linked to genetic mutations that affect brain development. Although these cases are relatively rare, they demonstrate how genetic abnormalities can disrupt the normal growth and functioning of the brain. Learn more about the possible genetic links associated with cerebral palsy.

Perinatal Causes

Perinatal causes of cerebral palsy occur around the time of delivery. These factors are significant, as they can directly cause brain injuries that result in cerebral palsy.

Birth Asphyxia 

One of the most significant perinatal causes of cerebral palsy is birth asphyxia, a condition where the baby’s brain is deprived of oxygen during delivery. This can occur due to various complications, such as prolonged or difficult labour, the umbilical cord becoming wrapped around the baby’s neck, delays in delivering the baby when there are signs of distress on the heart rate monitor. . When the brain is starved of oxygen for even a short period, it can result in permanent injury, leading to cerebral palsy.

Premature Birth

The NHS website lists babies born at 32 weeks or earlier as being at a particularly high risk of cerebral palsy. This is due to their underdeveloped organs and systems. Premature infants (especially those born before 32 weeks of gestation) are more susceptible to brain injuries, such as intraventricular haemorrhage (bleeding in the brain) or periventricular leukomalacia (softening of the white matter in the brain), both of which are linked to cerebral palsy.

Low Birth Weight 

Babies with a low birth weight, particularly those weighing less than 2,500 grams, are more likely to suffer from complications that can lead to cerebral palsy. Low birth weight often correlates with premature birth, and can be associated with a higher incidence of brain haemorrhages or infections that can cause brain damage.

Multiple Births

The risk of cerebral palsy is higher in twins, triplets and other multiple births. This increased risk is partly due to the higher likelihood of premature birth and low birth weight in multiple pregnancies. Additionally, the death of a co-twin or triplet in utero can increase the surviving babies’ risk of developing cerebral palsy.

Postnatal Causes

Postnatal causes of brain injury occur after birth and can also contribute to the development of CP.

Brain Infections

After birth, certain infections such as meningitis (an infection in the outer lining of the brain and spinal cord) or encephalitis (inflammation of the brain) can cause damage that may result in cerebral palsy. These infections are particularly dangerous in infants and young children, whose immune systems are still developing.

Head Injuries

Traumatic brain injuries in the early years of life can also cause cerebral palsy. These injuries may result from accidents, falls, or abuse (such as shaken baby syndrome). The severity of the brain injury often determines the extent of the resulting disabilities.

Severe Jaundice

Newborn jaundice, which causes yellowing of the skin and eyeballs , is common and usually harmless. However, if jaundice is severe and left untreated, it can lead to a condition called kernicterus, where high levels of bilirubin in the blood cause brain damage, potentially leading to cerebral palsy.

Lack of Oxygen (Hypoxia)

Any situation that leads to a lack of oxygen reaching the brain after birth can increase the risk of cerebral palsy. This includes incidents such as near-drowning, choking or severe asthma attacks.

Hypoglycaemia

Low blood sugars in the newborn period can also result in brain injury and cerebral palsy. 

Types of Neurological Disorders in Cerebral Palsy

Cerebral palsy manifests in several forms, each affecting the body differently. The types of cerebral palsy are classified based on the type of movement issues and the areas of the brain involved.

• Spastic cerebral palsy: The most common type, where muscles are stiff and movements can be awkward.
• Dyskinetic cerebral palsy: Characterised by uncontrolled movements, often affecting the hands, arms, feet and legs.
• Ataxic cerebral palsy: This type affects balance and depth perception, leading to shaky or uncoordinated movements.
• Mixed cerebral palsy: When symptoms of more than one type are present, it is referred to as mixed CP.

Each of these types of cerebral palsy requires different management and treatment approaches, tailored to the individual's needs.

Parents often notice early signs of cerebral palsy in infancy, such as delays in reaching developmental milestones, like sitting, crawling, or walking. Recognising mild cerebral palsy symptoms early can lead to better outcomes through early intervention and therapy.

How Is Cerebral Palsy Diagnosed?

The process of diagnosing typically involves a combination of monitoring developmental milestones, physical exams and imaging tests like MRI scans to look for brain abnormalities. Early diagnosis is essential for managing the condition effectively and tailoring interventions to the specific needs of the child.

How is Cerebral Palsy Treated?

Cerebral palsy treatment focuses on improving the individual’s quality of life and maximising their functional abilities. While there is no cure, there is hope and progress with various treatments working to manage symptoms and prevent complications.

• Physiotherapy: This is one of the most common treatments and helps improve muscle strength, flexibility and coordination.
• Occupational therapy: Aims to enhance the ability to perform daily activities.
• Speech therapy: Addresses communication issues and eating problems  and can be very important since cerebral palsy does affect speech in many cases.
• Medications: Used to manage symptoms like muscle spasticity or seizures.
• Surgery: In some cases, surgical intervention may be necessary to correct physical deformities or reduce muscle stiffness.

These cerebral palsy treatment options are often combined, depending on the individual’s needs, to provide the best possible outcomes.

Can Cerebral Palsy Be Cured?

Currently, there is no cure for cerebral palsy, meaning it is a lifelong condition. However, ongoing treatments and therapies, can significantly improve the quality of life for those with CP, helping them lead fulfilling lives.

Cerebral Palsy Support

Living with cerebral palsy can be challenging, both for the individuals affected and their families but there is support available. Various cerebral palsy support groups are available in the UK, offering a network for families to share experiences, advice, and encouragement. Cerebral palsy support groups provide resources and community for those dealing with the daily challenges of CP, helping them navigate everything from medical care to educational needs.

Find out more about the various support organisations by visiting JMW’s Cerebral Palsy Hub.

The Role of Medical Negligence

In some cases, cerebral palsy is caused or exacerbated by medical negligence during pregnancy, labour or after delivery. This might involve failures in monitoring the mother or baby’s condition, delays in performing a necessary C-section, or improper use of delivery tools such as forceps or vacuum extractors. When medical professionals fail to provide the standard level of care, and this failure results in brain injury, it can form the basis for a clinical negligence claim.