What other conditions are associated with cerebral palsy?
Many individuals with cerebral palsy have no additional medical disorders. However, because cerebral palsy involves the brain and the brain controls so many of the body’s functions, cerebral palsy can also cause seizures, impair intellectual development, and affect vision, hearing, and behavior. Coping with these disabilities may be even more of a challenge than coping with the motor impairments of cerebral palsy.
These additional medical conditions include:
- Mental retardation. Two-thirds of individuals with cerebral palsy will be intellectually impaired. Mental impairment is more common among those with spastic quadriplegia than in those with other types of cerebral palsy, and children who have epilepsy and an abnormal electroencephalogram (EEG) or MRI are also more likely to have mental retardation.
- Seizure disorder. As many as half of all children with cerebral palsy have seizures. Seizures can take the form of the classic convulsions of tonic-clonic seizures or the less obvious focal (partial) seizures, in which the only symptoms may be muscle twitches or mental confusion.
- Delayed growth and development. A syndrome called failure to thrive is common in children with moderate-to-severe cerebral palsy, especially those with spastic quadriparesis. Failure to thrive is a general term doctors use to describe children who lag behind in growth and development. In babies this lag usually takes the form of too little weight gain. In young children it can appear as abnormal shortness, and in teenagers it may appear as a combination of shortness and lack of sexual development.
In addition, the muscles and limbs affected by cerebral palsy tend to be smaller than normal. This is especially noticeable in children with spastic hemiplegia because limbs on the affected side of the body may not grow as quickly or as long as those on the normal side.
- Spinal deformities. Deformities of the spine — curvature (scoliosis), humpback (kyphosis), and saddle back (lordosis) — are associated with cerebral palsy. Spinal deformities can make sitting, standing, and walking difficult and cause chronic back pain.
- Impaired vision, hearing, or speech. A large number of children with cerebral palsy have strabismus, commonly called “cross eyes,” in which the eyes are misaligned because of differences between the left and right eye muscles. In an adult, strabismus causes double vision. In children, the brain adapts to the condition by ignoring signals from one of the misaligned eyes. Untreated, this can lead to poor vision in one eye and can interfere with the ability to judge distance. In some cases, doctors will recommend surgery to realign the muscles.
Children with hemiparesis may have hemianopia, which is defective vision or blindness that blurs the normal field of vision in one eye. In homonymous hemianopia, the impairment affects the same part of the visual field in both eyes.
Impaired hearing is also more frequent among those with cerebral palsy than in the general population. Speech and language disorders, such as difficulty forming words and speaking clearly, are present in more than a third of those with cerebral palsy.
- Drooling. Some individuals with cerebral palsy drool because they have poor control of the muscles of the throat, mouth, and tongue. Drooling can cause severe skin irritation. Because it is socially unacceptable, drooling may also isolate children from their peers.
- Incontinence. A common complication of cerebral palsy is incontinence, caused by poor control of the muscles that keep the bladder closed. Incontinence can take the form of bed-wetting, uncontrolled urination during physical activities, or slow leaking of urine throughout the day.
- Abnormal sensations and perceptions. Some children with cerebral palsy have difficulty feeling simple sensations, such as touch. They may have stereognosia, which makes it difficult to perceive and identify objects using only the sense of touch. A child with stereognosia, for example, would have trouble closing his eyes and sensing the difference between a hard ball or a sponge ball placed in his hand.