Cerebral Palsy (CP)
If your child has cerebral palsy, it’s important to get treatment from experts who work collaboratively to address the various ways the condition can affect your child’s life. Whether your child is already diagnosed or cerebral palsy is suspected, Duke Children’s team of specialists provides care that’s customized for your child.
About Cerebral Palsy
Cerebral palsy (CP) affects muscle tone, movement, and motor skills. It is usually caused by a brain injury that occurs before or during a child's birth or in their early developmental period. CP often causes spasticity, or muscle stiffness that’s sometimes accompanied by jerky movement, and can affect a child’s arms, legs, and face. Children with CP also can have associated hearing, vision, and cognitive impairments and seizures.
If Your Child Has -- or May Have -- CP
The first step is a thorough evaluation. Our doctors will perform a physical exam, learn about your child’s health history, and review MRI images of the brain and, in some cases, the spine. The doctor may also order blood tests or other diagnostic tests to identify possible causes of your child’s symptoms. Our doctors also will evaluate your child for conditions that occur with CP, such as seizures, scoliosis, contractures, reflux, and sleep problems.
Comprehensive Treatment for Cerebral Palsy
We understand the impact that living with cerebral palsy can have on your child and your family. Our team of specialists offers comprehensive care that’s tailored to your child’s unique physical, developmental, emotional, and academic needs.
- At our Neurodevelopmental Disorders Clinic, your child can be seen by several specialists in a single day, as needed. Our goal is to keep your medical visits to a minimum and to enable your child’s caregivers to share information and coordinate treatment.
- A neurodevelopmental neurologist will evaluate the ways cerebral palsy affects your child and recommend appropriate treatment. This includes assessing your child’s muscle tone, movement, and motor skills, as well as speech and language abilities, attention, and social and academic participation.
- Our pediatric orthopaedic surgeons screen for and treat musculoskeletal complications that can occur with cerebral palsy, including spinal curvature and hip problems.
- Our physical therapists evaluate your child and recommend exercises to help with pain or movement difficulties; they also will evaluate for adaptive equipment needs.
- Your child may also be seen by an occupational therapist, who can help with day-to-day tasks and participation in school.
- When necessary, we’ll refer your child to other specialists within our health system, such as a speech-language pathologist, dietitian, gastroenterologist, ophthalmologist, audiologist, social worker, or orthotics specialist.
- Our nurse clinic coordinator can answer your questions and guide you through the process of starting evaluation and treatment. If you are traveling from outside the Triangle area, the nurse coordinator can help ensure your child’s local doctors have the information they need to provide follow-up care.
- As an academic medical center, Duke is committed to staying abreast of and bringing to our patients the latest advances in care. For example, our experts have been involved in studying the potential of cord blood transfusions to treat children with cerebral palsy.
CEREBRAL PALSY
Treatments
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Medications may be prescribed to relax your child’s muscles, reduce spasticity, or relieve chronic pain.
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Oral medications are a primary approach to managing muscle tone.
In some children with cerebral palsy, injections of botulinum toxin (Botox) can reduce spasticity by blocking the nerve signals that cause muscles to stiffen. Note: This is considered an “off-label” use of Botox. The FDA has not evaluated the safety or effectiveness of Botox injections in children with cerebral palsy.
In cases of severe spasticity, doctors may offer a surgically implanted pump to deliver continuous, consistent doses of baclofen, a muscle-relaxing medication, directly to the spinal cord.
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Orthopaedic specialists evaluate and manage the impact of cerebral palsy on your child’s bones, joints, tendons, and ligaments. Our pediatric orthopaedic surgeons are skilled in surgical techniques to improve mobility and function and prevent or correct deformities. Wherever possible, our surgeons use minimally invasive approaches, performing surgery through small incisions to reduce pain and recovery time.
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Your child may be referred to a Duke pediatric neurosurgeon for selective dorsal rhizotomy, a type of spinal cord surgery that can reduce spasticity of the lower limbs and improve mobility. We also have pediatric neurosurgeons who are skilled in implanting baclofen medication pumps.