If My Child Has Cerebral Palsy, Will There Be Other Conditions?
Cerebral palsy is the most common motor disability in childhood. The Centers for Disease Control and Prevention (CDC) estimates that one in 345 children have cerebral palsy. But cerebral palsy is rarely all that a family will have to deal with after a diagnosis. When a child has another medical condition in addition to cerebral palsy, it is called a “co-occurring,” “associated,” or “coexisting” condition.
Nearly half of all children with cerebral palsy will have some type of co-occurring condition. The most common co-occurring condition, overall, is epilepsy, which is hyper-activity between brain cells causing recurring, unprovoked seizures. (CDC)
A study by the Murdoch Children’s Research Institute did find that for children who have cerebral palsy and white matter injury, “these particular seizures occur infrequently, and respond well to medicine. …There is also a good chance children will outgrow their seizures as they move into their teens.” This is reassuring news for parents, and we applaud further study into this field. However, Leventhal & Puga, P.C., must point out that “white matter injury” in the brain is largely associated with premature birth and insufficient oxygen to the baby. Our attorneys sit on the board of the American Association of Justice’s Birth Trauma Litigation Group and handle many lawsuits involving cerebral palsy, and we know that any medical negligence during birth—bad monitoring, miscommunication, failing to take quick action—can allow these conditions that ultimately lead to cerebral palsy.
We should never forget that epileptic seizures can cause injuries, brain damage, and sudden unexpected death in epilepsy (SUDEP), a poorly understood cause of death that occurs in about 1 in 1,000 people every year. If a doctor’s poor planning or inadequate medical care leads to cerebral palsy in a child, we strongly believe that doctor should pay for the child’s future care.
What Conditions Can Co-Occur with Cerebral Palsy?
- Epilepsy or a seizure disorder
- Intellectual disabilities
- Learning disabilities
- Delayed growth
- Spinal deformities
- Infections and illnesses
- Speech disorders
- Dental problems
- Drooling
- Impaired vision
- Impaired hearing
- Abnormal sensations
- Bladder problems
- Muscle tension and joint deformity
- Malnutrition
- Inactivity
It’s probably safe to say that a co-occurring condition is more likely than not, if your child was diagnosed with cerebral palsy.
A Look at the Numbers: 3 Studies on Co-Occurring Conditions
Researchers from the Autism and Developmental Disabilities Monitoring Network found that 60% of children with CP had another developmental disability in addition to cerebral palsy. Out of a sample population of 8-year-olds with cerebral palsy from Alabama, Georgia, Wisconsin, and Missouri:
- About 40% had an intellectual disability,
- About 35% had epilepsy,
- About 15% had vision impairment,
- About 25% had both an intellectual disability and epilepsy.
Children with limited or no walking ability were more likely to have epilepsy: 67%. Autism was rarer overall (6.9%) but more common in non-spastic or hypotonic cerebral palsy (18.4%). The rate of autism spectrum disorder among children with cerebral palsy was substantially higher than among children without cerebral palsy—about 7% vs. 1%!
The researchers concluded, “The higher frequency of autism spectrum disorder in non-spastic than in spastic subtypes of CP calls for closer examination.” Such an examination has yet to be published.
Another collaboration by the Surveillance for Cerebral Palsy in Europe noted the following numbers for co-occurring conditions alongside cerebral palsy:
- About 31% of children had a severe intellectual disability.
- About 11% of children had a severe visual disability.
- About 21% of children had epilepsy.
This study noted that although cerebral palsy is a “nonprogressive” condition (it will not get worse over time), as the child grows and develops, the way that cerebral palsy manifests may indeed change and seem to worsen, and needs to be treated accordingly.
Lastly, a study published in China examined children with cerebral palsy who were treated at a rehabilitation center from January 2007 to June 2009. Of those children:
- 89% had mental retardation,
- 24% had auditory limitations,
- 98% had a visual disorder,
- 02% had a language-speech disorder, and
- 16% had epilepsy.
The researchers found a strong correlation between spastic diplegia and a visual disorder; spastic hemiplegia and epilepsy; spastic quadriplegia and epilepsy and mental retardation; and both dyskinetic and mixed cerebral palsy and language-speech disorder. The type and severity of cerebral palsy a child has does seem to influence any co-occurring conditions. (Comorbidities in patients with cerebral palsy and their relationship with neurologic subtypes and Gross Motor Function Classification System levels)
What Causes Co-Occurring Conditions?
Many co-occurring conditions are actually sequalae—conditions that are caused by the previous disease or injury, usually the cerebral palsy itself.
For example, physical development in a child is often stimulated by movement. That’s why therapy for a weak limb involves vigorous exercises to strengthen and enlarge the muscles. With cerebral palsy, children have limited motor abilities, and those affected parts of their bodies simply cannot grow the same as a child without CP—therefore, delayed growth is a co-occurring condition.
Mental impairment is more common in spastic quadriplegia cases, because the cerebral palsy injury to the brain is more widespread, affecting the child more severely.
It could also be that the original damage to the brain (the “insult”) is to blame for the associated condition. Hearing loss in particular is caused by infant jaundice, or a lack of oxygen to the developing brain. A lack of oxygen to the brain also causes damage to the motor areas of the brain itself…which creates cerebral palsy.
Quality of Life for Cerebral Palsy and Co-Occurring Conditions
Co-occurring conditions definitely make a tough road even tougher.
Cerebral palsy can be difficult to bear, but children with cerebral palsy often lead rich, fulfilling lives and bring their parents and communities joy. Though they spend time in hospitals, therapy, and learning how compensate for any disabilities, children with cerebral palsy aren’t substantively different from any other child.
If you have questions about how or why your child acquired CP, or think that medical mistakes may have led to your child’s CP, talk to us at Leventhal & Puga, P.C. Our nationally-acclaimed lawyers have taken many cerebral palsy cases to trial to get justice for parents and their children. However, there are strict time limits for filing a birth injury claim, so we encourage you to speak to us as soon as possible. Call our Denver office at (303) 759-9945 to set up a no-cost initial consultation. We handle cases across the country, and have the resources and experience to defeat the largest hospital corporations if necessary to take care of our clients and their children.
Additional Information
National Institute of Neurological Disorders and Stroke: Cerebral Palsy