Prognosis and Life Expectancy for Cerebral Palsy

In our last post, we talked about the Diagnosing Cerebral Palsy. Here, we will talk about the prognosis and life expectancy for a person with Cerebral Palsy. In this discussion, we will address the various factors that can affect prognosis and life expectancy and what to expect after a diagnosis of Cerebral Palsy.

This information has been compiled from government sources, medical sources, and from consulting with experts on Cerebral Palsy.

Read on to learn more about prognosis and life expectancy for people with Cerebral Palsy.

Prognosis vs Life Expectancy

First, it helps to understand the differences and relation between prognosis and life expectancy.

Prognosis: means the expected course of a disease or disorder.

Life expectancy: means the average period of time that a person may be expected to live.

Generally, a good prognosis will correlate with a standard life expectancy compared to the general population. A bad prognosis may correlate to a diminished life expectancy.

However, while these words are used to describe what medical professionals expect will happen, a prognosis or a life expectancy is never certain. Whether the prognosis is bad or good, careful monitoring and a good treatment plan may help improve a person’s condition.

Prognosis for Cerebral Palsy

Because Cerebral Palsy is a condition that can affect a person in so many ways and because there can be related conditions, the prognosis for someone with CP can vary significantly. Any conversation about the prognosis of a child diagnosed with CP should include a lengthy discussion the factors and any relation conditions that determine the prognosis.

Medical professionals should answer questions and thoroughly explain a good or bad prognosis so that parents have an idea of what to expect. And, although cerebral palsy is a permanent and sometimes life threatening condition, the prognosis can change and improve over time. Early intervention and proper treatment are key to improving a child’s prognosis.

The following approximations were gathered from many studies on the severity and prognosis of CP:

• 50% of children with CP also have an intellectual disability from a related condition
• 75% of children experience pain caused by CP
• 33% cannot walk
• 10% are blind
• 4% are deaf
• 33% have hip displacement issues
• 25% cannot speak
• 25% have seizures or epilepsy
• 25% have poor bladder control
• 25% struggle with behavioral challenges
• 6% have swallowing difficulties and require a feeding tube

Although these conditions are serious, and sometimes life threatening, the American Academy of Pediatrics (AAP) note that early diagnosis and treatment of CP can significantly benefit the prognosis of a child with CP.

Furthermore, although permanent, Cerebral Palsy is not progressive. This is good news, because it means that CP does not get worse over time. As Doctors and scientists have learned more about how to treat CP, the prognosis for children with CP steadily improve.

Life Expectancy with Cerebral Palsy

Thinking about a child’s life expectancy is very difficult. However, the good news is that in many cases of CP, a child can be expected to live a full life compared to the general population.

In cases of moderate to severe CP or when there are other related conditions affecting the prognosis, the child’s life expectancy may be lower. Seizures, trouble eating or breathing, mobility limitations, intellectual impairment, and other factors can all affect a child’s life expectancy. However, careful monitoring and an effective treatment plan can help improve a poor life expectancy.

The average life expectancy in the United States is 78.8 years and most people with mild cases of CP can expect to live to a similar age. However, people with more severe cases of CP have a shortened life expectancy than the general population.

A study published by the National Institutes of Health explains that people exhibiting severe cerebral palsy symptoms that check “all four functional disability categories” have a 50% chance of making it to the age of 13 and a 25% chance of living to celebrate their 30th birthday.

With children, almost 1 in 15 with cerebral palsy experience difficulty with swallowing food and require a feeding tube for consumption. Complications like this can decrease life expectancy because as they adversely affect the quality of life and lead to nutritional difficulties.

Keep in mind, these shortened life expectancy estimates only refer to the most severe cases and many people who suffer from CP do go on to live long, happy lives, even if they need care from family members or professional caregivers.

Early signs of Cerebral Palsy

While symptoms are not immediately present in babies with CP, the neurological disorder becomes apparent during the developmental stage of six to nine months, when the baby is starting to mobilize, and motor developmental delay is more noticeable. Some common signs are:

• Babies with CP do not sit, roll over, walk or crawl when other children of their age start exhibiting the aforementioned developments.
• Birth defects, like spinal curvature or a small head/jawbone, are common along with orthopedic manifestations like irregular posture, motor dysfunction, slight clumsiness, increased muscle tone, dystonia or spasticity.

Challenges of living with Cerebral Palsy

Cerebral Palsy isn’t a degenerative disease that gets worse as a child ages, however that doesn’t mean it isn’t a challenging condition to manage. With many physical impairments, this can take a toll on a person’s body. The most common challenges someone with Cerebral Palsy faces are:

• They have learning disabilities, visual impairments, hearing problems, speech problems, drooling issues, and behavior problems
• They need braces, crutches, or a wheelchair to get around
• They need help to move around in class or reaching objects
• They need assistive devices for writing and speaking
• They have difficulty sitting still and have uncontrolled movements
• They have difficulty with bladder and bowel control and may need to use a bathroom frequently
• They have seizures

Causes of Cerebral Palsy

Muscle control takes place in the upper part of the brain called Cerebrum which is also responsible for communication skills, ability to learn, and memory.

CP occurs when there is damage or abnormal development of the cerebrum during pregnancy (more than 3-quarters of cases), delivery, or within five years of post-partum can be linked to causing CP.

While in several cases, there is no identifiable explanation for CP, usual causes include:

Premature birth:
Premature births are a common cause of CP. In the US 40% to 50% of all children with CP had a premature birth. 75-90% of these cases experienced problems around the time of birth and sometimes, just after birth. As opposed to single-birth infants, multiple-birth infants are more likely to have CP, as they are also susceptible to low birth-weight.

Infection during pregnancy:
The risk of a child developing CP is tripled if the mother contracts an infection during pregnancy, especially the kind not easily detected, like one in the fetal membranes. Rh blood type incompatibility can also be responsible for CP in infants, as the mother’s immune system will end up attacking the red blood cells of the fetus.

Similarity after birth, infections (such as meningitis) contracted by newborns can cause brain damage. Meningitis causes severe inflammation that can damage the motor control centers of the brain.

Birth injury / trauma:
Asphyxiation is a lack of oxygen reaching the brain. It can cause severe brain damage to a baby during birth when an early detachment of the placenta, a ruptured uterus during birth or the umbilical cord getting pinched in a way that restricts blood flow can cause oxygen deprivation and result in brain damage.

Another common cause of CP is blunt trauma to the infant or toddler brain. Head injuries may occur during labor or delivery or within the first several years of life.

Genetics:
Approximately 2% of all Cerebral Palsy cases are inherited and are autosomal recessive in nature. Glutamate decarboxylase-1 is considered one of the possible enzymes responsible for genetically inherited CP.

Prevention of Cerebral Palsy

Since the major causes of CP are diverse in nature, a range of preventative measures have been investigated over the years.

Electronic Fetal Monitoring (EFM)
EFM was extensively used for propping up obstetric litigation, however, as of 2014, many Obstetrician and Gynecologists associations worldwide have acknowledged EFM does not help in the prevention of CP and has no long-term benefits.

Magnesium Sulphate
In expectant mothers at a risk of a premature delivery, magnesium sulphate decreases the chances of CP in newborns. While magnesium sulphate has no adverse effects on infants, mothers receiving the drug are likely to experience respiratory depression and nausea.

Caffeine
Also used for treating apnea of prematurity and lessens CP risk in premature infants, however, there are multiple concerns regarding the long-term negative effects.

Antibiotics
A reasonable amount of evidence has shown that giving antibiotics to women experiencing preterm labor, whose water has not broken increases the risk of CP in the child. On a similar note, letting a preterm birth proceed instead of attempting to delay the birth can have a moderate risk of CP in the child.

Treatment of Cerebral Palsy

While various factors are expected to increase or decrease the projected life expectancy for a child diagnosed with CP, parental involvement and appropriate medical intervention can greatly help alleviate complications or at least make them less pronounced. Quality of care is critical to improved symptoms, comfort, and longevity.

Most of the childhood therapy efforts are directed towards:

• Improvement of gait and walking ability. Almost 60% of CP patients can comfortably walk with or without aids as adults.
• Speech and language therapy, as well. Children with CP experience learning difficulties that can hinder their progress at school, however, with individual attention, these obstacles can be overcome. Furthermore, if the CP patients can effectively communicate with their caregivers, medical professionals, parents, and peers, then their more problems can be more easily understood and solved.
• Assistive devices to CP patients in becoming more autonomous, by allowing them to work on their muscle control and strength. Supported by physical therapy shows them how to function properly within their environment and enhance their motor abilities.
• Surgical intervention in cases of severe Cerebral Palsy.

The goal of all Cerebral Palsy (CP) treatment/management is to encourage independence in CP patients. An individual who can take care of daily tasks, like taking a bath, getting dressed, or preparing a meal, becomes more confident and self-sufficient.

While people with severe CP may not perform these tasks, some CP patients achieve them admirably. Over time, the road to CP management has also moved away from conservative attempts to fix the physical problem, like spasticity in a limb, to making these treatments a part of a bigger goal of maximizing community engagement and independence for a CP patient.

Learn More About Treatment for Cerebral Palsy