Cerebral Palsy Prognosis

By Dr Ananya Mandal, MD

Children with mild forms of cerebral palsy have a normal life expectancy. For example, a two year-old child with mild palsy has a 99% chance of living to the age of 20, compared with a patient who has severe disease, where the figure may be as low as 40%.

If a child is able to sit up unaided at the age of 2, they will eventually be able to walk. If the child is incapable of sitting upright by the age of 4, there little chance that he or she may walk.

Children with impairment of movement of all four limbs (quadriplegia), severe epilepsy, severe mental retardation and other medical complications like reflux and pulmonary disease have a worse outcome.

Making a prediction of outcome

It is difficult to make predictions about prognosis in a child with cerebral palsy before the age of two. The only helping factor is that the disease is non-progressive and usually does not worsen. Children are continually developing both physically and mentally and this can make an accurate prediction of prognosis difficult. There are several tests and evaluations that help in predicting the outcome.

Prognostic information may be gathered using numerous ways. By imaging of the brain and nerves doctors may arrive at a predicted outcome. This is called prognosis based on neuroimaging. Neuroimaging is often combined with clinical evaluation and assessment. The child’s final physical and mental abilities, intellectual disabilities help in predicting the outcome and life expectance of the condition.

Cerebral palsy is not a worsening or degenerative condition but there is no cure for the condition. The children as well as the parents will have to come to terms with living with the condition despite its permanent and irreversible nature.

Life expectancy

Most children with cerebral palsy can live long, happy and quite normal lives. They may need regular visits to the health care professionals and require therapy or medications, and perhaps surgery at times.

Children with cerebral palsy may be offered special education assistance and require assistive technology devices and services to cope with physical impairments. These generally do not affect the life span of the child. Properly managing a child’s health status may help in optimizing life span according to studies.

In severe conditions, as well as improper management of the condition, life span may be shortened. Associated problems with cerebral palsy include mental retardation, feeding difficulties, seizures, vision impairment, and hearing impairment. These may severely affect life span and quality of life.

Factors that affect life span

Factors that affect the life span of a child with cerebral palsy include:

  • key disabilities and the number of impairments
  • level of severity of impairments
  • level of restricted mobility
  • severity of feeding difficulties
  • presence of seizures
  • vision problems
  • intellectual capabilities and severity of mental retardation
  • respiratory functions

Improving quality of life and increasing life span

To improve the quality of life as well as increase life span in a child with cerebral palsy certain goals need to be adopted. These include:

  • improving mobility
  • improving and maximizing independence in daily activities and fostering self care
  • controlling pain
  • improving social and peer associations and interactions
  • improve speech skills and communication
  • treating associated conditions like epilepsy
  • treating complications associated with cerebral palsy
  • improving feeding abilities and nutrient intake
  • improving learning potential
  • improve quality of life

Reviewed by April Cashin-Garbutt, BA Hons (Cantab)

Sources

  1. http://www.cdc.gov/ncbddd/cp/data.html
  2. http://www.disabledlawyering.org/what-is-the-prognosis-for-the-child-with-cerebral-palsy.html
  3. http://cerebralpalsy.org/about-cerebral-palsy/life-expectancy-of-cerebral-palsy/
  4. http://www.nhs.uk/conditions/Cerebral-palsy/Pages/Introduction.aspx
  5. http://www.bbc.co.uk/health/physical_health/conditions/cerebralpalsy1.shtml
  6. http://www.patient.co.uk/doctor/cerebral-palsy.htm
  7. http://pediatrics.uchicago.edu/chiefs/ClinicCurriculum/documents/RomantsevaCP.pdf

Further Reading

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