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Cerebral palsy

Cerebral palsy

Cerebral palsy (encephalopathy) is a condition affecting muscle tone, movement and coordination. It is the most common disability that occurs before, during or immediately after the birth of children and is related to a lack of oxygen to the brain. Shriners Hospitals for Children is considered a leader in treating the orthopaedic effects of cerebral palsy and it is one of the more commonly treated conditions at the St. Louis Shriners Hospital.

There are three main types of cerebral palsy (CP):

  • Ataxic – This type causes a disturbance in balance and depth perception.
  • Athetoid – This type leads to involuntary and uncontrolled movements.
  • Spastic – The most common type of cerebral palsy, which causes stiffness and movement difficulties.

Within each main type, there are several more specific diagnoses indicating a more specific area of neurological impairment, such as spastic hemiplegia, spastic diplegia, etc.

Cerebral palsy symptoms

Children with cerebral palsy can exhibit a wide range of symptoms, from mild to severe. Some typical indicators of cerebral palsy may include:

  • Abnormal muscle tone
  • Poorly coordinated movements
  • Persisting infant reflexes still present at an age when they should disappear
  • Involuntary movements
  • Tight or spastic muscles
  • Excessive drooling or difficulties speaking, sucking or swallowing
  • Difficulty engaging in precise motions, like writing or buttoning a shirt

Treatment options for cerebral palsy include:

  • Therapy: The most important part of any therapy program is the daily stretching exercises that the therapists have set up. Therapy is provided after surgery or to meet specific goals.
  • Occupational therapy may improve the development of the small muscles of the body such as the face, feet, fingers, hands and toes, in order to improve daily living skills and other activities.
  • Physical therapists work with the muscles of the abdomen, arms and legs to improve a variety of skills, including balance, walking, standing, using the stairs and transferring.
  • Orthotics (braces): Braces are used to:
    • Help muscle growth keep up with bone growth
    • Prevent foot and knee damage
    • Help support weak muscles
    • Protect the muscles after surgery
  • Medications may be prescribed to control or prevent seizures and/or to reduce spasticity, which can impact movement and motor skills.
  • Mobility aids such as crutches, a walker or a wheelchair may be necessary.
  • Serial casting: Casting is used to help stretch muscles that have gotten so tight that exercises and bracing do not help. When the muscle is stretched enough, the cast is removed and your child must wear a brace.
  • Botulinum toxin A injection: Botulinum toxin A can be used to reduce spasticity.
  • Surgery may be required to reduce spasticity in legs and improve muscle development.
  • Orthopaedic surgery may be required to take care of contractures in bone deformity.