What is cerebral palsy?
Cerebral palsy is a description of a range of different disorders, all of which result in motor disability. They are multiple syndromes which are grouped together because they share similar clinical and supportive, allied health services.
Cerebral palsy affects movement and posture, resulting in difficulty with walking, or dependence on walking aids or a wheelchair for mobility. There is instability, lack of motor skills and muscle coordination. Stiff muscles and spasms can lead to painful skeletal deformities and dislocations.
Other symptoms may include total or partial inability to speak, see, hear and/or eat, impaired cognitive ability, and epilepsy.
Around 34,000 Australians have this physical disability.
What causes cerebral palsy?
For the majority of cases, cerebral palsy is linked to events early in pregnancy which disrupt normal brain development.
At this stage, there is no pre-birth test, no known cure and in most cases the exact cause remains unclear.
In previous decades, the medical fraternity had widely believed birth trauma and a lack of oxygen supply during delivery to be the main cause of cerebral palsy, but this is now known to be a rare pathway with most cases born at term most likely having pathways which commenced before labour.
The rates of cerebral palsy remain closely related to how early you are born and whether you have restricted growth in utero, suggesting other causal pathways than just being born early.
And a greater understanding of the pathways into preterm cerebral palsy and how this might be reduced by improvements in neonatal intensive care has meant that the proportion of very preterm infants with cerebral palsy is now falling.
How is cerebral palsy treated?
While cerebral palsy is a lifelong disability, there are many interventions that can help reduce its impact on the body and improve quality of life. These include physiotherapy and occupational therapy, surgery, medication, speech pathology and educational support.
Our research impact
Our researchers have helped unravel the causes of cerebral palsy, relying heavily on data from one of the longest-standing cerebral palsy registers in the world, the WA Cerebral Palsy Register.
This register was started in 1977 to monitor incidence of the condition, enable research into the causes and assist in the planning of services. It recorded cases of cerebral palsy for people born or living in WA from 1956 onwards. And it has now been incorporated into the Western Australian Register of Developmental Anomalies.
Analysis of our register data changed the thinking of what causes cerebral palsy and enabled research focus to shift away from the birth process and into earlier periods of pregnancy. The WA register also influenced national data on the cerebral palsies and good data are now available in almost all states and territories.
Importantly, our researchers used the register data to show that cerebral palsy is not only the result of birth trauma and lack of oxygen supply. They found that greater intervention at birth, such as performing more caesarean sections, was not reducing the birth prevalence of cerebral palsy, as had been anticipated by obstetricians.
Work continues to investigate many possible causal factors, including neuronal migration disorders, genetic syndromes, genetic propensities, teratogens (agents that can cause malformation of an embryo), multiple pregnancy, inflammation, thrombotic disorders, intra-uterine strokes, infections and head trauma after birth.