Center for Cerebral Palsy

The Cerebral Palsy Center at UCLA and Luskin Orthopedic Institute for Children (LuskinOIC) strives to enhance physical abilities and independence for children with cerebral palsy. Our interdisciplinary team of medical experts is committed to addressing this complex, multifaceted neurological disorder by emphasizing early diagnosis, comprehensive care, and individualized treatment.

Signs and Symptom

Cerebral palsy is the most common childhood physical disability in the United States and throughout the world. There is not a single cause for cerebral palsy, and it is not caused by any specific genetic problem. It is a group of disorders affecting posture, strength and movement that occur as a result of an injury that occurs in the developing brain, typically around the time of birth.

Each child with cerebral palsy is unique, but symptoms may include:

• Abnormal muscle tone (too much or too little) Learn More
• Exaggerated reflexes
• Gastrointestinal and nutritional problems
• Impaired motor control
• Muscle spasms Learn More
• Poor balance
• Seizures
• Stiff muscles
• Vision and perception problems
• Weakness

Treatment and Recovery

The goal of treatment for children with cerebral palsy is to improve limitations and prevent complications — requiring a coordinated multidisciplinary team of specialists during your child’s growing years. 

A treatment plan may include:

• Therapy. Physical and occupational therapy are important parts of early intervention for children with cerebral palsy and may be a part of your child’s ongoing treatment for many years. 
• Surgical Preparedness Program. The Center for Cerebral Palsy developed a surgical preparedness program to reduce anxiety in patients and improve outcomes.
• Orthopedic Surgery. Many children and adolescents with cerebral palsy require surgery to improve joint mobility, walking efficiency, spinal alignment, and hip position. 
• Spasticity Management. Spasticity is the most common symptom of cerebral palsy. Spasticity management treatment options can increase ease of movement and decrease unwanted muscle activity in children. These treatments include neurotoxin injections (Botox and Dysport), Intrathecal Baclofen pump (delivers medicine directly into the fluid around the spinal cord), and selective posterior rhizotomy (a neurosurgical procedure to eliminate spastic reflexes, which we provide in consultation with our neurosurgery colleagues at UCLA).
• Deep Brain Stimulation. A small percentage of children with cerebral palsy have involuntary movement disorders called dystonia or choreoathetosis. Deep brain stimulation, or DBS, has been found effective in treating these disorders. DBS is often described as a “brain pacemaker” which uses strategically-placed electrodes to send pulses to the brain to correct the abnormal activity and ease symptoms. The orthopedic surgeons at LuskinOIC work closely with the pediatric neurosurgeons at UCLA, who have the expertise to perform these treatments, which can result in a better quality of life for your child and your family.

Common Types

Cerebral palsy can be classified into different types by identifying which limbs are involved, the motor dysfunction experienced by the child, and the child’s capacity for independent mobility.

Limb Involvement

Limb involvement can be broadly classified as bilateral cerebral palsy, meaning both sides of the body are involved or unilateral, meaning only 1 side of the body is involved. Some terms that are commonly used are:

• Quadriplegia. All 4 limbs are affected or have an impaired ability to move.
• Diplegia. The lower limbs (legs) are significantly more affected than the arms.
• Hemiplegia. Only 1 side of the body’s limbs are affected. This may also be referred to as unilateral cerebral palsy. Often, the arm is more affected than the leg.
• Triplegia. 3 limbs are affected. Usually both legs and one arm are affected.
• Monoplegia. 1 limb is affected. This is the least common type of cerebral palsy.
• Total body involvement. This term is used to describe a person who, in addition to the involvement of 4 limbs, has impairments in speech, vision or cognitive function.

Movement Disorder

This classification of cerebral palsy is described by the most prevalent movement disorder. In many cases, children with cerebral palsy will have more than 1 movement disorder present. 

Some of the common movement disorders include:

• Spasticity. The most common movement disorder in cerebral palsy, kids with spastic cerebral palsy have muscles that tighten or stiffen and prevents normal fluid movement. Spasticity is high muscle tone, which is worse when a patient is trying to move quickly as opposed to slowly. Moderate or severe spasticity may hinder movement and function and can make muscles and joints tight, leading to contractures. 
• Abnormal muscle tone. Muscle tone – or how “tight” muscles are – may be higher or lower than normal.
• Rigidity. Muscles that have rigidity feel heavy and like “a lead pipe” when they are moved passively regardless of how quick or slow the muscle is moving. Rigidity is found in cases of prematurity or near drowning.
• Hypotonia. Hypotonia is low muscle tone. These muscles are often described as loose or “floppy.” 
• Involuntary movements: Abnormal involuntary movement is caused by damage to the coordination centers of the developing brain and is referred to as dyskinesia.
• Dystonia. Involuntary, sustained, or intermittent muscle contractions that cause twisting and repetitive movements, abnormal postures or both.
• Athetosis. Slow, involuntary writhing movement of face and extremities.
• Chorea. Brief, irregular jerking movements that most commonly begin in the shoulders, neck, trunk and face.

Motor Function

One way to classify cerebral palsy is by examining a child’s capacity for independent mobility (e.g., walking and sitting). 

The most common classification for mobility is the Gross Motor Function Classification System (GMFCS), and it is divided into 5 levels, I-V, of independent ability based on normal motor milestones – walking, jumping, climbing stairs, etc. The higher the level of GMFCS, the more affected the child and the less independent mobility they have. 

GMFCS helps doctors and families understand a child’s current and future motor function, their relative risk for associated problems like scoliosis and hip dislocations, and what equipment, therapy, or surgery they might need in the future.

Our Experts in Cerebral Palsy

Timothy Schaub, MD

Soroush Baghdadi, MD