Introduction
In the 1860s, an English surgeon named William Little wrote the first medical descriptions of a puzzling disorder that struck children in the first years of life, causing stiff, Spastic muscles in their legs and, to a lesser degree, in their arms. These children had difficulty grasping objects, crawling, and walking. Unlike most other diseases that affect the brain, this condition didn’t get worse as the children grew older. Instead, their disabilities stayed relatively the same.

The disorder, which was called Little's disease for many years, is now known as spastic diplegia. It is one of a group of disorders that affect the control of movement and are gathered under the umbrella term of “Cerebral Palsy.”

Because it seemed that many of Little’s patients were born following premature or complicated deliveries, the doctor suggested their condition was the result of oxygen deprivation during birth, which damaged sensitive brain tissues controlling movement. But in 1897, the famous Psychiatrist Sigmund Freud disagreed. Noting that children with Cerebral Palsy often had other neurological problems such as mental retardation, visual disturbances, and seizures, Freud suggested that the disorder might have roots earlier in life, during the brain's development in the womb. "Difficult birth, in certain cases," he wrote, "is merely a symptom of deeper effects that influence the development of the Fetus."

In spite of Freud’s observation, for many decades the belief that birth complications caused most cases of cerebral palsy was widespread among physicians, families, and even medical researchers. In the 1980s, however, scientists funded by the National Institute of Neurological Disorders and Stroke (NINDS) analyzed extensive data from more than 35,000 newborns and their mothers, and discovered that complications during birth and labor accounted for only a fraction of the infants born with cerebral palsy — probably less than 10 percent. In most cases, they could find no single, obvious cause.

This finding challenged the accepted medical theory about the cause of cerebral palsy. It also stimulated researchers to search for other factors before, during, and after birth that were associated with the disorder.

Advances in imaging technology, such as Magnetic resonance imaging (MRI), have given researchers a way to look into the brains of infants and children with cerebral palsy and discover unique structural malformations and areas of damage. Basic science studies have identified Genetic mutations and deletions associated with the abnormal development of the fetal brain. These discoveries offer provocative clues about what could be going wrong during brain development to cause the abnormalities that lead to cerebral palsy.

Much of this new understanding about what causes cerebral palsy is the result of research spanning the past two decades that has been sponsored by the NINDS, the federal government’s leading supporter of neurological research. These findings have:

• identified new causes and risk factors for cerebral palsy;
• increased our understanding of how and why brain damage at critical stages of fetal development causes cerebral palsy;
• refined surgical techniques to correct abnormalities in muscle and bone;
• discovered new drugs to control stiff and spastic muscles and developed more precise methods to deliver them; and
• tested the effectiveness of therapies used to treat cerebral palsy to discover which methods work best.
  

What is Cerebral Palsy?
Doctors use the term cerebral palsy to refer to any one of a number of neurological disorders that appear in infancy or early childhood and permanently affect body movement and muscle coordination but aren’t progressive, in other words, they don’t get worse over time. The term cerebral refers to the two halves or hemispheres of the brain, in this case to the motor area of the brain’s outer layer (called the cerebral Cortex), the part of the brain that directs muscle movement; palsy refers to the loss or impairment of motor function.

Even though cerebral palsy affects muscle movement, it isn’t caused by problems in the muscles or nerves. It is caused by abnormalities inside the brain that disrupt the brain’s ability to control movement and posture.

In some cases of cerebral palsy, the cerebral motor cortex hasn’t developed normally during fetal growth. In others, the damage is a result of injury to the brain either before, during, or after birth. In either case, the damage is not repairable and the disabilities that result are permanent.

Children with cerebral palsy exhibit a wide variety of symptoms, including:

• lack of muscle coordination when performing voluntary movements (Ataxia);
• stiff or tight muscles and exaggerated reflexes (spasticity);
• walking with one foot or leg dragging;
• walking on the toes, a crouched gait, or a “scissored” gait;
• variations in muscle tone, either too stiff or too floppy;
• excessive drooling or difficulties swallowing or speaking;
• shaking (Tremor) or random involuntary movements;
• difficulty with precise motions, such as writing or buttoning a shirt.

The symptoms of cerebral palsy differ in type and severity from one person to the next, and may even change in an individual over time. Some people with cerebral palsy also have other medical disorders, including mental retardation, seizures, impaired vision or hearing, and abnormal physical sensations or perceptions.

Cerebral palsy doesn’t always cause profound disabilities. While one child with severe cerebral palsy might be unable to walk and need extensive, lifelong care, another with mild cerebral palsy might be only slightly awkward and require no special assistance.

Cerebral palsy isn’t a disease. It isn’t contagious and it can’t be passed from one generation to the next. There is no cure for cerebral palsy, but supportive treatments, medications, and surgery can help many individuals improve their motor skills and ability to communicate with the world.