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Group of permanent disorders of movement and posture due to non-progressive brain injury or malformation in the developing brain.
Group of permanent disorders of movement and posture due to non-progressive brain injury or malformation in the developing brain.
Risk Factors
Prematurity and low birth weight
Perinatal hypoxia or ischaemia
Infections (e.g. TORCH, meningitis, encephalitis)
Intracranial haemorrhage
Multiple gestation
Neonatal jaundice/kernicterus
Maternal thyroid disease, substance use
Aetiology
Antenatal: most common (e.g. genetic, infection, vascular insult)
Perinatal: birth asphyxia, traumatic delivery
Postnatal: sepsis, stroke, head injury
Pathophysiology
Damage to motor cortex, basal ganglia, cerebellum, or white matter tracts
Static injury → abnormal tone, posture, and motor function
Non-progressive but functional abilities may change with time
Diagnosis
Types
Spastic (most common): hypertonia, UMN signs, hemiplegic/diplegic/quadriplegic
Dyskinetic: involuntary movements, fluctuating tone (basal ganglia damage)
Ataxic: impaired coordination, balance (cerebellar damage)
Mixed: combination of features
Clinical diagnosis
Delayed motor milestones
Persistent primitive reflexes
Abnormal tone/posture
Asymmetry in movement or handedness before 18 months
Differential Diagnosis
Muscular dystrophy
Spinal cord lesions
Neurodegenerative conditions
Metabolic disorders
Investigations
MRI brain – assess injury pattern
Metabolic/genetic testing if diagnosis unclear
Management
Multidisciplinary: physiotherapy, occupational therapy, speech therapy
Spasticity management – oral baclofen, botulinum toxin, selective dorsal rhizotomy
Orthopaedic interventions – tendon release, bracing
Nutritional and feeding support
Antiepileptics for associated epilepsy
Educational and psychosocial support
Complications & Prognosis
Epilepsy (30–50%)
Feeding difficulties and malnutrition
Hip dislocation, scoliosis
Cognitive impairment, behavioural issues
Respiratory infections (aspiration risk)
Severity varies – many have normal intellect and mobility, others require lifelong care
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