Cerebral Palsy

Cerebral palsy refers to a group of neurologic disorders that impact a person’s motor skills and cognitive development. It typically presents with stiff muscles (called spasticity), uncontrollable movements (called dyskinesia), and/or poor balance and coordination (called ataxia). The most common form of cerebral palsy is called spastic cerebral palsy, where a person has increased muscle tone, making their muscles and difficult to move. Other types include dyskinetic cerebral palsy, where people cannot control the movement of their hands, arms, feet, legs, mouth, or tongue; ataxic cerebral palsy, where people have issues with balance, coordination, or writing; and mixed cerebral palsy, where people have symptoms of more than one type of cerebral palsy. Unfortunately, a byproduct of a cerebral palsy diagnosis can be significant cognitive delays and impairments.

The severity of a person’s cerebral palsy can range from mild to severe. In a mild case, a person with cerebral palsy may have an awkward walk or mild cognitive delay but may be able to function independently. By contrast, in a severe case, a person may be unable to control his movements, may be bound to a wheelchair, may have profound intellectual disabilities, and may need lifelong care to perform even the most basic tasks. 

Cerebral palsy is caused by the abnormal development of the brain or damage to the developing brain. This typically occurs during pregnancy, during labor and delivery, or after the child’s birth (typically during the first years of the child’s life). A small percentage of cerebral palsy cases occur after birth and are typically associated with an infection or head injury. These cases are called “acquired” cerebral palsy. Most cases of cerebral palsy, however, are congenital (i.e., occurring from birth).

The causes of abnormal development of the brain vary. In some cases, it is unclear why the child developed cerebral palsy. In others, however, the child may have had insufficient blood flow and oxygen to the brain during pregnancy or during labor and delivery, and it can be easier to determine the cause of the child’s cerebral palsy. In these cases, there may be significant warning signs that the baby was not getting adequate blood and oxygen to the brain for a prolonged period of time, and had the medical team delivered the child sooner, the child would not have developed cerebral palsy. If your child was diagnosed with cerebral palsy and the delivery team failed to act in a timely and appropriate manner during labor and delivery, then you may have a medical malpractice claim.

Not all cases of cerebral palsy can be avoided, as some may be due to factors beyond a medical professional’s control. Yet, in some cases, a healthcare provider’s failure to monitor the mother and her baby during pregnancy and labor, and deliver the baby quickly, can cause cerebral palsy. 

A classic warning sign that the child may be at risk for cerebral palsy, or may have already suffered cerebral palsy before birth, is evidence of fetal distress during pregnancy, or during labor and delivery. Signs of fetal distress during pregnancy include:

• Decreased movement by the baby during pregnancy
• Abnormal cramping
• Vaginal bleeding
• Excessive weight gain
• Inadequate weight gain

When a woman goes into labor, there are other signs of fetal distress that must be recognized timely and treated appropriately to avoid the risk of cerebral palsy and other injuries to the baby. Those include:

• Abnormal fetal heart rate
• Abnormal fetal heart rhythm
• Low amniotic fluid levels
• Abnormal biophysical profile (BPP) results
• High maternal blood pressure
• Inappropriate responses of the baby to contractions during labor
• Meconium-stained fluid (thick, greenish-black substance found in the amniotic fluid)

Because of the harm that fetal distress can cause a child, including cerebral palsy, it is important that the medical team recognize these potential signs immediately. Once recognized, the healthcare providers should move to alleviate it and, if it cannot be fixed, promptly deliver the child. If the healthcare team fails to do that, the child can suffer brain damage, including developing cerebral palsy. In that situation, the healthcare team may have committed medical malpractice. Read more.

Diagnosing cerebral palsy can be difficult, especially at a young age, due to the different types and functional levels of people with cerebral palsy. Other potential signs, depending on the age, include:

• A baby’s head lagging when picked up
• A baby feeling stiff
• A baby feeling floppy
• A baby that seems to overextend his back and neck away from the person holding him or her
• A child’s failure to meet a motor or movement milestone (things like rolling over, crawling, sitting, standing, or walking) 
• A child’s inability to bring his or her hands together or to his or her mouth
• A child who reaches out with only one hand while keeping the other in a fist
• A child who crawls in a lopsided manner by using one hand and one leg while dragging the others
• A child who hops on knees and scoots on his buttocks but does not crawl correctly

Many times, these behaviors are not indicative of cerebral palsy. However, because they may indicate that diagnosis, it is important to have a trained medical professional with experience in treating children with cerebral palsy (typically a pediatric neurologist) as part of the treatment team to help make this diagnosis. 

Unfortunately, there is no known cure for cerebral palsy. Nonetheless, there is treatment that can help to improve the lives of a person with cerebral palsy. Because early intervention can help to improve the cerebral palsy patient’s life, early diagnosis and early treatment is important. Treatment may include different medicines, medical procedures, equipment, and therapy (usually physical, occupational, and speech therapy). The healthcare team that assesses your child can make appropriate treatment recommendations, depending on the type and severity of cerebral palsy. There are also various governmental resources available to help families with children with cerebral palsy. 

Even with treatment and resources, the impact of a cerebral palsy diagnosis can be profound. The child with cerebral palsy may be dependent on the family or others for all needs, placing a significant burden on the family. Costs for the care, medication and therapy can be significant, but given the demands of a child with cerebral palsy, it can be difficult for a family to earn an income and provide appropriate and necessary care for their child. 

If your child has been diagnosed with cerebral palsy, and if you believe that you or your baby were not treated appropriately during your pregnancy or labor and delivery, then you should consider speaking with an attorney. Given the complexity of pregnancy and the labor and delivery process, it can be difficult to determine whether a healthcare provider’s medical malpractice caused the child’s cerebral palsy. Having an experienced medical malpractice lawyer who has handled several cases involving significant birth injuries like cerebral palsy is key to making these determinations, as the lawyer has the tools and knowhow to investigate your case, determine whether the medical team should have delivered your child sooner, and whether earlier delivery would have avoided the diagnosis of cerebral palsy. An experienced birth injury lawyer also knows how to get answers from your healthcare team, and can make them pay fair compensation for your and your child’s injuries.

The medical malpractice attorneys at Morris James have handled many complex birth injury cases, including those involving severe cases of cerebral palsy. They are familiar with the issues surrounding cerebral palsy, including the types of care required for the child’s needs, the variety of experts who can support a claim for malpractice, and the hurdles healthcare providers place before families who simply want answers about this devastating condition. Our attorneys know how to fight for your rights and will, if necessary, go to trial to obtain the maximum compensation for your child’s cerebral palsy injury.