Read our summary of the latest update on cerebral palsy guidance issued by the National Institute for Health and Care Excellence, which covers diagnosis, assessment and management for those aged up to 25.
Read our summary of the latest update on cerebral palsy guidance issued by the National Institute for Health and Care Excellence, which covers diagnosis, assessment and management for those aged up to 25
Cerebral palsy is an umbrella term for a group of permanent and non-progressive abnormalities of the fetal or neonatal brain, primarily leading to disorders of movement and posture. According to the National Institute for Health and Care Excellence (NICE), it is the most common cause of physical disability in children and young people in the developed world. Action Cerebral Palsy says about one in 400 UK births is affected, with an estimated 30,000 individuals having the condition.
In October, NICE published a new quality standard on cerebral palsy that covers diagnosis, assessment and management for those aged up to 25. It follows guidance published in January. Four standards look at follow-up for children at risk, referral for children with delayed milestones, information for parents and carers, and personal information folders to help patients and their families make informed decisions about care.
Signs and symptoms
The signs of cerebral palsy are not usually apparent at birth, with symptoms becoming noticeable during the first three years of life. Severity can range from minor difficulties to severe disability. Symptoms include delays in reaching developmental milestones, such as not sitting by eight months or not walking by 18 months, seeming too stiff or too floppy, weak arms or legs, fidgety, jerky, clumsy or uncontrolled movements, and walking on tip-toes. There may also be epileptic fits and difficulties with swallowing, speaking, vision and learning.
Causes and risk factors
While in many cases the exact cause is unclear, it can include bleeding in the infant’s brain or reduced blood and oxygen supply, an infection caught by the mother during pregnancy, the brain temporarily not getting enough oxygen during a difficult birth, meningitis, or a serious head injury.
How you can help your patient
Nurses can play a key role in helping to provide information for patients and families. This can help to improve the condition’s management, reduce the chance of complications, and lessen anxiety linked to diagnosis.
Liz Keenan, lead clinical nurse specialist for spasticity management at the National Hospital for Neurology and Neurosurgery, part of University College London Hospitals NHS Foundation Trust
‘These NICE quality standards have particularly drawn attention to early diagnosis – a crucial issue. This will raise awareness, getting people to focus on children at much earlier stages, and making sure there is clinical or developmental follow-up, rather than waiting for it to be picked up much later.
‘When you look at the statistics for cerebral palsy, it’s clear that it’s an area we need to be more aware about. The guidance highlights things that could be introduced from a child developmental point of view to help nurses raise concerns as early as possible.
‘Nurses are pivotal in seeing that there might be some motor milestones that a child may not be reaching with their movement. Nurses can highlight any issues, navigating families to the correct pathway, so the child can be monitored.’
Find out more
- NICE Cerebral palsy in children and young people (NICE, 2017)
- Cerebral palsy in under 25s: assessment and management (NICE, 2017)
- Action Cerebral Palsy
- Cerebral Palsy
- Improving transition for young people with cerebral palsy (Nursing Children and Young People, 2016)
- The impact of intellectual impairment on the quality of life of children with cerebral palsy (Nursing Children and Young People, 2010)