Cognitive Impairments Associated with Cerebral Palsy

Cerebral palsy (CP) is a neurological condition that affects movement and posture. Although it is primarily defined as a motor disability, the brain damage that results in cerebral palsy often causes co-occurring conditions such as epilepsy, vision and hearing problems, and cognitive impairments. Read on to learn about the connection between cerebral palsy and cognitive impairments.

Although a variety of environmental and genetic factors can cause cerebral palsy, it is most often the result of brain damage that occurs during or near the time of birth. This could be a hypoxic-ischemic birth injury (caused by a restriction in oxygenated blood flow to the brain) or a traumatic birth injury (in which the brain is damaged due to excessive force). Both types of birth injury can also lead to cognitive impairments.

The short answer to this question is “no – not everyone with cerebral palsy has cognitive impairments.” Many people with cerebral palsy have average or above average cognition. However, 50% of people with cerebral palsy have an intellectual disability. More specifically, about 20% of people with CP have a moderate to severe intellectual disability (1).

People with more profound physical impairments are statistically more likely to have cognitive disabilities as well. The Gross Motor Function Classification System (GMFCS), which is used to group people with cerebral palsy into five levels based on their physical abilities, can also predict intellectual function. Children with higher GMFCS levels (indicative of more severe physical symptoms) are more likely to have cognitive impairments. This is especially true of children with the following characteristics:

• Those who are unable to walk
• Those who begin walking later
• Those who have epilepsy
• Those who have hypotonic, dyskinetic, or quadriplegic cerebral palsy (2)

However, it is important to note that this is a general trend, not a rule. Some people with cerebral palsy experience serious physical symptoms (which may include problems with movement, speech, swallowing, etc), but their cognition is unaffected. Conversely, some people with cerebral palsy only have mild physical symptoms, but still have an intellectual disability.

Yes. For many years, it was believed that the primary outcome of hypoxic-ischemic brain damage was cerebral palsy. However, it is now well accepted that oxygen deprivation can also influence areas of the brain that are important for memory and attention, such as the hippocampus and the striatum, without resulting in cerebral palsy. Newborns who have hypoxic-ischemic brain damage are at higher risk of developing subtle or more severe cognitive deficits even in the absence of cerebral palsy.

If you suspect that your child has an intellectual disability that resulted from a preventable or mismanaged birth injury, you may want to consider pursuing legal action. The attorneys at ABC Law Centers: Birth Injury Lawyers focus exclusively on medical malpractice that occurs during pregnancy, birth, or early infancy. We also work closely with an in-house medical team, which enables us to delve deeper into complex medical issues.

1. Cerebral Palsy Alliance Research Foundation. (n.d.). Other Impairments. Retrieved September 21, 2018, from https://research.cerebralpalsy.org.au/what-is-cerebral-palsy/what-other-issues-are-associated-with-cerebral-palsy/
2. Dalvand, H., Dehghan, L., Hadian, M. R., Feizy, A., & Hosseini, S. A. (2012). Relationship between gross motor and intellectual function in children with cerebral palsy: a cross-sectional study. Archives of physical medicine and rehabilitation, 93(3), 480-484.
3. Hayes, B. C., Doherty, E., Grehan, A., Madigan, C., McGarvey, C., Mulvany, S., … & King, M. D. (2018). Neurodevelopmental outcome in survivors of hypoxic ischemic encephalopathy without cerebral palsy. European journal of pediatrics, 177(1), 19-32.