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Cerebral Palsy

GMJ News knowledge hub · last reviewed August 2026 · Georgian Medical Journal

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Cerebral palsy (CP) — a group of permanent, non-progressive disorders of movement and posture caused by damage to the developing brain before, during or shortly after birth — is the most common childhood physical disability, affecting approximately 17 million people globally (approximately 2-3 per 1,000 live births), with perinatal asphyxia, preterm birth, infection and genetic factors among the leading causes (WHO). CP manifestations span a vast spectrum — from mild motor impairment to complete dependence — and are frequently accompanied by epilepsy, intellectual disability, communication difficulties, pain and mental health challenges. Early intensive intervention (physiotherapy, botulinum toxin for spasticity, orthotic support, augmentative communication) substantially improves functional outcomes.

Key messages

17 million people — most common childhood physical disability
Cerebral palsy is the most common childhood physical disability globally — affecting approximately 17 million people (approximately 2-3 per 1,000 live births), caused by damage to the developing brain before, during or shortly after birth (WHO).
Not one disease — a spectrum
CP is a heterogeneous condition — ranging from mild motor impairment to complete physical dependence. Spastic CP (increased muscle tone) accounts for approximately 80%; dyskinetic/athetoid CP (involuntary movements) approximately 15%; ataxic CP approximately 5%.
Perinatal asphyxia remains the leading cause
Perinatal hypoxic-ischaemic encephalopathy (HIE) — brain injury from oxygen deprivation at birth — remains the single most common cause of CP in LMICs. Prevention of birth asphyxia (skilled birth attendance, emergency obstetric care) is the primary preventive intervention.
Botulinum toxin for spasticity
Intramuscular botulinum toxin (botox) injections — temporarily reducing spasticity in overactive muscles — are among the most evidence-based and widely used interventions for managing CP-related spasticity, improving function and preventing contracture development.
Early intervention is critical
Intensive early intervention (intensive physiotherapy, occupational therapy, constraint-induced movement therapy, early communication support) during the period of neuroplasticity (approximately 0-3 years) substantially improves functional outcomes.
Magnesium sulfate prevents CP
Antenatal magnesium sulfate (given to women with imminent preterm birth before 32-34 weeks) reduces the risk of cerebral palsy in the surviving infant by approximately 30% — one of the most impactful interventions for CP prevention.

Key statistics

~17M
people living with CP globally
WHO
2-3/1K
live births affected (range 1.5-4 per 1,000)
WHO
~80%
of CP is spastic type
WHO/SCPE
30%
CP risk reduction with antenatal magnesium sulfate
Cochrane/WHO
3x
higher CP rates in LMICs vs HICs
WHO
50%
of CP children have epilepsy
WHO

Cerebral palsy types by distribution — WHO/SCPE (Surveillance of CP in Europe)

Source: SCPE. Spastic bilateral CP is most common; dyskinetic and ataxic forms are rarer.

Glossary of key terms

Cerebral palsy (CP)
WHO/SCPEA group of permanent disorders of movement and posture — caused by non-progressive disturbances in the developing fetal or infant brain. CP is not a single diagnosis but a clinical description. The brain damage is non-progressive (the damage itself does not worsen), but the functional manifestations change with growth and development.
Hypoxic-ischaemic encephalopathy (HIE)
WHOBrain injury caused by oxygen deprivation and reduced blood flow during or around the time of birth — the most common cause of CP in LMICs. Severity: mild (normal outcome), moderate (significant CP/intellectual disability risk), severe (very high mortality/morbidity). Treated with therapeutic hypothermia (cooling) in HICs — reducing CP risk by approximately 30%.
Spasticity
WHO/ClinicalVelocity-dependent increase in muscle tone — a hallmark of spastic CP. Overactivity of stretch reflexes causes resistance to passive movement, muscle co-contraction, and over time — progressive joint contractures and bony deformities. Managed with physiotherapy, stretching, orthoses, botulinum toxin, oral medications (baclofen, diazepam, dantrolene), intrathecal baclofen, and orthopedic surgery.
Botulinum toxin (BoNT) for CP
WHO/AAPIntramuscular injection of botulinum toxin A (Botox/Dysport) — temporarily blocks neuromuscular transmission in overactive (spastic) muscles, reducing tone for 3-4 months. Used for targeted focal spasticity affecting gait, hand function or hygiene. Among the most evidence-based CP interventions.
Gross Motor Function Classification System (GMFCS)
WHO/SCPEA 5-level system classifying CP severity by functional mobility: Level I (walks without restrictions); Level II (walks with limitations); Level III (walks using handheld mobility device); Level IV (self-mobility limited, uses power wheelchair); Level V (transported in manual wheelchair). Essential for prognosis and communication.
Constraint-induced movement therapy (CIMT)
WHO/ResearchA rehabilitation approach for hemiplegic CP — constraining the stronger arm to encourage intensive use of the weaker arm. Evidence shows significant improvements in hand function when applied intensively during the early years of neuroplasticity.

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