Cerebral palsy in under 25s: assessment and management

Excerpt

Recognition of clinical risk and management for people with cerebral palsy changes throughout their lives. Understanding the aetiology of the condition, and so minimising the risk and early impact on the brain, may directly affect lifelong outcomes. Throughout growth and development, the assessment and management of complex comorbidities can change the trajectory of patient pathways. With increased longevity, there are now probably at least 3 times as many adults as children with cerebral palsy and as such it presents a considerable challenge for health and social services in the 21st century.

The management of cerebral palsy is a two-pronged approach, and is provided by a variety of multidisciplinary services with a focus on maximising individual function, choice and independence. The first of these is optimising movement and posture for optimal activity and participation while minimising potential secondary musculoskeletal deformity. The second is recognising and intervening to address the many developmental and clinical comorbidities that are associated with cerebral palsy. The former is dealt with by the NICE guideline Spasticity in under 19s, which concentrates on the motor disorder of cerebral palsy.

This guideline focuses on the second of these aspects, particularly where there may be variation in practice and in patient and family experience across England and Wales. It looks at practical areas of management that are important to children and young people with cerebral palsy, their families and carers, and a wide variety of healthcare and other professionals; these include causation, recognition and prognosis, as well as the associated developmental and clinical comorbidities.