Condition	Complications	Care
Abnormal neurologic control	Lack selective control of muscle activity and anticipatory regulation	Caregivers and patients should protect the joints and related soft tissues during movement, including avoidance of head injury.
Abnormal sensation and perception	Some children have impaired sensations to touch and pain with or without astereognosis.	Mittens may be needed during teething to prevent damage to fingers and hands.
Gastrointestinal problems (e.g., vomiting, constipation, or bowel obstruction)	Caused by delayed gastric emptying, abnormal autonomic control of gastrointestinal mobility, immobilization, inadequate oral intake, and prolonged colonic transit	Use stool softeners with narcotic pain medications. Perform bowel hygiene.
		Increase fluids and fiber with or without laxatives.
Hearing and vision abnormalities	Children may present with strabismus or hemianopia.	Screen early and periodically.
	Visual defects occur in 25 to 39 percent of adult patients.
	Eight to 18 percent of adults with cerebral palsy have hearing problems.
Impaired oral-motor functions	Can cause hypoxemia, temporomandibular joint contractures, vomiting, and aspiration pneumonia associated with gastroesophageal reflux, poor nutrition, failure to thrive, drooling, and communication difficulties	For feeding difficulties, use special diets, positioning, new feeding techniques, gastrostomy, or nasogastric tube feeding.*
		Medications, surgery, and biofeedback have been used to control drooling.
		Speech therapy and the use of computer voice synthesizers can help impaired communication.
Markedly reduced bone mass in nonambulatory adults and children	Can cause osteopenia, osteoporosis, fracture, scoliosis, or pain	Assess clinical conditions by physical examination and radiographic studies.
		Use medications, vitamins, and mineral supplementation to reduce bone loss.
		Encourage exercise.
		Ask about or use instruments to qualify and monitor pain.
		Adequately treat pain.
Mental health	Cognitive impairment is present in two thirds of patients with cerebral palsy.Neurosis and psychosis also can occur.	Encourage functionality and independence with living accommodations, transportation, exercise, mechanical aids, or employment opportunities.
		Provide counseling for emotional and psychological challenges.
		Monitor for needed medications.
Seizures	One half of children with cerebral palsy demonstrate seizure activity.	Monitor and control with medication.
Spasticity and contractures	Spasticity prevents the stretching of muscles and tendons. Consequently, they do not grow at the same rate as lengthening bones, forming contractures and difficulty with ambulation and fine- or gross-motor movements. Pain is created by hip dislocations, repetitive use syndromes, and degenerative joint disease.	Prevent with physical therapy with or without orthotic devices.
		Treat with drugs, surgery, or cerebral stimulation.
		Assess clinical condition by physical examination and radiographic studies.
		Ask or use instruments to qualify and monitor pain.
		Adequately treat the pain.
Urinary incontinence	Caused by impaired control of bladder muscles	Special exercises
		Biofeedback
		Prescription medications
		Surgery
		Surgically implanted devices to replace or aid muscles
		Specially designed undergarments