Cerebral palsy ("CP") is a group of disorders appearing in childhood in which the brain is not able to properly control muscle movement, balance and posture. CP is frequently caused when the brain is damaged during childbirth but it can also result from brain damage or development issues after birth. CP primarily causes physical movement disabilities but it can also cause intellectual disabilities. Individual cases of cerebral palsy can range from mild to very severe.
There are several different types of cerebral palsy: (1) spastic; (2) dyskinetic; and (3) hypotonic.
- Spastic Cerebral Palsy: with spastic CP muscles become excessive rigid and stiff, particularly in the arms and legs. This excessive rigidity makes it difficult to move and control the affected extremities. Sometimes spastic CP only affects one side of the body (hemiparesis). In more serve cases of spastic CP, the disability occurs on both sides of the body resulting in disability in all 4 limbs (quadriparesis). With both subtypes, the degree of spasticity can range from mild to very severe. Spastic CP is the most common subtype of cerebral palsy.
- Dyskinetic Cerebral Palsy: Children with the dyskinetic form of cerebral palsy suffer from sudden abnormal muscle movements that are involuntary. The involuntary movements of often occur when the child attempts to move.
- Hypotonic Cerebral Palsy: The term hypotonia refers to the absence of muscle tone. Children with hypotonic cerebral palsy have little or no muscle tone and a floppy, rag-doll appearance. This can be the most disabling type of cerebral palsy.
Cerebral palsy is not a life-threatening condition but it can sometimes result in a shorter life expectancy. Life expectancy refers to the average anticipated survival time of an individual with a certain condition. The life expectancy of children with cerebral palsy differs significantly depending on what type of cerebral palsy they have and the general severity of their CP. Life expectancy for children with CP is also dependent on what other co-existing medical conditions they may have.
The most powerful prognostic factors for survival have historically been mobility and feeding skills. Children with these skills consistently reach adulthood.
Life expectancy in litigation refers to the expected survival time of the victim, i.e., how long she is expected to live. For example, the life expectancy of a 52-year-old adult in the United States is 84 years of age. This, of course, is not a prediction for how long the person will live. It is an estimated average. For children with cerebral palsy, medical experts often provide opinions as to how long they believe the child will live given all of the relevant factors.
If your child's cerebral palsy resulted from medical negligence during childbirth or pregnancy, you may eventually be a plaintiff in a medical malpractice lawsuit. In a malpractice case, life expectancy is used to calculate the amount of monetary damages that you might be entitled to recover with respect to life care planning and determining long-term medical and other costs.
Obviously, no one can predict an exact life span for any of us. But there is a statistical and actuarial basis to sensibly estimate life expectancy for a child with cerebral palsy. There are a number of epidemiological studies, which you can find at the end of this article, that can assist with this process.
Practically, the litigation result is the perverse situation where the defense attorneys in a birth injury case are arguing that the damages awarded should be less because the harm done to the child is less because the child will die young because of the negligence caused by their clients. It is awful but defense lawyers do not hesitate to make this argument.
There is no question that severe cerebral palsy comes with a lower life expectancy. But some of these studies seem litigation driven. Mortality rates in cerebral palsy patients have fallen over the last fifty years. Some of the published studies -- which you cannot help but wonder if they were written for litigation --- were clearly unduly pessimistic.
How do our experts in litigation determine life expectancy in a child with a birth injury? Our experts make life span projections based on a comprehensive evaluation of the patient, the child's age, prognosis, medical history, the general state of health to date, the level of family support (which is a big deal) and the medical, surgical, and therapeutic interventions anticipated to support the child's life.
Children with comparatively mild to moderate cases of cerebral palsy can be expected to live much longer than those with severe CP cases. In fact, children with mild cases of cerebral palsy have expected lifespans that are very similar to the general population.
Thankfully, cerebral palsy is not a progressive condition. CP is caused by a one-time injury to the brain that does not get worse over time. However, there are a number of secondary health conditions associated with CP that can be progressive and have an impact on long-term life expectancy. Common examples include seizures, feeding difficulties, vision & hearing impairment, and intellectual disabilities.
So for example, if a child with cerebral palsy has difficulty chewing and swallowing their food and this condition worsens over time, they may have an increased risk of choking or aspirating and then getting sick which will lower life expectancy. However, these types of progressive secondary health conditions are typically associated with more severe cases of cerebral palsy. Children with moderate or mild CP can also have secondary health issues, but nothing that would actually decrease life expectancy.Getting a Cerebral Palsy Lawyer
Many cases of cerebral palsy are the result of medical malpractice during childbirth or pregnancy. The birth injury lawyers at Miller & Zois regularly handle cerebral palsy cases. We have the expertise and experience necessary to investigate your case and tell you whether you have a valid malpractice claim. Call us at 1.800.553.8082 or submit a request for a free consultation.Medical Literature on Cerebral Palsy Life Expectancy
- Nelson KE, et. al (2019). Survival and health care use after feeding tube placement in children with neurologic impairment. Pediatrics, 2019 Jan 24.[Almost half of the patients in this study had cerebral palsy.]
- Brooks JC, et. al: Recent trends in cerebral palsy survival. Part I: period and cohort effects. Developmental Medicine & Child Neurology 2014.
- Brooks JC, Strauss DJ, et. al: Recent trends in cerebral palsy survival. Part II: individual survival prognosis. Developmental Medicine & Child Neurology 2014.
- Strauss DJ, Rosenbloom L, Shavelle RM, Brooks JC (2012). Improved survival in cerebral palsy in recent decades? Developmental Medicine & Child Neurology, 54:867. DOI: 10.1111/j.1469-8749.2012.04349.x. Epub 2012 Jul 19
- Eyman, R. K., et. al: (1990). Life expectancy of profoundly handicapped people with mental retardation, New England Journal of Medicine, 323, 584-589.
- Hutton JL: Cerebral Palsy life expectancy. Clinics in Perinatology 2006; 33:545-555.
- Hutton JL, Pharoah POD: Life Expectancy in severe cerebral palsy. Archives of Diseases in Children 2006; 91:254-258. [This is study commonly cited by defense experts that suggests a median life expectancy of 12 years for children with cerebral palsy that have severe motor, cognitive, and visual impairments.]
- Katz RT: Life expectancy for children with cerebral palsy and mental retardation: Implications for life care planning. NeuroRehabilitation 2003; 18:261-270.
- Blair E, et. al: Life expectancy among people with cerebral palsy in Western Australia. Developmental Medicine & Child Neurology 2001;43:508-515.