Cognitive impairments: One out of every three children with CP has a mild intellectual impairment, one-third have moderate to severe impairments, and the remaining third have age-appropriate cognitive development similar to that of typically-developing peers. Children who have spastic quadriplegia are most likely to have more serious cognitive deficits. Under Federal law, developmental and educational systems have been established to address these cognitive impairments (see Developmental and Educational Teams section of this course). Nurses fill many key roles within these systems.


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As a rule, children with CP have significant cognitive delays.
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Seizure disorders: About half of the children with CP have some form of seizure disorder. The type and severity of the seizure depends on the part of the brain involved, and the degree of impairment. For example, mild involvement of one portion of the brain can cause partial seizures with very specific symptoms. More severe seizure disorders may involve the entire brain in a prolonged, uncontrolled burst of electricity that creates a generalized onset tonic-clonic seizure. These seizures are treated with anticonvulsant medications, vagal nerve stimulators, and rarely, surgery. Nurses working with these patients can teach parents to administer seizure medications, on time, with good technique, while watching for adverse effects of the anticonvulsants.

Hydrocephalus: Children with CP are more likely to develop hydrocephalus, or a blockage in the flow of cerebrospinal fluid. The blockage may be caused by malformations within the brain, precipitated by intracranial bleeding, or triggered by meningitis. Most of the time, the hydrocephalus is readily relieved with a ventriculoperitoneal shunt, which can be revised as the child grows up. Nurses working with these children can watch for early signs of shunt failure, including change in level of consciousness, seizures, and vomiting.


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It's important to perform regular neurological assessments of children with CP, since they are prone to seizures and hydrocephalus.
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