CMScript 6 of 2025: Focus on Cerebral palsy

Cerebral palsy (CP) is a brain disorder that typically begins in infancy or early childhood, resulting in permanent impairments to movement and muscle control. It happens when the brain develops abnormally or becomes damaged, either before birth, during birth, shortly after birth, or within the first few years of life.

CP is the leading cause of physical disability in children, affecting 2 to 3 out of every 1 000 live births. In parts of South Africa, the number is even higher, up to 10 in 1 000 due to gaps in access to quality maternal and newborn care.

Whether you are a parent, caregiver, or someone living with CP, understanding the condition is the first step to getting the right care and support. In this edition of CMScript, we unpack everything you need to know about Cerebral palsy and how your medical scheme can help with treatment, and long-term management.

The signs and symptoms of Cerebral palsy

The primary symptoms of cerebral palsy involve difficulties with movement and posture. The symptoms and severity vary from person to person, and they include:

• Movement and muscle issues: Poor coordination, stiff or floppy muscles, unusual walking patterns, and difficulty with fine motor skills.
• Neurological symptoms: Seizures, persistent baby reflexes, involuntary movements, and overactive reflexes.
• Developmental delays: Challenges with learning and behaviour, delayed growth milestones such as sitting, crawling and walking.
• Sensory and communication problems: Difficulties with vision, hearing, speech, or language, being overly irritable or not very responsive.
• Other complications: Microcephaly (unusually small head) or macrocephaly (larger than normal head size), spine or joint issues (like osteoarthritis) and incontinence.

The risk factors for Cerebral palsy and ways to prevent it

Common risk factors for CP are:

• Premature birth (especially before 28 weeks) and very low birth weight (under 1500 g).
• Birth complications such as birth asphyxia (lack of oxygen during delivery) and traumatic brain injury (from falls, accidents, or abuse).
• Congenital brain malformations and genetic abnormalities.
• Infections passed from mother to baby during pregnancy, such as Rubella (German Measles) and infections in children like tuberculosis meningitis.
• Medical conditions in newborns such as kernicterus (high bilirubin levels).

Prevention measures:

While not all cases are preventable, the following steps may reduce the risk:

• Avoiding exposure to harmful toxins during pregnancy.
• Regular prenatal check-ups and proper management of high-risk pregnancies, such as multiple pregnancies.
• Prompt treatment of infections in both mother and baby, and vaccinations against diseases like Rubella.
• Safe delivery practices, especially for preterm or complicated births.

Treatment and management of Cerebral palsy

Cerebral palsy requires a team-based, long-term approach to help individuals live meaningful, independent lives.

Management may include:

• Support from a range of healthcare professionals, including doctors, therapists, nurses, psychologists, and social workers.
• Medications to manage muscle spasticity.
• Surgery in some cases to improve movement or reduce pain.
• Assistive devices like wheelchairs, leg braces, or communication aids.

Early intervention and coordinated care can make a significant difference in outcomes and quality of life.

What is covered under PMB level of care

Cerebral palsy qualifies as a Prescribed Minimum Benefit (PMB) only when it causes problems that affect bodily functions such as breathing, eating, swallowing, bladder or bowel control, caused by a brain or spinal cord injury that does not worsen over time.

If these criteria are met and the condition is properly diagnosed with supportive evidence, PMB funding should cover:

• Assessment and diagnosis
• Physiotherapy, occupational therapy, speech and language therapy
• Medications for related symptoms such as seizures, muscle stiffness
• Access to assistive devices where clinically indicated
• Follow-up and rehabilitative care as part of chronic management
• In-hospital care and surgery if required

Be sure to contact your medical scheme for more information about specific treatment guidelines and pre-authorisation protocols to make sure your benefits are paid correctly.

Download the full CMScript here.