Cerebral Palsy

By:    Published: May 14, 2014

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Cerebral palsy is a disorder that affects muscle tone, posture and coordination of movement and motor skills. It is considered a congenital disorder, meaning that in most cases it is present before or during birth. Nearly 500,000 children and adults in the United States are living with cerebral palsy. Cerebral palsy is a permanent condition, but does not worsen over time. Many children diagnosed with cerebral palsy go on to lead typical lives with the use of therapy, assistive equipment or surgery.

Definition

Cerebral palsy is a neurological disorder; it is an injury or abnormality to the areas of the brain responsible for the movement of muscles and coordination. For a person with cerebral palsy, something as simple as standing still may be a challenge. Cerebral palsy can also impact other motor skills like breathing, bathroom function, eating and learning. Children with cerebral palsy may have one of the three forms of the disorder or a combination of the three, called Mixed Cerebral Palsy. The three types of cerebral palsy are:

  • Spastic Cerebral Palsy: the most common form of cerebral palsy, which causes impaired movement and muscle tightness.
  • Athetoid Cerebral Palsy: impairs the ability to control muscle movements leading to uncontrolled movement in those muscles.
  • Ataxic Cerebral Palsy: the child will have an impaired sense of perception and balance causing shaky movement or tremors.

Symptoms

Symptoms associated with cerebral palsy can vary greatly from person to person. Depending upon the type or mixture of types of cerebral palsy, symptoms can be very different for each child diagnosed. All symptoms will effect coordination, movement and muscle tone in some way. Symptoms associated with cerebral palsy include:

  • Stiffened muscle tone
  • Low or floppy muscle tone
  • Spasticity, which is characterized by stiff muscles and exaggerated reflexes.
  • Rigidity, which is characterized by stiff muscles and typical reflexes.
  • Ataxia, which is an absence of muscle coordination.
  • Involuntary movements
  • Tremors
  • Athetosis, which is characterized by slow, struggling movements.
  • Delayed motor skill milestones
  • Favoring one side of the body
  • Impaired gait while walking such as a crouched gait, scissor gait (when the knees cross) or wide gait.
  • Difficulty swallowing
  • Drooling
  • Difficulty eating
  • Difficulty sucking
  • Delayed speech progression
  • Difficulty speaking

Causes

Cerebral palsy is caused by an injury or abnormality within the brain. Typically, this brain trauma happens within the womb during fetal development, but can happen during birth or anytime during the child’s first two years while the brain is under development. In many cases, the exact cause of the abnormality or injury is never known. However, some possible causes for brain abnormality include:

  • Gene mutations in those genes that influence brain development
  • Prenatal infections that may affect the developing fetus
  • A loss of blood supply to the brain of the fetus resulting in fetal stroke
  • Lack of oxygen to the infant’s brain during birth
  • Traumatic brain injury to an infant as a result of accident, fall or abuse

Risk Factors

Several factors may raise the risk for cerebral palsy. These factors can be related to the mother’s health or pregnancy, illness to the infant or factors present at birth.

Maternal factors include:

  • Viral infections such as chickenpox or German measles
  • Cytomegalovirus – a virus with flu-like symptoms that can cause birth defects
  • Toxoplasmosis – an infection caused by parasites found in cat litter boxes and feces
  • Syphilis
  • Exposure to toxins

Illness to a newborn baby:

  • Severe jaundice or jaundice that is not treated (see: Jaundice In Newborns)
  • Viral Encephalitis – a virus that causes inflammation to the brain.
  • Bacterial Meningitis – an infection that causes swelling of the brain and spinal cord

Pregnancy factors:

  • Premature birth
  • Low birth weight
  • Breech birth
  • Pregnancy with multiples.

Diagnostic Testing

In many cases, cerebral palsy is diagnosed in infants shortly after birth, especially if there has been some risk noted before birth. Generally, high-risk pregnancies are monitored very closely and doctors will likely know if any symptoms suggest a diagnosis of cerebral palsy early on.

For others, in which symptoms or risk may not be obvious, diagnosis may be made sometime during the first years of life when the child is not reaching developmental milestones. If your child is suspected of having cerebral palsy, your doctor will likely order various tests to rule out other conditions and make a formal diagnosis. These diagnostic procedures include:

  • MRI of the brain
  • CT scan of the brain
  • Cranial ultrasound
  • EEG, in children with seizures present to rule out epilepsy
  • Blood tests to screen for genetic markers, blood-clotting issue that ay result in stroke, or metabolic disorders.

Additionally, your doctor may suggest that your child be screened for other impairments which may be present along with cerebral palsy. Assessments may be done to identify any of the following impairments:

  • Vision
  • Hearing
  • Speech
  • Learning disabilities
  • Intellect
  • Mental retardation

Treatment Options

There is no cure for cerebral palsy, but with early treatment, a child’s abilities can be greatly improved. The earlier treatment begins, the better that child’s chances for conquering learning difficulties and adopting new ways of dealing with everyday challenges. People with cerebral palsy will likely require a long-term treatment plan that includes a variety of specialists including:

  • Pediatrician
  • Neurologist
  • Occupational therapist
  • Developmental pediatrician or therapist
  • Psychologist
  • Social worker
  • Special education teachers

A diagnosis of cerebral palsy will require a variety of treatment options including:

  • Prescription medications that can address muscle spasticity and manage pain. The proper medication will be chosen based upon the nature of the spasticity be it isolated or generalized.
  • Physical therapy to improve flexibility, mobility and balance.
  • Occupational therapy, which will introduce assistive technology and alternatives to improve the child’s independence.
  • Speech therapy to strengthen the child’s ability to speak or communicate using sign language or communication devices.
  • Surgery to correct bone deformities caused by severe spasticity or to alleviate muscle tightness.

Prevention

In many instances there is no way to prevent cerebral palsy. However, as a pregnant woman, you may be able to decreases the risks to your unborn child by taking some precautionary measures. If you are pregnant or trying to conceive, these tips can boost your health and lessen risks to your child:

  • Maintain a healthy diet and lifestyle.
  • Get proper prenatal care and continued care throughout your pregnancy.
  • Once your child is born, be sure he or she is safe. Use proper car seat restraints, helmets during physical activity, proper sleep safety and proper supervision.

Tips For Parents

Having a child diagnosed with cerebral palsy can be emotionally difficult and a challenge for the entire family. It may be helpful to both you and your child to:

  • Always encourage your child’s independence. Praise them for even the smallest of accomplishments.
  • Allow them to try to do things for themselves. Even when you feel you could do it faster or more efficiently, allow your child a sense of independence.
  • Always be an advocate for your child. Speak up and ask questions. Ensure that your child is receiving the proper care.
  • Seek out support. It may be helpful for you, your child and your family to join a support group or receive private counseling to cope with cerebral palsy and its impact on daily life.

Cerebral palsy is a neurological disorder that affects muscle coordination and movement. It is a lifelong condition that will likely require long-term treatment. There is no cure for cerebral palsy, but with therapy, assistive technologies, and possibly surgery, people with cerebral palsy can lead near normal lives.

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