Published on Mar 13, 2020 - 5 min read
Cerebral palsy (CP) is a collection of disorders that result from damage to the developing brain. Read the article to know about its causes, symptoms, types, and treatment.
Cerebral palsy, otherwise called CP, is a group of disorders that affect the coordination and movement of muscles. It generally results from damage to the developing brain before, during, or immediately after birth. In a few cases, the sense of sight, smell, and hearing can also get affected. “Cerebral” means the brain and “palsy” means weakness. According to the Centers for Disease Control and Prevention (CDC), it is the primary cause of motor disabilities in children, and it affects approximately 1.5 to 4 in every 1,000 children in the world.
The signs and symptoms of cerebral palsy, such as limbs and trunk rigidity, abnormal reflexes, improper posture, wobbling gait, and involuntary movements, appear during infancy. Such kids have problems with swallowing, their eyes do not focus on an object, and reduced range of motion in the joints because of muscle stiffness. The degree of symptoms varies, as some can even walk and have almost normal intellectually, while some might need assistance and have intellectual disabilities. Severe cases might result in epilepsy, hearing loss, and blindness.
The types of CP are:
Spastic Cerebral Palsy - It is the most common type and affects about 80 % of patients with CP. Here, the patients have increased muscle tone, making their muscles stiff. Depending on the body parts affected, this type is classified into:
Spastic diplegia - the legs are mainly affected, and the arms are less affected or not affected.
Spastic hemiplegia - only one side of the body is affected.
Spastic quadriplegia - it is the most severe form as it affects the entire body.
Dyskinetic Cerebral Palsy - such patients find it difficult to control the movement of the hands and feet, making it challenging to walk or sit.
Hypotonic Cerebral Palsy - the muscle tone is reduced, which results in floppy and overly relaxed muscles.
Ataxic Cerebral Palsy - these patients have balance and coordination problems.
Mixed Cerebral Palsy - these patients have symptoms of more than one type of CP.
The signs and symptoms can vary. The common movement and coordination problems associated with cerebral palsy are:
Rigidity - the muscles are stiff but the reflexes are normal.
Spasticity - the muscles are stiff with exaggerated or brisk reflexes.
Ataxia - problems with balance and muscle coordination.
Slow and squirming movements.
The child will favor one side of his or her body. For example, dragging a leg while crawling.
Delayed motor skills development like crawling, rolling over, and pushing up on arms.
The child will have difficulty walking. He or she might walk tip-toed, have wobbly gait, a crouched gait, or a scissors-like gait.
Problems sucking or eating.
The child may drool excessively or have problems swallowing.
Speech development may be delayed or the child might find it difficult to speak.
This condition can either affect the entire body or just one side or one limb. The symptoms do not worsen with age as the brain problem that causes CP does not get altered with age. But with age, some symptoms may get less or more or less obvious. The following are the brain abnormalities associated with cerebral palsy:
Abnormal perceptions of pain.
Diseases of the mouth or oral cavity.
Problems in brain development or brain injury before, during, or immediately after birth are the main causes of cerebral palsy. The affected body part and symptoms depend on the part of the brain that is damaged. This damage can also occur during delivery or in the first few years of life. The following are the possible causes of cerebral palsy:
Lack of oxygen to the brain during birth (asphyxia neonatorum).
If a pregnant woman gets infected with German measles or herpes.
Brain bleed or intracranial hemorrhage.
Road traffic accident or child abuse that results in head injuries.
Brain infections like meningitis or encephalitis.
The following factors increase the risk of cerebral palsy:
Low birth weight.
Breech birth (baby’s buttocks or feet come out first).
Babies with a low Apgar score (used to check baby’s physical health).
Being exposed to toxins such as methylmercury (found in fish skin) during pregnancy.
Rh incompatibility (mother’s and baby’s blood Rh type is incompatible).
The doctor will take a complete medical history, perform a physical exam, conduct a neurological exam, and evaluate the symptoms. If needed, he or she might suggest to get some of the following tests to diagnose CP:
Electroencephalogram (EEG) - to check the electrical activity of the brain.
MRI scan - strong radio waves and magnets are used to produce detailed images of the brain, which is checked for brain injury.
CT scan - cross-sectional images of the brain are produced, which can help identify brain damage.
Cranial ultrasound - high-frequency sound waves are used to get images of the brain.
Blood tests are done to rule out other conditions that can cause similar symptoms.
If you get diagnosed with CP, then the neurologist will perform other tests to detect vision impairment, deafness, speech problems, intellectual disabilities, and movement disorders.
Children with cerebral palsy need prolonged care and treatment. You might need to work with a group of healthcare professionals to help your kid. The treatment options include:
Injections to the muscle or nerve - Botox or other agents are injected into a specific muscle to tighten it. These injections might be needed every three months.
Muscle relaxants - Diazepam, Baclofen, Dantrolene, etc., are used to relax the muscles. Baclofen is sometimes delivered into the spinal cord.
Physical therapy - Various exercises and muscle training can help with muscle strength, flexibility, and balance. Braces or splints might be needed to improve walking and to stretch stiff muscles.
Occupational therapy - Occupational therapy will help the child adjust to his or her disabilities and teach them ways to conduct their day to day activities. It includes teaching the child to use walkers, canes, or electric wheelchairs.
Speech therapy - Kids with speech problems are guided to speak clearly or they are taught sign language to communicate.
Orthopedic surgery - In cases of severe contractures, bone or joint surgeries might be needed to place the arms or legs back in the right position. Or it is done to lengthen muscles.
Selective dorsal rhizotomy - Here, the surgeon cuts the nerves that supply the spastic muscles. This helps the muscle relax and relieve pain.
Some of the possible complications of cerebral palsy are:
Contracture - the shortening of muscle tissue due to spasticity. It inhibits bone growth and makes the bone bend.
Malnutrition due to swallowing or sucking problems.
Heart and lung disease.
Psychiatric conditions, such as depression, due to social isolation and disabilities.
Bowel or urinary incontinence.
As of now, there is no cure for cerebral palsy, but medicines are various therapies can manage the condition effectively. For more information on cerebral palsy, consult a neurologist online!
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