Cerebral Palsy - Causes, Symptoms, Types, and Treatment

What Is Cerebral Palsy?

Cerebral palsy, or 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, affecting approximately 1.5 to 4 in every 1,000 children worldwide.

The signs and symptoms of cerebral palsy, such as limb and trunk rigidity, abnormal reflexes, improper posture, wobbling gait, and involuntary movements, appear during infancy. In addition, such kids have problems with swallowing, their eyes do not focus on an object, and they have a 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 intellectual, while others might need assistance and have intellectual disabilities. Severe cases might result in epilepsy, hearing loss, and blindness.

What Are the Types of Cerebral Palsy?

The types of cerebral palsy include:

1. Spastic Cerebral Palsy - It is the most common type and affects about 80 % of patients with cerebral palsy. Here, the patients have increased muscle tone, making their muscles stiff. Depending on the body parts affected, this type is classified into:

• Spastic Diplegia - In this type, muscle stiffness is mainly seen in the legs, and the arms are less affected or unaffected. Patient with this type has difficulty walking.

• Spastic Hemiplegia - In this type, only one side of the body is affected. Usually, arms are more affected than legs.

• Spastic Quadriplegia - It is the most severe form, as it affects the entire body. Patients with this spastic quadriplegia cannot walk and face other developmental conditions like seizures, intellectual disability, and problems with vision, speech, or hearing.

2. Dyskinetic Cerebral Palsy - In this condition, patients find it difficult to control the movement of the hands and feet, making it challenging to walk or sit.

3. Hypotonic Cerebral Palsy - This condition reduces muscle tone, resulting in floppy and overly relaxed muscles.

4. Ataxic Cerebral Palsy - Patients with this condition have balance and coordination problems.

5. Mixed Cerebral Palsy - These patients have symptoms of more than one type of CP.

What Are the Signs and Symptoms of Cerebral Palsy?

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).

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• Ataxia (problems with balance and muscle coordination).

• Tremors.

• Slow and squirming movements.

• The child will favor one side of their 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. They might walk tip-toed, have a wobbly gait, a crouched gait, or a scissors-like gait.

• Problems in sucking or eating.

• The child may drool excessively or have problems swallowing.

• Learning disabilities.

• Seizures.

• Speech development may be delayed, or the child might find it difficult to speak.

This condition can affect the entire body or just one side or limb. The symptoms do not worsen with age as the brain issues that cause CP does not get altered with age. But with age, some symptoms may get less or more noticeable. The following are the brain abnormalities associated with cerebral palsy:

• Vision problems.

• Hearing disabilities.

• Intellectual disabilities.

• Seizures.

• Psychological conditions.

• Abnormal perceptions of pain.

• Urinary incontinence.

• Diseases of the mouth or oral cavity.

What Causes Cerebral Palsy?

Problems in brain development or brain injury before, during, or immediately after birth are the leading causes of cerebral palsy. The affected body part and symptoms depend on the damaged part of the brain. This damage can also occur during delivery or in the first few years of life. The following are the possible causes of cerebral palsy:

• Gene mutations.

• Lack of oxygen to the brain during birth (asphyxia neonatorum).

• Infant jaundice.

• If a pregnant woman gets infected with German measles or herpes.

• Brain bleed or intracranial hemorrhage.

• Road traffic accidents or child abuse that results in head injuries.

• Brain infections like meningitis or encephalitis.

What Are the Risk Factors of Cerebral Palsy?

The following factors increase the risk of cerebral palsy:

• Low birth weight.

• Premature birth.

• Multiple pregnancies.

• Breech birth (baby’s buttocks or feet come out first instead of head).

• Babies with a low Apgar score (it is used to check the baby’s physical health).

• Exposure to toxins such as methylmercury (found in fish skin) during pregnancy.

• Rh incompatibility (blood of mother and baby is Rh type incompatible).

How Is Cerebral Palsy Diagnosed?

The doctor will take a complete medical history, perform a physical examination, conduct a neurological examination, and evaluate the symptoms. If needed, the patient might suggest getting some of the following tests to diagnose CP:

• Electroencephalogram (EEG) - To check the electrical activity of the brain.

• MRI (Magnetic Resonance Imaging) Scan - Strong radio waves and magnets are used to produce detailed images of the brain, which are checked for brain injury.

• CT (Computed Tomography) Scan - Cross-sectional or three-dimensional images of the brain are produced, which can help identify brain damage.

• Cranial Ultrasound - High-frequency sound waves are used to get brain images.

• Blood Tests - These are done to rule out other conditions that can cause similar symptoms.

If a person gets diagnosed with CP, the neurologist will perform other tests to detect vision impairment, deafness, speech problems, intellectual disabilities, and movement disorders.

What Are the Treatment Options for Cerebral Palsy?

Children with cerebral palsy need prolonged care and treatment. Parents might need to work with healthcare professionals to help their kids. The treatment options include the following:

I. Medicines:

• 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, and Dantrolene, are used to relax the muscles. Baclofen is sometimes delivered into the spinal cord.

II. Therapies:

• 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 stretch stiff muscles.

• Occupational Therapy - Occupational therapy will help the child adjust to their disabilities and teach them ways to conduct their day-to-day activities. It includes teaching the child to use walkers, canes, or electric wheelchairs.

Conclusion:

Currently, there is no cure for cerebral palsy, but various medicines and therapies can manage the condition effectively. Moreover, the treatment varies from person to person, and some patients might need long-term care for their symptoms.

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