cerebral palsy
TRANSCRIPT
CEREBRAL PALSYSUMMARY
What is it? How common is it? The development of cerebral palsy. Why does it happen? Contributing factors or cause. What happens physically. The main effects. How cp affect development. Areas of the brain affected. Parts of the body affected. Getting older. Secondary ageing effects. Depression and cp. Challenging behaviour and cp. Risk factors.
What is it?
Cerebral palsy (cp) is not a disease or an illness.
It is the description of a physical impairment that affects movement.
The movement problems vary from barely noticeable to extremely severe.
It is as individual as people themselves.
How common is it?
In recent years there has been a slight increase in the proportion of children who have cp.
Currently about one in every 400 child is affected.
Among these, the percentage of severely and multiply disabled people needing support is growing.
those people will need continue need support throughout their lives.
How common is it?
There has never been a single explanation of what cerebral palsy is.
1984 P. Scrutton wrote, “The almost infinite variety (and the lack of common language to describe this variety accurately) makes learning about it very difficult indeed.”
It is not specific condition - unlike Down’s Syndrome for example, which is an identifiable chromosomal disorder.
How common is it?
Cerebral palsy can be defined as “a persistent disorder of movement and
posture, as the result of one or more non-progressive abnormalities in the brain.”
The development of cp
The characteristics of the motor disorder, the way the person is affected and muscle tone may alter significantly, particularly during the early years of life.
In the first few months any potential difficulties may not be immediately obvious.
It is possible for some signs not to show until the child is between 12 and 18 months or older.
Why does it happen?
Studies suggest that cerebral palsy is due mostly to factors affecting the brain before birth.
It is commonly the result of one or more abnormalities in the brain, before growth and development are complete.
Contributing factors or cause
Some of the factors associated with the incidence of cerebral palsy are:
• Low birth-weight• Premature birth• Multiple births• Asphyxia (lack of oxygen)• Infection• Cerebral bleed• Infection in the early part of pregnancy;• Infection or accident in the early years of a child’s life.
There may also be a genetic link, but this is quite rare.
What happens physically?
The brain impairment is non-progressive.
It is not necessarily that the physical capacity and function will remain the same throughout the life.
Can be maturational, developmental or aging changes, that can affect the individual’s ability.
What are the main effects?
Cerebral palsy is primarily a disorder of voluntary movement and co-ordination, due to a defect or lesion of the immature brain.
Because of other areas of the brain may also have been affected there is a possibility of ‘associated’ or ‘related’ difficulties such as sensory or perceptual impairment.
Other associated difficulties may include learning difficulties or epilepsy (seizures).
How can cp affect development
The brain ‘learn’ how to position and focus the eyes, make noises and sounds, chew food, control the muscle used when going to the toilet and those used for breathing.
Growing babies and children have to learn to use many other muscle besides those concerned with the co-ordination and movement of arms, legs, trunk, and so on.
Areas of the brain affected
Cortex:
Spastic cerebral palsy (spasticity). Disorder control of movements.
• Increase muscle tone or hypertonia.
• Some muscle become very stiff and weak.
Areas of the brain affected Basal Ganglia: Athetoid cerebral palsy
(athetosis).
• Also called Dyskinetic cerebral palsy.
• Usually comprises slow writhing.
• Loss of control of the posture.• Tend to make unwanted
movements.• Involuntary spasms,• jerky arm and leg
movements.
Areas of the brain affected
Cerebellum: Ataxia cerebral palsy (ataxia).
• Disordered movements.• Short and jerky movements.• Often muscle tone is normal
or decreased.• Shaky hand movements.• irregular speech.• Unsteady walking.• Problem with balance.• Spatial awareness.
Parts of the body affected: Diplegia
Is where both legs are affected more than
the hands and arms.
Parts of the body affected:
Hemiplegia
One side of the body (including arm and
leg) is affected.
Parts of the body affected: Quadriplegia/Tetraplegia
All four limbs are involved, usually trunk and neck.
Getting Older
For those who have lived a lifetime with a physical impairment, the effects of ageing can become apparent earlier than expected.
Cerebral palsy is an example of developmental disorder in which physical functioning can deteriorate with ageing as a result of poor mechanical efficiency.
Getting Older
What is clear is that people with cerebral palsy age in the same way as non-disable people (primary ageing) but some people with cerebral palsy may also experience secondary ageing effects.
These are likely to be long-term effects of the original impairment.
Secondary Ageing Effects
Unfortunately the effects of cp can bring problems of secondary ageing much earlier than in the general population.
Following are some of the more common problems reported by people in their thirties and forties or, sometimes, a little earlier.
Secondary Ageing effect in cp
Increased levels of pain and discomfort. Osteoarthritis (pain and stiffness in the joints). Increase in spasms. Increase in contractures (shortening of muscles). Less efficient motor control (body parts involved in
movements). Joint problems. Tight muscles. Gastro-intestinal (digestive system) problems. New back pain and increase in back pain. Emergence / increase in incontinence. Loss of joint flexibility. Reduced energy levels and fatigue.
Depression and cp
Sometimes changes of mood can be related to depression in a person who has cerebral palsy.
Depression is twice as common in women, with men being more likely to show anti-social behaviour.
In some cases of depression a review of the person’s lifestyle can be helpful but for others, anti-depressant drugs or counselling may be necessary.
Challenging behaviour an cp There are four main categories of challenging behaviour and
actions can range from moderate to severe.
Self-injurious behaviour includes had-banging, scratching, pulling, eye poking, picking, grinding teeth, eating non-foodstuffs.
Aggressive behaviour toward others includes biting and scratching, hitting , pinching, grabbing, hair pulling, throwing objects, verbal abuse, screaming, spitting.
Stereotyped behaviour including repetitive movements, rocking, repetitive speech, and repetitive manipulation of objects.
Non-person directed behaviour includes damage to property, hyperactivity, stealing, inappropriate sexualised behaviour, destruction of clothing, incontinence, temper tantrums, lack of awareness of danger withdrawal.
The link between cp and challenging behaviour
A large proportion of people with cerebral palsy also have a learning disability.
Many people will also have a severe cognitive impairment, which means they cannot reason well or understand their environment fully.
The most common aims of challenging behaviour are:
Self-stimulation Gaining the attention of others Avoidance
In most people who have severe learning disability, these behaviour are not premeditated and are not designed to purposely upset.
Risk Factors
Three significant indicators for challenging behaviour in cerebral palsy can be indentified.
These are:
Damage to the nervous system Learning disability Epilepsy (especially if poorly controlled)
Risk Factors
Additional factors are:
Age (reaching a peak between age 15 – 34 with a reduction in challenging behaviour in the mid-thirties).
Gender (men exhibit more challenging behaviour than women).
Multiple disabilities.
Communication difficulties.
Challenging behaviour is not unusual especially where someone cannot communicate effectively.
Challenging behaviour can, however, occur across the whole range of intelligence and can be severe in people with mild or no intellectual disability with cp, mainly out of sheer frustration.
