Cerebral palsy

CEREBRAL – BRAIN

PALSY – WEAKNESS, PARALYSIS OR LACK OF MUSCLE CONTROL.

CEREBRAL PALSY (CP) IS A PERMANENT PHYSICAL CONDITION THAT AFFECTS MOVEMENT. ITS EFFECT CAN BE AS MILD AS JUST A WEAKNESS IN ONE HAND RANGING TO ALMOST COMPLETE LACK OF MOVEMENT.

Signs & Symptoms

While the central feature of CP is a disorder with movement, difficulties with thinking, learning, feeling, communication and behavior often occur along with cerebral palsy.

Of those with CP, • 28% have epilepsy, • 58% have difficulties with

communication, • at least 42% have problems with their

vision, • and 23–56% have learning disabilities.

Babies born with severe CP often have an irregular posture; their bodies may be either very floppy or very stiff. Birth defects, such as spinal curvature, a small jawbone, or a small head sometimes occur along with CP. Symptoms may appear or change as a child gets older.

Resulting conditions can include seizures, epilepsy, apraxia, dysarthria or other communication disorders, eating problems, sensory impairments, intellectual disability, learning disabilities, urinary incontinence, fecal incontinence, and/or behavioral disorders.

Classically, CP becomes evident when the baby reaches the developmental stage at 6 1⁄2 to 9 months and is starting to mobilize, where preferential use of limbs, asymmetry, or gross motor developmental delay is seen.

Causes

Cerebral palsy is due to damage occurring to the developing brain. This damage can occur during pregnancy, delivery, the first month of life, or less commonly in early childhood. Structural problems in the brain are seen in 80% of cases, most commonly within the white matter. More than three quarters of cases are believed to result from issues that occur during pregnancy.

While in certain cases there is no identifiable cause, typical causes include problems in intrauterine development (e.g. exposure to radiation, infection), hypoxia of the brain, and birth trauma during labor and delivery, and complications around birth or during childhood.

Treatment for cerebral palsy

Although cerebral palsy is a lifelong disability, there are many interventions that can help reduce its impact on the body and the individual’s quality of life. An intervention is a service that aims to improve the condition of cerebral palsy and the day-to-day experience of the person living with it.

Can cerebral palsy be prevented or cured?

At present, there is no way to totally prevent or cure cerebral palsy.

Two interventions are now being used to reduce the risk or severity of cerebral palsy:

Magnesium Sulphate – is given to pregnant mothers when they are at risk of very preterm birth. This can help protect babies from the brain injury that leads to cerebral palsy.

Cooling Cap – Newborn babies who have suffered a brain injury due to lack of oxygen before birth (hypoxic ischemic encephalopathy) may be treated with a special cooling cap which aims to reduce the impact of the brain injury.

Interventions for movement issues

Medication

Medical specialists may prescribe medications that assist movement issues. Some medications are taken orally (e.g. diazepam) and others are injected or delivered through surgically implanted pumps (e.g. Baclofen). Many children with cerebral palsy benefit from Botulinum toxin type A injections into muscles affected by spasticity. This intervention is used from about two years of age and is most effective when used in conjunction with therapy.

Surgical procedures

Selective Dorsal Rhizotomy (SDR) is a neurosurgical procedure that is used in a small percentage of children with cerebral palsy to permanently reduce spasticity in their legs.

Physiotherapy and occupational therapy

Physiotherapists and occupational therapists focus on encouraging a person’s day-to-day movement skills such as sitting, walking, playing, dressing and toileting. They will use a range of specialist interventions such as movement training and equipment, e.g. walking frames, wheelchairs, supportive seating, footwear and orthotics.