This disorder is caused by abnormal development or damage in one or more parts of the brain that control muscle tone and movement. Child with cerebral palsy has difficulty controlling and coordinating muscles. Very simple movements for that child are difficult. Other names for this disorder are a static encephalopathy, spastic diplegia, and "Littles disease,". It is caused by a permanent brain defect or an injury at birth or shortly thereafter. Causes of Cerebral palsy are birth complications, some compilcations during the pregnancy, and some complications after birth. In many cases, the exact cause of the Cerebral palsy is never known. There are four types of cerebral palsy - spastic cerebral palsy, athetoid cerebral palsy, ataxic cerebral palsy, and mixed cerebral palsy.
Early signs include the delayed milestones such as controlling head, rolling over, sitting without support, crawling, or walking. Symptoms of Cerebral palsy could include spasticity, poor muscle tone, uncontrolled movements, and problems with posture, balance, coordination, walking, speech, swallowing, seizures, breathing problems, mental retardation, learning disabilitiesskeletal deformities, eating difficulties, dental problems, bladder and bowel control problems, digestive problems, and hearing and vision problems.
Spastic(pyramidal) cerebral palsy is common, the patient's muscles in a continuing state of spasms. This type is classified by which part of the body is affected: diplegia, hemiplegia or quadriplegia. Athetoid cerebral palsy is folowed by slow and uncontrolled movements . Ataxic cerebral palsy appears in only 5% to 10% of the cases. The most common form of cerebral palsy by far is mixed cerebral palsy, combine spasticitic and athetoid symptoms.
Risk factors for Cerebral palsy include: breech presentation, a complicated labor and delivery, premature birth, vascular or respiratory problems, premature birth, low birth weight, multiple births. In many cases of cerebral palsy are a result of a combination of prenatal, perinatal, and postnatal factors.
After birth doctor check the baby's heart rate, breathing, muscle tone, reflexes and skin color during the first minutes after birth. A low Apgar score is often an indicator of cerebral palsy.
Symptoms manifested by the mother during pregnancy may also suggest the possibility of cerebral palsy in the child. Severe proteinuria late in pregnancy , maternal bleeding and vaginal bleeding during the sixth to ninth months, during pregnancy are linked to higher risk of cerebral palsy affecting the child. Mothers with seizures are also more likely to have a child with cerebral palsy. Seizures in the newborn child may also indicate cerebral palsy. If your child was born prematurely, had a low birth weight or you had certain complications during the pregnancy, labor, or delivery, the child should be monitored carefully over time for signs of CP. You should visit a doctor if your child has a seizure or your child’s movements seem unusually jerky, abrupt or uncoordinated.
You should discus to your child’s doctor about any problems that suggest a lack of control or muscles or movements.
Exams and Tests
There is no medical test that confirms the diagnosis of cerebral palsy. The diagnosis is made on the basis of information gathered by the child’s doctor and, in some cases, other consultants.
Cerebral Palsy Treatment
Most children with cerebral palsy require significant medical and physical care. That includes physical, occupational, and speech therapy. With early treatment, the disabilities associated with cerebral palsy can be reduced. Many different therapies are available. A treatment should be individual. A treatment may work for one child but not for another. The parents and therapy team should work together to choose right treatments. Treatment methods are: physical therapy, medications, intramuscular alcohol injections and surgery.
Physical therapy is a very important treatment. There are exercises specifically designed to maintain muscle tone and prevent muscular atrophy. Physical therapy could include stretching, physical exercises, and other activities that develop muscle strength, flexibility, and control. The purpose of physical therapy is to maximize function and minimize disabling contractures. With appropriate therapy the child should develop skills like holding the head up, sitting unsupported, or walking.
The occupational therapy helps the patient with Cerebral Palsy to learn physical skills. The goal of therapy is that individual become independent as possible in everyday life. Many children with cerebral palsy, can benefit from the services of a specialist in learning disabilities. Children with cerebral palsy could have emotional problems and behavior problems. They can benefit from sessions with a psychologist.
Speech therapy helps the patient overcome communication problems. Many children with cerebral palsy have problems speaking.
Children with cerebral palsy often have gastroesophageal reflux and swallowing and feeding problems. A gastroenterologist, a nutritionist, and a swallowing therapist can assess nutritional status and treat problems. Swallowing therapy helps the child eat and drink independently. In some cases children with severe swallowing problems require feeding through a tube.
Children with cerebral palsy may have breathing problems. The muscles that control expansion and contraction of the lungs are disabled. A specialist in pulmonologist should be consulted for management of the lung disease.
There is special equipment that may be helpful for patient with Cerebral Palsy. Special equipment could include customized wheelchairs, walkers, positioning devices, scooters, and tricycles.
Medications are often used to prevent or control the seizures sometimes associated with the disease. Some new medications have proven effective, in controlling spasticity. Intramuscular alcohol injections have also provided relief of spasticity. Medications used to relieve spasticity and abnormal movements include dopaminergic drugs, muscle relaxants, benzodiazepines and Botulinum toxin type A. Dopaminergic drugs increase the level of a brain chemical called dopamine, or Muscle relaxants reduce spasticity by relaxing the muscle directly. Benzodiazepines act on brain chemistry to relax muscles. Botulinum toxin type A is used to decrease spasticity of muscles of the arms or legs, which improves range of motion and overall mobility.
Operations used in the treatment of cerebral palsy include the dorsal rhizotomy, implantation of a baclofen pump, stereotactic surgery, reconstructive surgery… Some skeletal problems such as scoliosis can be corrected with surgery. Severe spasticity can be corrected with a number of surgical procedures.
There is no cure for Cerebral palsy. Treatment methods are focused on the management of symptoms and enhancing the quality of life. The goal of treatments children with CP is to help them reach their full physical, mental, and emotional potential.