Cerebral Palsy is a disorder of movement, muscle tone or posture. It affects the ability to move in a coordinated and purposeful way. The exact cause is unknown, but many cases are the result of problems during pregnancy in which the brain is damaged or it does not develop normally. It can be caused from anything that interferes with normal brain development such as infections and maternal health problems. It usually occurs before or during birth, or during the first 3 to 5 years of a child’s life.
Cerebral palsy is one of the most common congenital (existing before birth or at birth) disorders of childhood. There are a number of factors that are associated with an increased risk of developing CP. Certain infections during pregnancy such as: 1. ) German measles (rubella), this is a viral infection that can be prevented with a vaccine 2. ) Chickenpox (varicella), another viral infection that can be prevented by a vaccine 3. ) Cytomegalovirus, is a common virus that can cause flu-like symptoms and can lead to birth defects if a mother contracts her first infection during pregnancy 4.).
Toxoplasmosis is an infection caused by a parasite found in soil and feces of infected cats 5. ) Syphilis, a sexually transmitted bacterial infection can cause CP 6. ) Exposures to toxins such as mercury 7. ) other problems that may increase the risk of CP, such as thyroid problems, mental retardation, and seizures. There are certain illnesses in the infant that can increase the risk of CP such as:
1. ) if the newborn contracts bacterial meningitis or viral encephalitis 2. ) severe or untreated jaundice 3.) premature birth – especially those who weigh less than 3. 3 pounds 4. ) breech babies which is feet first position during labor instead of the head first position 5. ) multiple babies – the risk of CP increases with the number of babies sharing the uterus 6. ) lead poisoning 7. ) malnutrition 8. ) shaken baby syndrome – being shaken as an infant 9. ) being in a car accident while not properly restrained. Children with CP have different degrees of physical disability. Some can be mild, while others are severely affected.
Signs and symptoms include: muscle tone is either too stiff or floppy, tremors or involuntary movements, lack of muscle coordination (ataxia), slow, writhing movements (athetosis), delay in reaching motor skills milestones, such as sitting up or crawling, difficulty walking, such as walking on their toes or a scissors-like gait with knees crossing or a wide gait, they have excessive drooling or difficulty swallowing, difficulty with sucking or eating, delays in speech development, difficulty with precise motions, such as picking up a crayon or spoon.
Children may have visual impairments or blindness, hearing loss, food aspiration (food or fluid enters the lungs), tooth decay, sleep disorders, weak and brittle bones and may have behavioral problems. Some children may develop seizures and mental retardation. Cerebral palsy can be diagnosed very early in an infant known to be at risk for developing the condition. In others who are not at high risk, it may be more difficult to diagnose these children. Doctors may have to wait until they see a delay in normal milestones, around 4 to 7 months.
If developmental milestones are mildly delayed, the diagnosis may not be made until the child is a toddler. There are tests that can help confirm the diagnosis of CP. Brain scans such as MRI’s are usually the preferred imaging test. Cranial ultrasounds and CT scans may be done. If the child has seizures which often occurs in CP, the doctor may order an EEG which records the electrical activity of the brain. Lab tests will be done to rule out other conditions that may mimic CP. Lab tests may also be done for genetic or metabolic problems.
Other tests will be done to identify vision, hearing, and speech impairments as well as intellectual disabilities, developmental delays, or mental retardation. There will be many different types of physicians involved in the care of adults and children with CP. Some of these include: pediatricians, physiatrist, neurologist, orthopedist, occupational and developmental therapists, social workers, and special education teachers. There are certain medications to treat Cerebral palsy.
Drugs that help lessen the tightness of the muscles may be used to improve functional abilities, treat pain, and manage the complications that are related to the spasticity. If the spasticity is isolated to one muscle group, the physician may recommend Botox injections directly into the muscle. If the whole body is affected, muscle relaxants can be used. Some of these can be taken orally or pumped directly into the spinal cord with a tube that gets surgically implanted under the skin of the abdomen. Orthopedic surgeries may be needed in children that have severe deformities.
These surgeries are done to lengthen muscles and tendons that are too short because of contractures. If they have severe contractures, they may need surgery on bones or joints to place their arms and legs in their correct positions. These corrections can lessen their pain, improve mobility, and make it easier to use a walker, braces or crutches. When other treatments have not helped, surgeons may cut the nerves serving the spastic muscles. This relaxes the muscle and lessens the pain, but numbness is one of the risks to this surgery.
There are some steps that one can do to lessen the risks of developing CP. Pregnant women should make sure they are vaccinated against diseases such as rubella, which may prevent an infection that could cause fetal brain damage. Pregnant women should stay healthy heading into a pregnancy. Pregnant women should seek early and continuous prenatal care to prevent premature birth, low birth weight and infections. Controlling diabetes, anemia, high blood pressure, seizures, and nutritional deficiencies during pregnancy can also help prevent some premature births.
All parents should practice good child safety such as, provide your child with a car seat, bicycle helmet, safety rails on beds and appropriate supervision. The whole family faces new challenges when a child is diagnosed with CP. It is important to foster the child’s independence and be an advocate for the child. It is important for families to find support to help them cope with CP and its effects. There are many support groups, organizations and counseling services available.