Cerebral Palsy

Cerebral palsy refers to a number of conditions that appear in infancy or early childhood which affect body movement and muscle coordination. Cerebral palsy is caused by bryan inutt to the brain regions that control motor movements. It is neither contagious nor progressive, that is, it does not worsen with time. Cerebral palsy is associated with disability in some patients.

Causes

Cerebral palsy is caused by damage to the regions of the brain responsible for motor control and in some children it affects the speech and behaviour areas. It is thought that such damage occurs while the child is in the womb but may also occur at birth or in the first years of life. Premature infants are at a slightly greater risk of developing cerebral palsy than normal-term newborns. Other possible causes of cerebral palsy include brain infection (meningitis), head injuries, and severe jaundice.

Terminology

Cerebral palsy is actually an umbrella term that covers a variety of specific conditions. The majority of cases involve spastic cerebral palsy, which confers on patients an impairment of (motor) neuromuscular mobility. Ataxic cerebral palsy involves poor muscle coordination and often manifests in deficits in fine motor skills, such as writing. Hypotonia refers to weak muscle structure that often is inadequate to support the body. Hypertonia refers to very tight or rigid muscles. People with cerebral palsy may exhibit either hypotonia or hypertonia, but those with athetoid or dyskinetic cerebral palsy have mixed muscle tone, that is, some hypotonia and some hypertonia.  Those with athetoid cerebral palsy may have difficulty walking, sitting up, holding a cup, or carrying out other ordinary tasks.

Cerebral palsy may effect one to four limbs. Spastic hemiplegia affects one side of the body (right or left), while spastic diplegia affects the lower extremities only (both legs and feet). A person with spastic diplegia may have little or no symptoms in the upper body. Those with spastic monoplegia have only one limb affected, while spastic triplegia affects three limbs. Spastic quadriplegia affects all four limbs, most often with about equal effect on each limb.

Symptoms of Cerebral Palsy

Cerebral palsy is most commonly diagnosed in childhood. Such children may have:

  • Abnormal muscle tone (very stiff bodies or very floppy bodies) or (walking on tip toes with inversion and adduction (scizoring))
  • Irregular posture
  • Spasms or involuntary movements
  • Unsteady gait, lack of balance, poor coordination
  • Seizures
  • Speech and language disorders
  • Sensory impairments
  • Learning disabilities
  • Behavioural disorders

The severity of symptoms varies considerably. In some children, the signs of cerebral palsy may only make the child seem a bit clumsy or uncoordinated. In other children, symptoms may cause the child to be profoundly disabled. Signs and symptoms of cerebral palsy may change as the child grows up, but the condition itself does not worsen.

Some cerebral palsy patients may have increased or decreased sensitivity around the mouth area, making it difficult for them to eat or swallow (or for infants to nurse). Urinary incontinence, increased drooling, and irregular breathing patterns may also occur in severe cerebral palsy patients.

Treatment

Cerebral palsy cannot be cured. The focus of treatment involves preventing or treating the sequelae of the brain disorders associated with cerebral palsy from impeding the child’s healthy development. Since children’s brains are not completely developed and possess extraordinary abilities in terms of re-routing signal pathways, early treatment is very important.

Many treatment methods are available to help cerebral palsy patients and include physical therapy, occupational therapy, speech therapy, drug therapy, hyperbaric oxygen treatments, bracing and the use of orthotic devices, and botox injection then surgery. Surgery involve first treatment of spasticity if it is handicapping, and in advanced cases the treatment of the complications of spasticity such as tendon shortening or fixed deformities, or joint sub-luxations.

People with cerebral palsy require life-long treatment to help manage their condition. Treatment options are highly individualised to meet the specific needs and goals of individual patients.

Prognosis

It is important for cerebral palsy patients and their families to work with highly trained specialists who are aware of the latest therapeutic advances and who can offer a wide range of treatment options. The Neuro Spinal Hospital can provide therapies from physical and occupational therapy to very specialised functional neurosurgery and orthopedic surgery as well as drug therapy and speech therapy and other care. Not all patients with cerebral palsy have learning disabilities, but those that do require special therapy. Such learning disabilities do not mean the child is intellectually impaired.  Problems with language, common in cerebral palsy, should not cause families and educators to underestimate the child’s intelligence.

Risk Factors

There is no known hereditary risk for cerebral palsy. The exact cause of the condition is not known but may be related to inadequate oxygen supply to the brain at certain crucial periods in the uterus, during birth, or early childhood. Girls are at slightly higher risk than boys for developing the condition. Premature infants are at higher risk for cerebral palsy than full-term infants.

Conclusion

Cerebral palsy is a life-long disorder that requires consistent, high-quality medical care from expert team. There are many types and degrees of severity of cerebral palsy. As a general rule, the earlier the condition is diagnosed and treated, the better the outcome for the patient. At the Neuro Spinal Hospital we provide these children the best expert assessment and treatment starting from physiotherapy, occupational therapy, selective botox injections to the spastic muslces, the functional surgical techniques targeting the harmful spasticity such as selective peripheral neurotomies, posterior functional rhizotomies, and intrathecal infusion of Baclofen.