Cerebral Palsy

Overview

Cerebral palsy is a neurological condition which results from damage to the developing brain, especially to the regions responsible for controlling muscle movement. It may also result from the under-development of some brain parts in children. Cerebral palsy is a common cause of disability in children, even though it does not occur widely.

This condition is popularly referred to as a movement or posture disorder, due to its disruptive impact upon muscle movement. Cerebral palsy is also considered to be a developmental disability affecting the way one's brain develops, obstructing its natural evolution.

What is Cerebral palsy?

Cerebral palsy refers to several conditions that, together, damage the muscles responsible for movement and maintaining postures. It is usually diagnosed in young kids, from infants to pre-schoolers showing varying symptoms. Some kids can showcase unusually exaggerated reflexes while others can face difficulty walking steadily.

In any case, the symptoms may differ from one child to another and cannot be generalised. The condition can manifest in several ways, yet, it never gets worse at any point. While there is no permanent cure, with appropriate medication and supervision from a doctor one can live a high-quality, fruitful life.

Types of Cerebral Palsy

The types of cerebral palsy can be categorised based on the impact they have on various body parts. Here are the diagnosed types of cerebral palsy diagnosed in children:

1. Spastic Cerebral Palsy

Spastic cerebral palsy is the most common type of CP that stiffens the muscles. Due to this condition, repetitive, exaggerated and jerky movements are prompted. Its subtypes include spastic hemiplegia, spastic diplegia and spastic quadriplegia which affect various parts of the body.

2. Dyskinetic Cerebral Palsy

Dyskinetic cerebral palsy causes slower and uncontrolled bodily responses, via the feet, hands and arms. In some children, the tongue and overall face muscles may be reactive, causing them to make awkward faces. They may also find it difficult to walk straight.

3. Ataxic Cerebral Palsy

This type of cerebral palsy affects the children’s ability to maintain balance. They struggle to find a positive footing with depth perception. Such kids face difficulties with delivering precision through their movements, for example, while writing, painting within the lines, etc.

4. Hypnotic Cerebral Palsy

Hypnotic cerebral palsy affects the firmness of muscles, resulting in loss of strength and floppy movements. This causes the child to miss out on certain developmental stages including crawling, walking, running, and more. Loss of head control and stability are the main culprits here.

5. Mixed Cerebral Palsy

If the child develops more than one type of cerebral palsy mentioned above, the condition is referred to as “mixed cerebral palsy”.

Below is a table listing the types of cerebral palsy based on the body parts it affects:

Type of Cerebral Palsy	Body Parts Affected
Monoplegia	One arm or leg
Diplegia	Both limbs; usually the legs
Hemiplegia	One entire side of the body
Triplegia	Three limbs (Example: two legs, one arm affected)
Quadriplegia	All four limbs are affected
Double hemiplegia	All four limbs are affected; one side is impacted more than the other.

Symptoms of Cerebral Palsy

Depending on the type of cerebral palsy, symptoms may differ. However, they commonly appear in the form of coordination and movement disorders, trouble in speech and eating patterns, developmental delays, etc.

Movement disorders may show up in the form of awkward reflexes from, stiffened to floppy muscles; lack of balance when standing or walking; jerky or slow, uncontrolled tremors; struggles with ensuring precision, etc.

Speech and eating-related symptoms manifest via a delay in speech development, problems with forming coherent words, eating and chewing activities; trouble with swallowing and occasional drooling, among others.

Finally, developmental disorders may show up in the form of intellectual, learning and overall growth-related delay.

Causes of Cerebral Palsy

Cerebral palsy is a condition resulting from incomplete brain development or due to damage caused at the moulding stage. While it typically lays claws even before the child is born, signs may occur at birth or during early infancy; symptoms becoming more traceable through pre-school years. Some causes that may lead to brain under-development include gene mutation and lack of oxygen to the brain during a rough delivery procedure.

Infections in the mother may affect the unborn baby; the child developing infections may also suffer from swelling in the brain area. A stroke may obstruct the blood flow to the brain. There can also be cases of bleeding into the unborn child's brain, while in the womb or as it is born. Finally, an injury caused to the child’s head may result in the development of cerebral palsy.

Risk Factors of Cerebral Palsy

A mother exposed to infections at the time of pregnancy increases the risk of children developing cerebral palsy. Cytomegalovirus and German measles are viral infections which make the kids prone to cerebral palsy. Herpes can be passed from the pregnant mother to the child. Syphilis is a bacterial infection which may be caused by sexual encounters. Other infections that may lead to birth defects of the baby include toxoplasmosis, zika virus infection, intrauterine infections, etc.

Babies are at risk of developing cerebral palsy if they suffer from illnesses like bacterial meningitis, viral encephalitis or severe cases of jaundice. Certain risk factors like the low weight of the baby at the time of birth (below 2.5 KG); premature births, and multiple or complicated delivery – may contribute to the child's under-developed brain condition.

Diagnosis of Cerebral Palsy

Diagnosis of cerebral palsy is usually done a little less than or a year after birth, as the associated symptoms become prominent and permanent. Affected children will be referred to rehabilitation specialists, pediatric neurologists and child development specialists who will proceed to conduct the necessary tests and diagnose them.

Brain imaging is also prescribed, consisting of MRI scans and cranial ultrasound. They help healthcare professionals identify alterations in a child’s brain. Secondly, an electroencephalogram (ECG) will allow for the identification of possible epilepsy.

Subsequent lab tests shall include examination of blood, skin or urine samples. Finally, the child’s vision, speech, hearing, intellect, development and movement will be tested, so professionals can be on top of any other underlying conditions.

Treatment of Cerebral Palsy

Cerebral palsy treatment is usually life-long with professionals at standby. While there is no permanent cure for the condition, active treatment can help the affected child live a high-quality life.

Muscle/nerve injections like onabotulinum toxin A are often recommended. Muscle relaxants like Fleqsuvy, Ozobax, Lyvispah, tizanidine diazepam or dantrolene may help relax the muscles. There are also Botox injections that can control drooling.

Physical, occupational, recreational and speech/language therapies shall be prescribed post-diagnosis. In the case of complications like the development of contractures, orthopaedic surgery may be necessary. Selective dorsal rhizotomy can also be recommended if other treatments have not made walking/moving any easier.

Preventive Measures for Cerebral Palsy

Preventative measures that the pregnant-to-be-mother can essentially undertake include getting vaccinated, shutting down possible exposure to viruses or infections, keeping any underlying health issues in check and control, etc. Staying away from addictive substances including alcohol, drugs, cigarettes, and more during pregnancy can also help.

Myths and Facts Related to Cerebral Palsy

Here are some myths related to cerebral palsy and the factual alternatives to them:

Myth 1: People with Cerebral Palsy are not Intelligent
Fact: While some kids diagnosed with cerebral palsy may have learning disabilities, others may not. Certain individuals have no problem keeping up with intellectual concepts.

Myth 2: People with Cerebral palsy Cannot be in Social Situations
Fact: People with cerebral palsy can very well mix up in social situations, as long as they are comfortable with it. They do not have to stay locked away from the world even though they do require general assistance every once in a while.

Myth 3: Cerebral Palsy is Contagious
Fact: Cerebral palsy is in no way contagious. It cannot be spread from one person to another.

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