Cerebral Palsy
Cerebral Palsy
The term “cerebral paralysis” was used for the first time more than 170 years ago, by the English orthopaedic surgeon William Little, who correlated a difficult labour and neonatal
hypoxia with limb spasticity and consequential musculoskeletal deformities.
Cerebral palsy (CP) is the most common childhood motor disability disorder. As a consequence of impairment to an infant’s growing brain, cerebral palsy (CP) is a set of disorders that impair muscle tone, posture, and movement. Though the damage does not worsen with time, the symptoms do vary as a result of growth and development.
Children with Cerebral palsy often have one or more related disorders, such as
- Learning impairments
- Developmental delays
- Seizures
- Visual or hearing abnormalities, and
- Speech and communication difficulties.
They may also have additional medical challenges, including feeding and nutritional difficulties, as well as breathing problems.
What are the different types of cerebral palsy?
Cerebral palsy is classified into numerous categories. They are categorized according to the kind of motor function difficulties that the child has:
- Spastic diplegia is characterized by spastic movements of the legs.
- Spastic quadriplegia is characterized by spastic movements in all four limbs (both arms and legs)
- Spastic hemiplegia is characterized by spasticity that affects just one half of the body, or one side (such as the right arm and right leg)
- Athetoid: characterized by uncontrollable, and purposeless movements
- Dystonia is characterized by persistent or recurrent muscular contractions that do not release, resulting in twisted or fixed postures.
What are the underlying risk factors of cerebral palsy?
There are several risk factors of cerebral palsy, but they all occur during pregnancy, birth, or immediately after delivery. Brain abnormalities, infection, and stroke are all common causes.
Preconception: maternal illness, malnutrition, infection
Prenatal: vaginal bleeding, abnormalities of placenta, multiple pregnancy, intrauterine hypoxia, premature rupture of membrane
Perinatal: premature birth, forceps/vacuum delivery, prolonged labour, asphyxia, meconium aspiration
Postnatal: respiratory distress, mechanical ventilation, infection, increased bilirubin, brain hemorrhage, seizure
What exactly are the signs and symptoms of cerebral palsy?
Cerebral palsy symptoms might differ from child to child. Symptoms include muscular weakness and impaired motor control, as well as muscle tightness (spasticity) and movement abnormalities (dyskinesias).
Other symptoms that children with this condition may experience include:
- Seizures
- Eyesight Impairment Or Difficulty Seeing
- Hearing Loss Or Difficulty Hearing
- Difficulties With Speaking
- Nutritional Difficulties
- Respiratory Problems
- Gastroesophageal Reflux Disease (Gerd)
- Disabilities In Learning
- Behavioral Problems
- Developmental Delays
- Swallowing Difficulties (Dysphagia)
- Constipation
- Fragile Bones
How is cerebral palsy diagnosed?
Doctors commonly diagnose cerebral palsy (CP) in children between the ages of 6 and 24 months, since this is when they begin to fail developmental milestones such as walking and coordinating hand and head motions.
A comprehensive history and physical examination are required to diagnose CP. A neurologist or pediatrician collects a comprehensive history of the mother’s pregnancy, as well as the child’s birth and infancy, during the first evaluation.
The diagnostic test includes
- MRI: reveals anatomic anomalies characteristic of particular CP types; it also allows for a better understanding
of pathogenesis, brain damage aetiology and structural and functional dependencies in CP - Due to the complexity of problems in the clinical presentation of CP, psychological tests, vision evaluation, audiometric tests
and electroencephalography (EEG) are carried out.
What are the Treatment options for Cerebral Palsy?
Medications aid in the management of cerebral palsy
While medicine cannot treat or cure CP, it may help manage some symptoms. Among the medications are:
- Antispasmodics: decreases muscle spasms and relieves muscle stiffness e.g Baclofen/Liofen
- Anticonvulsants: These medications are used to treat seizures in children.
- Anticholinergics: aids in the treatment of youngsters who have stiffness and uncontrolled drooling e.g Trihexiphenidyl (Pacitane, Bexol)
- Gabapentin
- Botulinum toxin injections: aids in the reduction of muscular tension.
Eye and dental evaluation
Orthopedic surveillance surgery: . Spasticity in the legs may also be reduced with surgery by elongating or releasing tight muscles and tendons that are excessively short. Scoliosis, hip dislocations, and ankle and foot abnormalities are also treated surgically.
Neurosurgery: implantation of a baclofen pump, selective dorsal rhizotomy, selective peripheral neurotomy
Therapy options for cerebral palsy
To treat symptoms, your child’s doctor may advise one or more types of therapy. These might include:
Physiotherapy (PT): By extending your child’s spastic muscles, physical therapy may help avoid muscular contractures. Many children undergo physical therapy on a daily basis to participate in stretches, strengthening exercises, and play activities that may help them improve their flexibility, endurance, and mobility. Physical therapy may be used in conjunction with orthotic devices such as a brace or splint.
Occupational Therapy (OT): OT can assist children with cerebral palsy gain independence, confidence, and key life skills. The occupational therapist will utilize exercises, games, and training to help your child improve fine motor skills, hand-eye coordination, and master fundamental functions like dressing and bathing.
Speech Therapy: A speech therapist may help your child with speaking, swallowing, and feeding issues. Depending on the condition, speech therapy may involve augmentative communication (using a computer system to assist with the communication) and feeding skill improvement.