Cerebral palsy

Cerebral palsy (CP) refers to a group of health conditions that impair the ability to move and retain a balance posture. It’s one of the most common movements and motor disabilities among children. Cerebral palsy occurs due to abnormal or immature development of the brain or damage that affects the developing brain. This impacts an individual’s ability to control the muscles. 

Generally, cerebral palsy leads to a wide range of disabilities, ranging from minor to chronic. In case your child is diagnosed with the condition, it’s essential to understand what to expect. This will also help you learn the essential ways of managing the problem and ensure that your child is not severely affected. 

Types of Cerebral Palsy 

Medical providers categorize CP based on the main associated kind of movement and the affected regions of the brain. Overall, thetypes of cerebral palsy include the following; 

• Spastic cerebral palsy 

This is typically the most widespread form of CP. It affects approximately 75 to 80 percent of individuals with CP. Spastic cerebral palsy patients have and elevated muscle tone. This indicates that the muscles become stiffer; hence their movements tend to be a bit awkward. 

In most cases, spastic cerebral palsy is typically described depending on the areas of the body that are affected. They include; 

Spastic diplegia or diparesis: With this type, muscle stiffness is mostly in the legs while the arms are either less affected or not affected at all. 

Spastic hemiplegia or hemiparesis: This affects just a single section of the patient’s body; often, the arm is highly affected compared to the leg. 

Spastic quadriplegia or quadriparesis: This is the most extreme type of spastic cerebral palsy, affecting all four limbs, the face, and the trunk. 

• Dyskinetic cerebral palsy 

Dyskinetic cerebral palsy patients experience difficulty controlling the mobility of their arms, hand, legs, and feet. This makes it hard to walk or sit; hence the movements become uncontrollable. They can also be sluggish and writhing or quick and jerky. When the face and tongue are impaired, the individual experiences difficulty swallowing, sucking, and communicating. 

• Ataxic cerebral palsy 

Patients with ataxic cerebral palsy have control and coordination issues. When walking, they can feel unsteady or shaky. Fast movements or the movements that require a lot of control, such as writing, can also be difficult. When trying to reach for something, they can have difficulty controlling the arms and hands. 

• Mixed cerebral palsy 

Some individuals can have signs and symptoms of more than one form of cerebral palsy. Spastic and dyskinetic cerebral palsy is the most common form of mixed CP.

Causes of Cerebral Palsy 

Cerebral palsy occurs following a disruption or abnormality in the development of the brain, especially before childbirth. This affects the section of the brain that regulates coordination, movement, and posture. Brain damage can also arise during child delivery or the early years of life. 

Mostly, the actual causes of cerebral palsy are not known. However, some of the potential factors that can contribute to the condition include the following; 

• Changes or mutations of the genes resulting in abnormal development of the brain 
• Maternal infections, including herpes simplex and German measles that affect the growing fetus
• Infant infections that lead to inflammation inside or around the child’s brain 
• Bleeding within the brain while in the womb or after birth 
• Traumatic head injury caused by a fall or a car accident
• Insufficient or lack of oxygen supply (asphyxia neonatorum) to the brain associated with labor and child delivery 

Signs and Symptoms Cerebral Palsy 

Cerebral palsy symptoms and signs vary highly from one patient to another ranging from mild to severe. While some experience sitting and walking difficulties, others have a problem grabbing objects.  

With time, the CP symptoms can either become more intense or less severe. Moreover, they can vary based on the affected area of the brain. 

The commons signs and symptoms can thus include the following; 

• Delays in achieving motor ability goals like pushing up on the arms, crawling, or sitting up
• Difficulties with fine motor skills, including buttoning a shirt or gathering up utensils 
• Exaggerated reflexes and stiff muscles (spasticity) 
• Favoring a single section of the body; for instance, creeping with one hand or pulling one leg when crawling 
• Instability of posture and lack of coordination of the muscle (ataxia) 
• Learning problems
• Muscle tone variations, including being too stiff or floppy 
• Muscles that are stiff but have natural reflexes 
• Seizures 
• Slow, writhing motions 
• Speech development delays or trouble speaking 
• Sucking or eating difficulties 
• Too much drooling or swallowing difficulties 
• Tremors or involuntary vibrations when moving
• Walking difficulties; for instance, walking on the toes, a crouched walk, a scissors-like gait where the knees are crossed, a long gait, or asymmetrical pace 

Cerebral Palsy Diagnosis 

Cerebral palsy symptoms and signs tend to be more evident with time. Therefore, the doctor may not perform a diagnosis till a few months after delivery. The diagnosis will involve conducting a thorough medical history. It will also include a physical test that entails a systematic neurological examination and assessing the symptoms. 

Other additional diagnostic tests and procedures that doctor can conduct include:

Electroencephalogram (EEG): This aims at measuring the electrical activity within the brain. The doctor can recommend EEG if the patient has symptoms of epilepsy, which triggers seizures. 

Magnetic resonance imaging (MRI): An MRI scan generates detailed pictures of the brain using radio waves and strong magnetic fields. It is capable of detecting certain defects or injuries within the brain.

Computerized tomography (CT) scan: This enables doctors to obtain accurate cross-sectional pictures of the brain. CT scan can also show any damage or injury in the brain. 

Cranial ultrasound: This is a comparatively simple and fast way of obtaining basic pictures of the brain among young infants. Cranial ultrasound uses high-frequency sound waves for this purpose. 

Blood test: Doctors can recommend a blood test to rule out any possible conditions, including bleeding problems. 

Health Conditions Associated With Cerebral Palsy 

Patients diagnosed with CP can also have other underlying health problems, including; 

• Communication problems such as language and speech disorders 
• Spinal deformity including lordosis, scoliosis, and kyphosis 
• Osteoarthritis 
• Drooling 
• Incontinence 
• Contractures that develops when the muscles are locked in painful angles 
• Osteopenia; bone density which causes the bones to break easily 
• Dental issues 

Cerebral Palsy Treatment Options 

The initial aim of cerebral palsy treatment is to prevent more complications and enhance limitations. Minors and adults with CP usually require comprehensive long-term care while administering other significant forms of treatment. 

Depending on the type of CP, the extent, and the patient’s age, the treatment options can include the following; 

Medications: 

The goal of medications is to minimize pain, enhance functional abilities, and manage certain CP symptoms complications. The types of medications that doctor can recommend or prescribe are; 

• Oral muscle relaxants, including dantrolene, diazepam, and baclofen to help relax and calm the muscles 
• Nerve or muscle injections such as Botox and Dysport to address tightening of a particular muscle 

Therapies: 

Various therapies form part of the significant role in addressing cerebral palsy. They include; 

Physical therapy: Muscle workouts and training will help improve the child's resilience, stability, coordination, motor growth, and movement. Physical therapy also enables the parent to learn how to provide for the child's basic needs while at home. This includes washing and feeding him or her.

Speech and language therapy: The pathologists may assist the child in improving his or her ability to talk effectively or communicate with sign languages. If communicating is challenging, they may also educate them on using communication tools, including a computer or speech synthesizer. 

Occupational therapy: With occupational therapy, the therapists support the child in gaining independence with everyday tasks. This also includes activities at home, school, and in the neighborhood. Quadrupedal canes, walkers, seating structures, and electric wheelchairs are examples of adaptive devices that might be recommended for the child. 

Recreational therapy: Standard or adaptive recreational or organized sports events, including therapeutic horseback riding or skiing, can be helpful to some children. Recreational therapy enables the child to develop and improve his or her motor skills, speech, and mental well-being.

Surgery: 

At times, a surgical procedure might be necessary to ease muscle tightness and treat bone anomalies associated with spasticity. The surgical treatment options can include; 

Orthopedic surgery: Doctors can recommend this type of surgery for minors with severe contractures and deformities. It can be performed on the joints or bones to put the hips, legs, or arms in the right position. 

Cutting nerve fibers: If other treatment forms fail to address the problem, the doctor can recommend cutting the nerves that serve the spastic muscles. This procedure is known as a selective dorsal rhizotomy. It aims at relaxing the muscles and lessening pain. 

Conclusion 

Cerebral palsy is a chronic health condition that impairs a person’s mobility, muscle tone, and motor skills. It generally prevents the ability to move in a purposeful and coordinated manner. CP is more common among young children aging three to five years. It can also trigger other health issues affecting vision, learning, and hearing. 

CloudHospital specializes in helping children diagnosed with cerebral palsy. It works with several professional medical experts from renowned healthcare facilities. Their objective is to diagnose, treat, and manage CP to ensure that the patient lives a normal healthy life.