A group of disorders affecting the muscle movement and coordination is collectively called as cerebral palsy. Cerebral palsy starts in the cerebrum area which controls body movements and is a non-progressive disease. Cerebral palsy also affects the vision, hearing, and sensation.
Cerebral palsy is of two types, namely:
- Congenital cerebral palsy: Infants are born with this disease
- Acquired cerebral palsy: It develops at a later stage
Cerebral palsy is not immediately observed after the birth of the child. The symptoms appear at a later stage, one or two years after the birth of the child.
The symptoms of cerebral palsy are:
- Difficulty speaking or delay in speech development
- Variations in the muscle tone, such as being stiff or loose
- Seizures or convulsions
- Excessive drooling or difficulty in swallowing
- Involuntary movements or tremors
- Slow, twisting movements (athetosis)
- Lack of muscle coordination (ataxia)
- Muscle stiffness with exaggerated reflexes (spasticity)
- Muscle stiffness with normal reflexes (rigidity)
- Difficulty in walking (abnormal gait)
People with cerebral palsy caused due to brain abnormalities might develop these following symptoms in addition to the ones mentioned above.
- Urinary incontinence
- Psychiatric conditions
- Oral diseases
- Intellectual disabilities
- Trouble with vision and hearing
- Pain perceptions
- Abnormal touch
Cerebral palsy is caused due to an injury or disruption during brain development. This brain damage may occur within the first five years of birth or during pregnancy.
There are various reasons for brain damage to occur to the fetus during pregnancy, which are as follows:
- Lack of oxygen in the mother’s womb
- Mother may develop infections, such as rubella, cytomegalovirus, toxoplasmosis etc
- Preterm delivery
- Low blood pressure
- Gene mutations
- Head trauma
- Brain stroke in the fetus
- Intracranial hemorrhage
- Blood diseases such as Rh disease, blood clotting disorders etc.
Factors causing stroke in fetus
Several factors are responsible for causing stroke in a fetus. These include:
- Blood clot in the placenta
- Clotting disorder in the fetus
- Inflammation of the placenta
- Arterial blood flow interruptions in the brain
- Pelvic inflammatory disease
- Small pelvis in the mother
- Maternal malnutrition
- Consumption of alcohol, illegal drugs during pregnancy
Risk factors during childbirth that cause cerebral palsy are:
- Emergency cesarean
- Prolonged second stage of labor
- Vacuum extraction used during delivery
- Umbilical cord abnormalities
- Fetal heart anomalies
- Damaged placenta
- Multiple births (twins)
The following are a few causes of cerebral palsy that is caused due to brain damage after birth:
- Head injury
- Drowning accident
- Infections like meningitis
Diagnosis is performed when the doctor suspects the child to have cerebral palsy. The doctor refers the child to a pediatric neurologist after performing a physical examination of the child. He may also record the child’s medical history for further evaluation.
The doctor may recommend a few diagnostic tests to rule out other possible disease conditions that show similar symptoms. The diagnostic tests are:
- A cranial ultrasound test is performed to obtain images of the brain and provides a valuable preliminary assessment of the brain.
- An MRI scan of the brain is carried out to identify any abnormalities or lesions in the child’s brain.
- Electroencephalogram (EEG) test is performed to determine the electrical conductivity or activity in the child’s brain.
Cerebral palsy is a lifelong disorder, but its impact on the child can be reduced by increasing the quality of life of the child. There is a medical care team that closely works together and ensures a better quality of life for the patient.
Treatment for the symptoms of cerebral palsy includes:
- Medications such as botox injections are administered for improving drooling and oral muscle relaxants provide relief from stiff and contracted muscles.
- Some non-drug therapies such as physical therapy, occupational therapy, speech and language therapy, and recreation therapy improve the child’s motor skills, speech and emotional well-being.
- Orthopedic surgery is performed to correct the bone abnormalities and lessen the muscle tightness.
- Dorsal rhizotomy is a surgery performed to reduce the severity of the muscle stiffness by cutting nerves that serve spastic muscles.
The following modalities will help children with cerebral palsy. They are:
- Fostering the child’s independence in doing small and regular activities
- Advocating the child’s health improvement Building confidence in the child with the help of support groups, organizations and counseling service groups
Prevention or lifestyle changes
It is difficult to prevent cerebral palsy; however, a change in the lifestyle may help in reducing the risk of developing the condition. The following are the preventive measures:
- Vaccination prevents infections, so always stay vaccinated
- Precautions must be taken to avoid any infections
- Consulting the doctor on a regular basis can prevent the birth of premature babies, low birth weight babies, and infections
- Head injuries in children can be avoided by opting for safety rail on beds, bicycle helmet, car seat, etc.