CEREBRAL PALSY

Cerebral Palsy

Cerebral Palsy

Introduction

Cerebral palsy (CP) is a term used for a group of non-contagious and non-progressive disorders affecting a child's ability to move and maintain balance and body position. It is one of the most common childhood disorders that can occur during pregnancy, child birth or after birth (Kavanaugh, 1982). CP is not currently curable. However, training, getting the right therapy, special equipment and, in some cases, surgery can make a big difference.

Etiology

All the conditions that can cause damage to the cognitive areas of the brain with resultant mental retardation (MR) can also affect the motor areas of the brain and result in cerebral palsy. These include:

Prenatal Prematurity, acute maternal infections (e.g. rubella), chronic maternal infections (e.g. syphilis, herpes), RH incompatibility, radiation, drugs (e.g. alcohol, cocaine), maternal dysfunctions (e.g. diabetes, hypertension).

Neonatal Precipitate birth, apnea, hypoxia (most common), birth injury, prolonged/ difficult labor.

Postnatal Trauma, brain tumors, infections (e.g. encephalitis, meningitis), toxins (e.g. lead, hydrocarbons).

What causes Cerebral Palsy?

CP is caused by damage to the motor control centers of the developing brain (Wicliffe, 1977). There are many possible causes of the brain damage, and the causes of most cases are unknown. Some of the known causes include:

Maternal infections: German measles (rubella), chickenpox (varicella), cytomegalovirus, toxoplasmosis and syphilis (a sexually transmitted disease) are linked to CP.

Infant illnesses: Meningitis (causing inflammation of the protective membranes covering the brain and spinal cord) and viral encephalitis (causing inflammation of the brain itself) are also linked to CP.

Congenital abnormalities can affect how the child's brain develops during the first 6 months of pregnancy. Exposure to toxins and radiation increases the risk of mutations in genes that are responsible for brain development.

Other causes include bleeding in the brain, head injury, lack of oxygen and severe jaundice.

Premature birth, very low birth-weight, breech births (feet-first position), multiple babies, using toxic substances during pregnancy and poor health of mothers during pregnancy are additional factors that may increase the risk of cerebral palsy.

Signs and Symptoms

Depending on how much of the brain is affected and which parts of the body are controlled by that section of the brain, the child can have a mild or severe case of CP. While early signs may be present from birth, if signs and symptoms are mild, definite diagnosis might be difficult before the age of 4 or 5 years. Generally, cerebral palsy is diagnosed by the 1st or 2nd year.

Signs and symptoms of CP may include lack of muscle coordination, stiff muscles, irregular walking with one foot or leg dragging, variations in muscle tone (too stiff to too floppy), too much drooling, difficulty in swallowing, sucking or speaking, and tremors (Brown et al, 1985). In addition to varying degrees of physical disabilities, some children with cerebral palsy may also have associated medical problems such as difficulty with vision, hearing and speech, mental problems, mental retardation, seizures, abnormal sensation and urinary incontinence that may require long term care. About 50 percent of people with CP need to use braces, walkers, wheelchairs and other assistive ...