Cerebral Palsy refers to a group of different disorders in a movement which is permanent and appears in early stages of childhood. Broadly describing, it is a group of chronic palsies or disorders which obstructs control of movement as a result of damage to the brain in developing stage. Usually, it begins at an early age, often at the age of two or three years and it is a brain disorder which is non-progressive. Non-progressive disorder means that the disorder of the brain doesn’t get worse over a lifetime. But, it is important to note that the symptoms of brain disorder can change over a lifetime. Sometimes the effects become too worse and sometimes it becomes better. Cerebral Palsy is one of the common reasons noted for chronic disability in children.
According to statistics, around 10,000 infants have Cerebral Palsy and in the US around 1,500 preschoolers are diagnosed with it every year. According to the United Cerebral Palsy Association, around 764,000 Americans have Cerebral Palsy. In patients, it has been noted that almost 35% and 50% of the children with CP also have other disorders such as seizure disorder and mental retardation to some level. They may also have problems related to vision, speech, hearing, language and learning problems. Cerebral Palsy is different factors which may affect the movement of the body and its posture. There are reflex movement and muscle stiffening which occur without the person having control over it in one part or all over the body. Cerebral Palsy can have mild to severe impact.
A lot of research and studies have been carried out to find out about Cerebral Palsy but there is still a lot to be discovered. A lot of facts still remains unknown about its causes, however, most evidence points out towards the fact that the common factors responsible for Cerebral Palsy are birth injuries, infection and lack of oxygen to the brain before during or after the birth. Premature infants are at high risk of Cerebral Palsy. Other health problems in early infanthood like meningitis, severe dehydration, and physical trauma can be causative factors for injury in the brain which may result in Cerebral Palsy.
Causes of Cerebral Palsy
As mentioned earlier, there are various causes which may result in Cerebral Palsy. It is mostly caused because of the injury or problem in the brain that happens during pregnancy or birth and in the early infant stage. Congenital palsy refers to the type of cerebral palsy that occurs because of the injury to the brain of the child during the pregnancy stage. It may not be detected even after months of the birth of the child. According to studies it has been found that almost 70 percent cases of palsy are caused because of this reason. 20 percent of cerebral palsy are caused because of brain injury during the birth process. In many cases of Cerebral Palsy, the exact cause may be difficult to find out. Some of the common reasons for Cerebral Palsy are mentioned below:
- Infections during pregnancy stage
The developing nervous system of the fetus can be damaged because of the infection in the pregnancy stage. Different infections like rubella, cytomegalovirus may be responsible for the infections. Similarly, toxoplasmosis is an infection which is caused by a parasite living in uncooked meat or cat feces. This infection can also cause Cerebral palsy. There are many other types of infections which are not detected in the women who are pregnant but those infections may be responsible for the Cerebral Palsy.
- Severe jaundice in the infant stages
Jaundice occurs when there is more bilirubin in the blood. Normally, the liver filters the bilirubin but most of the times the liver of the newborn child needs a few days for this process to be started properly. So in most cases, newborn infants are diagnosed with jaundice. Mostly phototherapy helps to cure jaundice at this stage and there are no impacts but in some cases, jaundice may damage the brain cells in the child when it is left untreated.
- Incompatibility of RH in mother and child
This is a condition in which antibodies are produced in the mother’s body which can destroy the blood cells in the fetus. A type of jaundice may occur because of this process in the newborn child and it may affect the brain cells.
- Trauma during birth
There can be physical and metabolic trauma during the process of birth. It can cause brain damage to the fetus whose development is under threat during the development stage.
- Deprivation of oxygen during birth
When there is a shortage of oxygen to the brain of the child before, during or immediately after birth then it may result in damage to the brain cells. The damage to the brain can be a cause of Cerebral palsy. Similarly, injury to the brain during, before or immediately after the birth may also affect the brain resulting in Cerebral Palsy.
Apart from these possible causes, there are various other factors which increase the chances of a child being diagnosed with Cerebral Palsy. They are as follows:
- Breech births in which the feet, buttocks or the knees come out first during delivery.
- Respiratory and vascular problems in the infant during the birth process.
- Physical defects such as a hernia in the groin, an abnormal type of small jawbone and faulty jaw bone formation.
- Low Apgar score within 10-20 minutes after the delivery of the child. Apgar test involves the heart rate, muscle tone, reflex, color and breathing to give a score from 0 which is low to 2 which is normal.
- Low weight at birth (less than 2.5 Kgs) or premature birth ( less than 37 weeks).
- Birth of twin children
- Abnormally small head as in cases of microcephaly in which there is a malfunction of the congenital nervous system.
- Seizures immediately after birth.
Similarly, if the mothers in the late pregnancy stages are bleeding excessively or more protein levels in the urine are at high risk of giving birth to a child with cerebral palsy. Similarly, mothers with retardations, seizures, hypothyroidism or hyperthyroidism are also at high risk of cerebral palsy. All the children in the risk group may not be born with Cerebral palsy but the doctors and the parents need to be extra careful if there are any risk factors involved.
Symptoms of Cerebral Palsy
The most common symptoms of Cerebral Palsy is that the person will have problems with movement and posture of the body. However, in some cases, the physical problems may be worse than in other cases. Some people who have cerebral palsy may be limping and it may be a bit difficult to walk but other people may not have control over body movement. They may also have problems to eat and speak. People who have severe kind of Cerebral palsy will also have other problems with Intellectual disability or seizures. Small babies with cerebral palsy have problems with their body posture. Their body may become stiff or floppy. Different birth defects like small jawbone, small head or abnormal shape of the spine may occur in case of cerebral palsy. The symptoms of cerebral palsy will not get worse over a lifetime. However, different symptoms may appear, change or it may even become worse as the child grows older. Most of the times, the symptoms may not be noticed immediately in children born with cerebral palsy.
Diagnosis of Cerebral Palsy
Cerebral Palsy can be diagnosed by a medical professional or a doctor. The doctor may seek a medical history of the child and do physical examinations. It is important for the doctor to know about the development, growth and any problems of the child. Different tests like CT scan, MRI of the head may also be necessary. Ultrasound images of the brain may also be required to know about the cause of Cerebral Palsy. The doctors can identify the problem within the first few weeks of birth if the child has severe kind of cerebral palsy. Usually, it is the parents who may notice that the child does not have abilities and skills as in the children of the same age group. The delay in development of the children could be the early signs of the problem. It is also important to know that the symptoms may not be noticed at all before the child is 1-3 years of age even if the condition is present in the child from an earlier stage.
Treatment of Cerebral Palsy
There is no permanent cure for Cerebral Palsy. However, there are various things with which we can make the life better of a person with cerebral palsy. There are things which can be done to deal with the symptoms in a better way and make the most out of the abilities of the child. Those treatments can prevent further problems and also help in improvement of overall quality of life. The most common and reliable treatment is Physical therapy. Many types of Medicines, equipment and surgery are available for the treatment of Cerebral Palsy. Different advanced types of equipment and support machines like wheelchairs, walkers can be of great help for people with Cerebral Palsy. It is necessary to pay a regular visit to the doctor to learn about the developing condition of the child with cerebral palsy.
Physical therapy is a treatment procedure which must be applied immediately after the diagnosis of the problem. The procedure may be continued for a lifetime of the child and it may also be started before the problem is diagnosed in certain conditions. It may be possible to prevent the necessity of surgery with the help of Physical therapy. However, the focus of the Physical therapy may change in case of surgery or if new conditions develop. Special Physical therapy may be necessary for six months after the surgery.
Devices and equipment
There are many devices and equipment available now which can help to a great extent in improving the quality of life of the person with Cerebral Palsy. These Devices and equipment help to improve and maintain mobility of the joints, to make the muscles strong and relax the muscles which are overactive. The types of equipment will help in the daily activities. There is special equipment like crutches, standers, special seats, orthotics, casts, walkers, wheelchairs and special chairs which can help with the problems. Different type of device may be used depending upon the need of the child.
Other treatments like Occupational therapy may be beneficial to the teens and adults to live in an independent manner by getting used to their limitations and making the best of their abilities. Similarly, Speech therapies can help to control the muscles of the mouth. It is to be started in early school years and continued over the school years. Speech therapy will help to learn how to eat and speak. A registered dietician may be helpful in determining appropriate kind of diet for the child depending on the condition. Massage therapy and yoga can be helpful to help the muscles relax and make them strong to a great extent. Similarly breathing exercises may be helpful to prevent lung problems. Behavioral therapy can be of great help for the children with Cerebral Palsy to learn ways of communicating with others.
Dealing with Cerebral Palsy
It is a very difficult condition if you have a family member with Cerebral Palsy. It is necessary to seek family and community support if you have a child with Cerebral Palsy. If you have a child with special needs then you need to share and speak up with other people because of which you will feel stronger. Counseling is equally important because you may go through different types of emotions and experiences. Counseling will help you to deal with those emotions effectively. You can also provide counseling and emotional support to the child with cerebral palsy so that they can feel stronger and deal with the problem strongly. It is not easy to accept the fact that your child has Cerebral Palsy and it is even more difficult to take care of a child with such condition. However, good knowledge of the condition is necessary to provide appropriate support and care to the child.