Cerebral palsy is a group of neurological disorders that affect movement and appear in early childhood. Symptoms of cerebral palsy include stiff and weak muscles, tremors, and impaired coordination.
Other problems associated with cerebral palsy include issues with hearing, vision, sensations, speaking, and swallowing.
Sometimes, they may be problems with learning, reasoning, and thinking. Infants with cerebral palsy do not often crawl, roll over, or sit the way other children do.
Abnormal brain development and trauma to the parts of the brain that control balance, posture, and movement can cause cerebral palsy. These problems typically occur during pregnancy, during childbirth or shortly after childbirth.
Preterm birth, infections during pregnancy, head trauma during the first few years of life, and exposure to toxic chemicals like mercury may increase the risk of cerebral palsy.
Diagnosis occurs by blood tests and imaging tools to rule out other possible causes. Cerebral palsy can be prevented by immunization and creating a safe environment around the child to avoid head injuries.
There is no known cure for the condition. However, treatment options are available to treat the symptoms. These include physical therapy, assistive technology, occupational therapy, speech therapy, and medications like diazepam.
Cerebral palsy is a movement disorder that is prevalent in children. The first known description of the disorder was mentioned in the work of Hippocrates in the 5th Century BCE.
William John Little conducted further studies of the ailment in the 1800s.
Types of Cerebral Palsy
Spastic Cerebral Palsy
This is the most common type of cerebral palsy. It affects about 80% of people living with cerebral palsy, causing stiffness of the muscles, exaggerated reflexes, and impaired ability to walk.
People living with spastic cerebral palsy typically have walking anomalies. They may also have weakness of the muscles and may experience paralysis. The symptoms of spastic cerebral palsy may affect one side of the body or the entire body.
Dyskinetic Cerebral Palsy
Involuntary and abnormal movement of the arms, legs, and hands, paralysis of the face are some of the hallmarks of dyskinetic cerebral palsy. The movement can be slow and lethargic, or rapid and jerky, making it difficult for the person to sit, walk, talk or swallow.
Hypotonic Cerebral Palsy
This type of cerebral palsy causes a decline in muscle tone and unusually relaxed muscles. The arms and legs appear soft and floppy. Infants with this type of cerebral palsy may have trouble breathing and difficulty in controlling their heads.
As time passes, they may struggle to sit upright as a result of weakened muscles. Poor reflexes, walking abnormalities, and difficulty speaking are associated problems of hypotonic cerebral palsy.
Ataxic Cerebral Palsy
This is the least common type of cerebral palsy. Some of the characteristics of ataxic cerebral palsy include voluntary movements that appear clumsy and disorganized, impaired balance and coordination, and difficulty with motor functions such as walking, writing, and holding objects.
Causes of Cerebral Palsy
The cerebrum, located to the brain, is responsible for muscle control, ability to learn, communication skills, and memory. Damage to this part of the brain, during or within five years of birth, can cause cerebral palsy.
It can also affect vision and hearing. Other conditions that may put a child at risk of developing cerebral palsy include:
Brain damage after birth
Abnormal brain development
A disturbance in the development of the brain, especially during the first six months of pregnancy when the mind of the embryo is vulnerable, may affect the way the brain communicates with the body and other functions.
This disruption can occur as a result of the mutation of genes responsible for brain development. Other factors include infections such as toxoplasmosis, rubella, herpes, and head injury.
This is the type of damage that affects the white matter in the brain due to a lack of oxygen in the womb. This could occur as a result of an infection during pregnancy, such as rubella.
Also, drug abuse, low blood pressure, and preterm delivery may lead to the development of cerebral palsy.
Sometimes, the fetus may experience a stroke that could result in bleeding in the brain. This bleeding can impede the flow of blood to vital brain tissue, thus, damaging or killing it. The escaped blood further clots and damages the surrounding tissue.
The following are factors that can lead to fetal stroke during pregnancy:
- Inflammation of the placenta
- Blood clotting in the placenta that blocks blood flow
- Untreated pre-eclampsia in the mother
- Disruption in the flow of blood to the fetal brain
- Pelvic inflammatory infection of the mother
- Clotting disorder in the fetus
The following factors may increase the baby’s risk of developing cerebral palsy during delivery:
- Abnormalities in the umbilical cord
- A hurried cesarean
- Defects in the heart of the fetus
- Prolonged labor
- Use of vacuum extraction during delivery
Furthermore, certain factors may increase the risk of cerebral palsy. These include:
- Damaged placenta
- Malnourishment while pregnant
- Sexually transmitted diseases such as herpes
- Multiple births
- Drug and alcohol abuse during pregnancy
- Small pelvis in the mother
- Abnormal formation of the fetal brain
- Baby settles feet first instead of head first during delivery (Breech position)
Signs and Symptoms of Cerebral Palsy
The symptoms of cerebral palsy vary from one person to another. Some people living with the condition may have difficulty sitting or walking.
While others may have trouble grasping objects. The symptoms can become more or less severe over time. They are also dependent on the part of the brain that is affected.
Symptoms of cerebral palsy include:
- Ataxia or the inability to control the muscles
- Delayed speech development
- Varied muscle tone with some muscles being too stiff or too floppy
- Difficulty swallowing and excessive drooling
- Delayed movement of the child such as sitting up alone, crawling or rolling over
- Neurological problems such as mental disabilities and seizures
- Difficulty walking
Symptoms of the disorder may not manifest until months or years after. They, however, appear before the age of 3 or 4.
The doctor will require the infant’s medical history and development and the mother’s medical history while pregnant.
The doctor will also examine the child and observe their muscle tone, movement, motor skills, posture, and reflexes.
Neurological exams would be needed to evaluate the child’s symptoms. The following tests can be carried out:
- An electroencephalogram (EEG) test is used to assess the electrical activity in the brain.
- A CT scan used to create clear, cross-sectional images of the brain.
- An MRI scan uses magnetic fields and radio waves to produce images of the brain. It is used to identify any abnormalities, tumors, or injuries in the brain.
- A cranial ultrasound uses high-frequency sound to produce low definition images of the brains of infants
- Blood tests to rule out other possible infections
Specialists may be required to test for neurological problems associated with cerebral palsy. These tests may detect:
- Vision impairment or loss
- Mental or intellectual disability
- Movement disorders
- Speech impediments
The doctor may also refer the child to an educational psychologist to evaluate mental development.
Cerebral Palsy has no cure. There are, however, treatment options available to manage the symptoms and improve general well being.
On confirmation of cerebral palsy diagnosis, a team of health professionals consisting of a doctor, speech therapist, pediatrician, and educational psychologist will help look after the child’s needs.
Other treatment options include medication like diazepam and baclofen, physical therapy, recreational therapy, occupational therapy, and assistive technology such as strollers and wheelchairs.
Treatment options vary among individuals and depend entirely on their needs.