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Cerebral palsy

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Dr. Sandeep Borse
Neurologist

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More From Cerebral palsy

Cerebral palsy is a neurological disorder that affects the motor nerves and usually appears in infancy or early childhood. It affects one in every five hundred children and caused by abnormal brain development or damage to the brain during early developmental stages. The motor function and muscle coordination is permanently affected but the condition does not worsen with time.

Cerebral refers to the brain, whereas palsy refers to weakness. Coordination problems may occur in some people. This abnormality affects the persons controlling ability over his or her muscles. The symptoms experienced by people may vary distinctly. A person whose cerebral palsy is severe might need to use equipment like a walker and may require lifelong care. However, a person with mild cerebral palsy has mild discomfort in walking but may not need any help. Most people with cerebral palsy have movement and posture issues.

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Types

Cerebral palsy is mainly classified into three categories depending upon the severity of the disease – mild, moderate or severe cerebral palsy. However, it is also classified into different types based on various factors.

Depending upon the body parts affected, it is broadly divided into four categories –


  • Spastic: A spastic cerebral palsy has increased muscle tone, which results in stiffness and awkward moments. It affects a different part of the body like legs, arms or sometimes even all four limbs. It may be periodic or permanent in nature.

  • Ataxic: In Ataxic cerebral palsy, problems with coordination and balance are seen. There may be unsteady walking or problems while writing. There are problems related to activities requiring concentration.

  • Dyskinetic: There is trouble in controlling the movement of hands, arms, feet or legs in dyskinetic cerebral palsy. The moments are described as rapid and jerky or slow and difficult.

  • Mixed: You may experience more than one of the above types of cerebral palsy, which refers to mixed cerebral palsy. It can affect one or more parts of your body , sometimes leading to disabilities.


Based on the part of the brain that is injured, disease can be classified into –

  • Hemiplegic – In this case, half the body is affected (usually, upper body is paralysed)

  • Diplegic – Both the legs (lower part of the body) are paralysed, in this type of condition.

  • Quadriplegic – Both the arms and legs are affected meaning the entire body is paralysed in people suffering from this type of condition.

Symptoms

The common signs and symptoms of children suffering from cerebral palsy are -


  • Children suffering from this disease also exhibit some other conditions like overall development delay, particularly delay in speaking, visual impairment and hearing problems and in some cases neurological conditions like seizures or convulsions.

  • They also report visual impairment and hearing problems and in some cases neurological conditions like seizures or convulsions.

  • Children suffer primarily from motor development issues which leads to slower than normal movements and trouble performing the more basic tasks like sitting down or lifting the head up.

  • Children with cerebral palsy can have normal intelligence despite of motor and movement difficulties.

  • Some children suffer primarily from motor development issues which makes it difficult for them to exhibit normal motor actions like sitting down or putting their head up. They usually have delayed head control, learn to sit or stand up late or in some cases have trouble standing at all.

Causes And Risk Factor

Causes

Although this condition affects muscle movement, it is not caused due to complications in the nerves or muscles but due to abnormalities the parts of the brain that control muscle movements. In most cases, it is due to an injury to the brain caused before, during or after birth in kids. It often leads to slower movements and trouble performing the more basic tasks.

Risk Factors

The common factors that increase the risk of cerebral palsy are –


  • Infections during pregnancy might damage the nervous system of the fetus leading to cerebral palsy.

  • Children, who have low birth weights, suffer from infections at an early stage on or are premature.

  • Deprivation of oxygen to the fetal brain or trauma to the head during labour and delivery might increase the risk of cerebral palsy in kids.

  • Other health problems such as physical birth defects, vascular or respiratory problems in the infant during birth and congenital nervous system malformation increase the possibility that a child will later be diagnosed with cerebral palsy later in life.

Prevention

Cerebral palsy is impossible or very difficult to prevent, but you can take precautions to prevent its occurrence in babies. Early care and treatment may help you to live a good quality of lifestyle. If you’re planning for a baby, consult with your physician to take appropriate prenatal care. The physician will keep a watch on your baby’s health and alert you if any issues arise.

Make sure your child is properly vaccinated to prevent infections that may lead to cerebral palsy.

Diagnosis

Early detection of the condition can lead to early intervention and thus, aid in management of the disease. Cerebral palsy is diagnosed based on the child’s history and physical examination. Various tests like the EEG or an MRI scan to search for abnormality in the brain are usually used to find the associated conditions.

Treatment

Although there is no ‘cure’ for cerebral palsy, the condition can be effectively managed. It is important to not lose Parents whose children suffer from cerebral palsy should not to lose hope and stay positive. The common treatment methods include drugs, physiotherapy and occupational therapy.

Speech and language therapy and treatment for the hearing and vision problems may be needed. Horse riding or hippotherapy is thought to be the most effective neuro-development strategies used today. Scientists have built a device called robo-ankle that can assist people with cerebral palsy. In a new research, doctors have found a way to convert skin cells into brain cells which could be a boon to those who suffer from several brain abnormalities like cerebral palsy.

The therapies used to treat Cerebral palsy include:

1. Medications: Medicines are prescribed to help with spastic movements, pain relief, seizures and other symptoms related to cerebral palsy.

Some common prescriptions include:


  • Baclofen or other muscle relaxants

  • Diazepam

  • Anticonvulsants

  • Anticholinergics

  • Antacids

  • Stool softeners

  • Sleep inducing medication


2. Surgery: Surgical procedures are done to improve movement and manage pain. Scoliosis surgery and repair of dislocated joints is common.

3. Therapy: Different therapies help improve the physical, mental and social well-being of a child. Standard treatments include music, aqua, play, speech etc.

Lifestyle/management


  • There are many assistive devices that can be used to help with improving communication skills like computers, computer software’s, voice synthesizers are some commonly used devices.

  • Improvement in balance and coordination is seen with the use of orthopaedic devices. Orthopaedic devices like braces, chairs, wheelchairs, rollers are used to make daily functioning easier. People with vision problems may make use of glasses. You can use hearing aids for hearing issues.

  • Many children also take the help of therapies like herbal medicine, acupuncture, movement therapy, dietary supplements etc.

  • Stem cell therapy is a significant ongoing therapy being researched for the treatment of cerebral palsy. Stem cells develop and convert into other type of cells in body, research to check their ability to treat and repair neuronal and cerebral function is being conducted.

Prognosis And Complications

Prognosis

The path of the disease depends upon how severe it is. Most of the people diagnosed with cerebral palsy get better with proper treatment and therapies. Children with mild symptoms live an undisturbed and good lifestyle whereas the ones with severe symptoms might face long-term immobility and bed ridden lifestyle.

The use of walkers or crutches helps children learn to work independently and increase mobility. The children grow and develop differently there is no such one progression of the disease. Care should be taken so that there is no development of other medical complications due to cerebral palsy.

Complications

There are many problems that accompany cerebral palsy. They include physical and cognitive disabilities (learning ability or understanding capabilities). The damage caused to the cerebrum can also lead to problems like:


  • Hearing loss

  • Loss of ability to see (vision impairment)

  • Speech problems

  • Drooling

  • Insomnia (trouble falling asleep)

  • Behavioural issues

  • Disabilities related to learning

  • Weak bones (Osteoporosis)

Reference


  • CDC. Cerebral Palsy [Internet] [Updated Dec 31, 2020]. Available at: https://www.cdc.gov/ncbddd/cp/facts.html#:~:text=Cerebral%20palsy%20(CP)%20is%20a,problems%20with%20using%20the%20muscles.

  • Cleveland Clinic. Cerebral Palsy [Internet] [Updated Nov 11, 2020]. Available at: https://www.cdc.gov/ncbddd/cp/facts.html#:~:text=Cerebral%20palsy%20(CP)%20is%20a,problems%20with%20using%20the%20muscles.

  • Cerebral Palsy Guidance. Cerebral Palsy [Internet] [Updated June 11, 2020]. Available at: https://www.cerebralpalsyguidance.com/cerebral-palsy/

  • NINDS. Cerebral Palsy Hope through Research. [Internet] [Updated July 2013] Avaliable at: https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Hope-Through-Research/Cerebral-Palsy-Hope-Through-Research.

  • Kids Health. Cerebral Palsy [Internet] [Updated on Sept 2018] Avaliable at: https://kidshealth.org/en/parents/cerebral-palsy.html

More From Cerebral palsy

World Cerebral Palsy Day: Orthopaedic complications of Cerebral Palsy

World Cerebral Palsy Day: Orthopaedic complications of Cerebral Palsy

Dr Rakesh Lalla Consultant Intervention Neurologist Fortis Hospital Kalyan and Dr Pramod Bhor, Orthopedist and Joint Replacement Surgeon, Hiranandani Hospital Vashi- A Fortis Network Hospital, share their insights on World Cerebral Palsy Day. The experts highlight the complications and the importance of monitoring orthopaedic health.

World Cerebral Palsy Day: Orthopaedic complications of Cerebral Palsy

World Cerebral Palsy Day: Orthopaedic complications of Cerebral Palsy

Dr Rakesh Lalla Consultant Intervention Neurologist Fortis Hospital Kalyan and Dr Pramod Bhor, Orthopedist and Joint Replacement Surgeon, Hiranandani Hospital Vashi- A Fortis Network Hospital, share their insights on World Cerebral Palsy Day. The experts highlight the complications and the importance of monitoring orthopaedic health.

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