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Cerebral Palsy Introduction

 

Cerebral Palsy (CP) is a term used to describe a number of chronic conditions involving motor (physical) and brain (neurological) function.  Cerebral Palsy is not a disease but a life-long condition that affects the communication between the brain and the muscles, causing a permanent state of uncoordinated movement and posturing.[1]

 

There is not one single cause but several triggering factors that could contribute to the manifestation of this disorder.  It was in the 1860's when the symptoms of Cerebral Palsy were first described; at that time the disorder came to be known as Little's disease.  William Little, and English surgeon, observed the stiff, spastic leg movements of children as they tried to grasp objects, and attempt to walk and crawl. He noticed that as these children grew older, their condition didn't improve or grow worse.  What was apparent in each child was the presence of mental retardation, visual disturbances and seizures.  He then suggested that depletion of oxygen during birth was the cause of these behaviors.  Sigmund Freud, however, disagreed and proposed there was some other, notable event that occurred prior to birth. "Difficult birth, in certain cases," he wrote, "is merely a symptom of deeper effects that influence the development of the fetus." [2]

 

Today, the cause of cerebral palsy is still somewhat elusive.  Many different types of brain injury can lead to cerebral palsy, and many times an exact cause cannot be determined.  Birth injuries and oxygen deprivation to the brain before, during, and immediately after birth, account for approximately 10 to 15% of all cases. [3]  It has also been theorized that because the first few years of life are a more tenuous time for infants, the threat and onset of severe illness, inflammation, trauma or severe dehydration could cause brain damage, which may result in cerebral palsy. Other risk factors include; premature birth, low birth weight, blood type incompatibility between mother and child, lack of proper nutrients during fetal development via the placenta and absence of growth factors during fetal development.[4]

 

The diagnosis of cerebral palsy is difficult in early infancy, due to many other conditions that can have similar presentation. As the child matures, developmental milestones can be key indicators of poor coordination, weakness and mental delay. Typically, doctors diagnose cerebral palsy in infants by testing their motor skills, thoroughly analyzing their medical history, and employing some diagnostic tests such as magnetic resonance imaging (MRI) or computed tomography (CT) to discern the nature of any brain damage and help rule out other conditions.[5]

 

 

Cerebral Palsy Symptoms

 

Because Cerebral Palsy is an umbrella term for several chronic conditions, its manifestation depends on the classification of the disorder. Symptoms can range from mild to severe and thus cause varying degrees of handicap. In all forms of cerebral palsy there is difficulty with annunciation of words, seeing or hearing properly and behavioral problems. Cerebral Palsy may be grouped into 4 main groups, depending on symptoms displayed and other factors.

 

Spastic

  • Approximately 70% of children with cerebral palsy have the spastic version.

  • Stiff and weak muscles- can affect arms legs on one side of both

  • Poorly developed affected legs/arms

  • Mental retardation (sometimes severe)

  • Seizures

  • Trouble swallowing

  • Choking on secretions from mouth and stomach

  • Difficulty breathing
     

Choreoathetoid

  • Affects nearly 20% of children with cerebral palsy

  • Spontaneous, slow muscle movement

  • Jerky abrupt movements

  • Symptoms better with sleep

  • Symptoms worse with strong emotions

  • Rarely have seizures

  • Usually have normal intelligence

Ataxic

  • About 10% of children with cerebral palsy have the ataxic form

  • Poor coordination, shaky movements

  • Muscle weakness and trembling

  • Difficulty with rapid or fine movements

  • Difficulty walking

Mixed

  • Those with this form typically have a combination of symptoms of ataxic

  • Cerebral Palsy and Choreoathetoid Cerebral Palsy.[6]

 

Cerebral Palsy Statistics
  • About 764,000 children and adults in the United States manifest one or more of the symptoms of cerebral palsy.
     

  • Currently, approximately 8,000 babies and infants are diagnosed with the condition every year.
     

  • 1,200 - 1,500 preschool age children are said to have cerebral palsy each year.[7]

 

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