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Cerebral Palsy

What Is Cerebral Palsy?

A result of brain damage incurred either before or during birth, cerebral palsy is a group of conditions characterized by muscle spasticity and incoordination as well as cognitive deficits. These conditions range from mild to severe. While the brain damage does not get better or worse over time, the symptoms resulting from the brain damage may change, depending on the health condition of the patient. With therapy and training, someone with cerebral palsy can function more effectively and independently. People with cerebral palsy are more likely to have intellectual and/or developmental delays and chronic conditions, such as seizures

Cerebral palsy doesn’t have one root cause. In the United States, about 70 percent of children with cerebral palsy develop it before they are born, about 20 percent develop it during the birth process and the final 10 percent develop it in early childhood as a result of a brain infection, like bacterial meningitis, or a head injury.

Risk Factors

Cerebral palsy is associated with a number of risk factors, including:

  • Impaired blood supply to the fetus’ brain

  • Certain blood-type incompatibilities between mother and fetus

  • Certain viral or bacterial infections that affect the mother or infant

  • Inadequate fetal growth

  • Low birth weight

  • Poor transfer of nutrients or oxygen from the placenta to the fetus

  • Premature birth

  • Prolonged loss of oxygen during birth

  • Severe jaundice after birth

The presence of a risk factor does not necessarily mean the child will develop cerebral palsy, but parents can reduce the chance by avoiding risk factors whenever possible — for example, through Rhesus testing for incompatible blood levels and regular prenatal care.

Symptoms

Parents are often the first to notice the signs of cerebral palsy when their baby doesn’t meet the developmental milestones — rolling over, smiling, sitting, crawling, walking — that typically occur before 18 months. Symptoms include:

  • Abnormal muscle tone — Infants with cerebral palsy are born and experience a brief period of hypotonia (weak muscles) before developing the hypertonia (rigid and spastic muscles) often associated with the condition. An infant may feel very stiff or very floppy when a parent picks him or her up.

  • Unusual posture and movements — Children with cerebral palsy might have an unusual gait or favor one side of their body, e.g. using only one hand and leg to push themselves while crawling.

Treatment Options

Although cerebral palsy can’t be cured, early diagnosis followed by specialized, coordinated care can help children with the condition develop to their highest potential. The range of treatment options include:

  • Early intervention — A team that includes doctors, nurses, trained educators, social workers, and speech and occupational therapists can begin working with children at a young age to address physical and developmental challenges in children with cerebral palsy.

  • Drug treatments — A number of oral and injectable medications may treat the symptoms, including diazepam, baclofen (which can also be delivered via an implantable pump), dantrolene sodium, tizanidine and botulinum toxin, can reduce muscle stiffness and spasticity.

  • Orthopaedic surgery — Surgeons can employ various techniques to help improve gait and ease chronic pain and spasticity. Often orthopaedic surgeries involve lengthening muscles and tendons that are too short and causing pain.

  • Selective dorsal rhizotomy — Generally reserved for cases in which medications and therapy have been unsuccessful, this surgery requires cutting spinal nerves that are overactive and causing severe spasticity.

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