A Report On Cerebral Palsy In Children
Cerebral Palsy is a group of neuromuscular conditions that affects one’s motor abilities due to damage to the motor area of the brain. It is a non-progressive, lifelong impairment of movement and coordination that develops before, during and immediately after birth. The type of severity depends on the location and amount of brain damage. Areas usually affected are the Motor Cortex which controls precision and control of voluntary movement. Basal Ganglia responsible for planning and programming the motor commands of movement. And Cerebellum which receives input from sensory systems of the spinal cord that produces motor learning, regulates balance and muscle coordination.
The causes of Cerebral Palsy are Idiopathic meaning scientist are not one hundred percent sure of the cause prenatally before birth to when the mother has a premature birth or has maternal infections. Perinatally they can be complications during pregnancy that can cause Cerebral Palsy. And postnatally, in the infant before the age of three months, brain tumors, epileptic seizures and fever can cause Cerebral Palsy.
There are three types of Cerebral Palsy known as Spastic, Dyskinetic, and Ataxia. And there are two sub-levels under those three types of Cerebral Palsy which are known has Pyramidal: Hemiplegia, Diplegia, Quadriplegia and Extrapyramidal: Athetoid, Dystonic, and Ataxia.
Spasticity is an increased resistance to passive motion. Spasticity affects between 45-70 percent of the body due to damage to the motor cortex and further damage to the basal ganglia and cerebellum. The location and variation in degree of the Spasticity depends on the hypertonicity of the individual’s muscles and how stiff they are. Which usually involves arm flexors and leg extensors depending on posture, positioning, emotional factors and pre-movement stretching.
Dyskinetic is a movement disorder sustained by involuntary muscle contractions that cause twisting and repetitive abnormal movements.
Diplegia primarily the affects the lower limbs usually the legs more than the arms. In Diplegia, if all four limbs are affected it is considered a sub-set of Quadriplegia. If the legs or arms are predominantly affected, some individuals can walk and run with a stable base for support as much as possible while some require a wheelchair for functional abilities. In Quadriplegia 20 percent the total body is affected, the severity can vary from mild to severe.
Hemiplegia affects 40 percent one side of the body predominantly but do not assume that the function of the less affected is “normal”. Most individuals modify activities to accommodate dysfunction.
Damage the basal ganglia is mostly the reason for Athetosis for people who have Cerebral Palsy. The interference in muscle tone in mild athetosis or even severe athetosis is more apparent visually in the fingers, wrists, toes and ankles. The unwanted movements that are only apparent while attempting to perform specific motor tasks as with handwriting, attempting to stand, and unwanted head and arm movements. Many people with Athetosis use wheelchairs due to the poor control of muscles involved in slurred speech and in swallowing while eating meals.
The Diagnosis of Cerebral Palsy is based on a thorough birth history of the patient (Prenatal, perinatal, and postnatal) the and by physical examination. A Cerebral Palsy diagnosis is often made within the two years of a child’s life. Neuroimaging is a part of the diagnosis evaluation of Cerebral Palsy and can provide the parents of a child with Cerebral Palsy with medical management and neurodevelopment outcomes for the child’s future.
The leading cause of death in children with a severe disability including Cerebral Palsy, is chronic respiratory infections and more than 90 percent of deaths in children with severe Cerebral Palsy are caused by pneumonia. Respiratory dysfunctions might also affect sleep and sleep breathing problems in children with Cerebral Palsy compared to those of healthy children. Children with Cerebral Palsy also have an increased of epilepsy, visual impairment and hearing impairment as well as gastrointestinal impairments.
Cerebral palsy refers to a group of chronic disorders that involve degrees of brain damage that affect body control and movement. The term cerebral refers to the brain, while palsy describes a disorder that impairs the control of body movement. These disorders are not the result of muscles or nerves problems. Instead, they are due to impaired motor areas in the brain that disrupt its ability to control movement and posture. The condition typically appears within the first few years of life and it is not marked by regression. Cerebral palsy is a non-contagious, non-progressive neuro-muscular disorder that impairs standard muscle control.
Cerebral Palsy can either be present before birth, can occur during the delivery process, or can even develop up to several years after a child is born. The disorder is most commonly a non-progressive motor disorder. More severe symptoms in children with cerebral palsy may result in basically no muscle control, greatly affecting their lives. There are some individuals that suffer a mild cerebral palsy form. Many people do not know that mild cerebral palsy exists because the symptoms of this cerebral palsy form are able to lead “normal” lives. Since cerebral palsy is caused from brain damage, the severity of the cerebral palsy is dependent upon how much brain damage exists.
Sometimes, mild cerebral palsy patients cause other disorders to occur. The way that these disorders affect the mild cerebral palsy individual can be mild or severe, requiring the mild cerebral palsy patient to need more treatment. Since every mild cerebral palsy patient is affected in his/her own way, developing an individualized mild cerebral palsy treatment plan is required. There are many different types of cerebral palsy. Types of cerebral palsy are classified by the type of movement problems caused by brain impairment that indicate motor disability include spastic, ataxic, athetoid and mixed cerebral palsy. The disorder usually does not get any worse; yet it is an irreversible, everlasting illness that does not subside.
Cerebral palsy occurs either during pregnancy or after pregnancy as the brain is impaired while in the process of developing. The effects of cerebral palsy are important when factored into a person’s lifestyle because it can affect a person’s posture, balance, hearing, and ability to move, communicating, eating, sleeping and learning. People who have Cerebral Palsy may also be prone to seizures and have intellectual impairments. Mixed cerebral palsy is characterized by both spastic and non-spastic impairments. The type of mixed cerebral palsy that is most common encompasses the extremities to be affected by both spasticity and athetosis. The research and investigation of cerebral palsy has advanced all over the world allowing the knowledge of this disorder to be studied and the ability to understand the concept and treatment possibilities of cerebral palsy.
When these parts of the brain are damaged, the messages are not received properly as it should. Thus, the miscommunication affects the muscles. For example, when the brain commands the affected limb to straighten, it cannot, making the hand, or foot turn inward involuntarily than outward. Unfortunately, the brain damage is irreversible. And while it is possible to at least lessen certain risks for Cerebral Palsy with modern medicine and technology, it cannot be prevented.
Cerebral palsy cannot be easily diagnosed in infancy. However, there are early signs that could suggest Cerebral Palsy that include stiffness, difficulty with crawling, standing and moving in position, and favoring one side. It can be noticed when the baby does not roll over properly and fails to meet developmental milestones. Children with the disorder are usually diagnosed at about before age three years or even earlier. The pediatrician can sometimes diagnose cerebral palsy during the baby’s check-up as was the case in my diagnosis when I was 11-months old.
As with many other children that are affected and diagnosed with cerebral palsy some will have speech and/or language abnormalities. Factors that either contribute or supplement in the defective speech of these children usually include visual and audible discrepancies and reduced visual motor management. As the problems experienced by children with a diagnosis of Cerebral Palsy range widely, there is no single universally appropriate form of treatment.
Poor speech impairs communication and is often interpreted as a sign of cognitive impairment, which can be very frustrating to children with cerebral palsy, especially the majority who have average to above average intelligence. Sensory and motor discrepancies are important factors that need to be of concern during speech therapy as well. Another way, a doctor asks the parents with a child who has possible Cerebral Palsy is by observations in their child daily physical movements. A doctor can perform a M. R. I. to produce an image of the brain, do intelligence tests, test reflexes, and do self-observations by having the child do simple commands (ex. stand up straight) and refer to eye or ear specialists if need be. Blood tests are done to see if there are other conditions as early signs do not always translate to Cerebral Palsy.
Cerebral palsy is a blanket term for impaired or loss of motor function due to damage to an immature brain. The injury must occur before, during, or immediately after birth to be considered cerebral palsy. Evidence suggests that most of the damage occurs during prenatal development. Because of all of this, people with Cerebral Palsy have trouble with speaking, eating, moving, learning, and controlling eye movements. One of the most common side effects of cerebral palsy is spasticity. Spasticity causes increased muscle tone and tension. Some effects of spasticity are inhibition of movement, muscle growth, and protein synthesis, limited stretching of muscles in daily activities, muscle and joint deformities. If left alone, severe spasticity can lead to permanently stiff muscles. Approximately 80 out of 100 patients with cerebral palsy have varying degrees of spasticity. While there is currently no cure for cerebral palsy, a wide variety of treatments are available.
The original thought was that Cerebral Palsy was a result of birth trauma and the physician’s competence was a large factor in the incidence of Cerebral Palsy. It appears that only 8% of Cerebral Palsy cases are due from intrapartum events but most of these seemed to originate their etiology from prenatal or postnatal factors. Most Cerebral Palsy patients with 'normal intelligence' have perceptual problems and must be placed in learning disability classes. Several theories have been given as to the causes of Cerebral Palsy which include neonatal jaundice, genetics, infections of infancy, neonatal asphyxia, and birth trauma. Neonatal jaundice causes bilirubin encephalopathy which is not common today with Rh immunization and other clinical advances that prevent the massive lysis of child Red Blood Cells. Genetic causes of Cerebral Palsy have been linked to an autosomal recessive gene in a few cases of the ataxic diplegia form. Infancy attributions include head trauma and meningitis. This conclusion comes from the fact that Cerebral Palsy children had similar Apgar scores except for acidosis of the veins in approximately 17% of the Cerebral Palsy children compared to 0 in normal children. This may be due to a lack of equipment at the time to diagnose the acidosis, especially in cerebral acidosis. But, as medical technologies have evolved over time, I am hopefully that scientists’ and kinetics can further help individuals and families with children who have Cerebral Palsy. Also, C-sections do not protect against Cerebral Palsy and are not advised unless they are normally applicable.
