Cp Cerebral Palsy

Cerebral palsy, which is also called CP, is a motor impairment due to an injury to the brain before it is fully mature. These motor problems are initially seen in the first few years of the child’s life and generally don’t worsen over time.

What is going on in the body?

Cerebral palsy is a motor impairment caused by an injury to the brain. The brain damage may occur before birth, during delivery, or even after the child is born. There are four major types of cerebral palsy:

spastic CP, which involves permanent stiffness and contracture of the muscles

athetoid, or dyskinetic, CP, which causes slow writhing movements

ataxic CP, which is rare and affects the balance and depth perception

mixed forms of CP, which include characteristics of the other three types of CP

At one time, CP was thought to be caused by the infant getting too little oxygen during birth. More recent studies suggest that most cases come from problems during pregnancy.

What are the causes and risks of the disease?

The brain damage that causes CP can occur before birth, during labor and delivery, or in the first few years of life. Common causes include the following:

brain infections, such as meningitis or encephalitis

head injuries from accidents or child abuse

newborn jaundice

Rh incompatibility between the mother and fetus

severe oxygen deprivation during labor or delivery

stroke in the fetus or newborn, caused by clotting problems

toxoplasma infection, also called toxoplasmosis \ \other infections, such as hepatitis B, syphilis, and herpes zoster, the virus that causes chickenpox \ \ rubella, the virus that causes German measles\ \ cytomegalovirus, or CMV\ \ herpes simplex virus, the cause of genital herpes \ TORCH infections in the mother during pregnancy

Following are some of the risk factors for cerebral palsy:

breech birth, in which the baby is delivered feet first

complicated labor and delivery

hypothyroidism, communication\ \education, including reading, writing, and basic math\ \motor function\ \personal care, such as bathing, dressing, eating, and toileting\ \social skills\ \thinking skills, such as decision making, problem solving, and self-direction\ \working\mental retardation, or seizures in the mother

low APGAR score, which is a measurement of the baby’s health taken right after delivery

low birth weight and premature birth

multiple births, such as twins

nervous system abnormalities, such as a small brain

seizures in the newborn

vaginal bleeding or protein in the mother’s urine during the third trimester of pregnancy

What are the signs and symptoms of the disease?

Cerebral palsy may cause a variety of symptoms, depending on the type of CP and the amount of brain damage. In addition to the motor problems described above, people with CP may have the following symptoms:

abnormal sensation or perception

epilepsy, or seizure disorder

hearing impairments

communication\ \education, including reading, writing, and basic math\ \motor function\ \personal care, such as bathing, dressing, eating, and toileting\ \social skills\ \thinking skills, such as decision making, problem solving, and self-direction\ \working\mental retardation or learning disabilities

speech impairments

visual impairments, including strabismus, or crossed eyes

How is the disease diagnosed?

The diagnosis of cerebral palsy begins with a medical history and physical exam. The healthcare provider will look for signs of muscle problems related to nervous system injury. Delays in normal development will also be assessed. It may take time for the diagnosis to become clear. Some signs of CP may change over time. Some signs may appear after the diagnosis has been made.

The healthcare provider may order the following tests to rule out other disorders, or to look for the cause of the CP:

cranial CT scan

cranial MRI

EEG

ultrasound of the brain

What can be done to prevent the disease?

Cerebral palsy is not always preventable. The following recommendations may prevent some cases of CP:

good prenatal care

measures to prevent child abuse

phototherapy treatment for infants with newborn jaundice

RhoGAM injections after pregnancies and miscarriages for women who are Rh negative

rubella immunizations before pregnancy for women who are not already immune to German measles

use of appropriate car seats for infants and children

What are the long-term effects of the disease?

CP can affect different areas of the brain. There can be many long-term effects from brain injury involving many areas of functioning. People with CP may have various limitations in activity due to movement problems. Learning disabilities or communication\ \education, including reading, writing, and basic math\ \motor function\ \personal care, such as bathing, dressing, eating, and toileting\ \social skills\ \thinking skills, such as decision making, problem solving, and self-direction\ \working\mental retardation may impair the person’s ability to live independently. Some individuals with CP will need lifelong assistance for activities of daily living.

The imbalance of muscle tone and strength can result in skeletal problems. The child may develop scoliosis, or curvature of the spine. The joints may lose their ability to bend, and the hip joints may dislocate easily.

What are the risks to others?

Cerebral palsy is not contagious and poses no risk to others.

What are the treatments for the disease?

Cerebral palsy cannot be cured. Treatment is geared toward improving the individual’s functional abilities and quality of life.

Behavioral therapy can help reinforce behaviors that maximize abilities and skills.

Early intervention programs can help younger infants and their parents maximize development.

Educational planning should start before the child reaches school age.

Medicines, such as baclofen or methocarbamol, can help to relax muscles.

Occupational therapy can help the child with self-care and other activities of daily living.

Physical therapy can help develop basic movement skills.

Speech therapy can help with speech and language impairments.

Surgery on muscles, bones, joints, or the nervous system can improve motor skills.

Children with CP should be helped to lead as normal a life as possible. Sports for children with disabilities provide instruction and opportunity to participate in team activities.

What are the side effects of the treatments?

Medicines used to treat CP may cause allergic reactions, stomach upset, or drowsiness. Surgery may cause bleeding, infection, or allergic reaction to anesthesia.

What happens after treatment for the disease?

Most children with CP need some type of assistance or treatment for life. Severely affected children may need intense, around-the-clock care for the rest of their lives.

How is the disease monitored?

Continuous monitoring by the caregivers and healthcare providers helps identify problems early. This allows treatment to be started at the earliest time to maximize function and quality of life. Any new or worsening symptoms should be reported to the healthcare provider.