Cerebral palsy also known as CP is a neurological disorder that occurs during infancy. It causes muscular problems and sometimes speech problems due to brain damage usually sustained when a child is in utero or while being born.
Definition & Facts
Cerebral palsy is a condition that primarily affects the muscles, more specifically muscle movement and coordination. Cerebral refers to the portion of the brain that is affected, and palsy refers to a varying level of muscle paralysis. CP is typically caused by damage to a developing brain, usually before birth.
Cerebral palsy can be classified three ways: congenital, acquired, and genetic. Congenital cases result from brain damage that occurs before a child is born. Acquired usually occurs after a child is born, and genetic is passed through parents.
Nearly 10,000 infants 1,500 preschoolers are diagnosed each year. Many children that have cerebral palsy also have seizure disorders and some degree of mental retardation. Other problems they may have include learning disabilities and speech disabilities, vision problems, hearing problems, and/or language disabilities.
Symptoms & Complaints
- Hypotonia – decreased muscle tone giving the appearance of floppy limbs
- Hypertonia – increased muscle tone giving the appearance of rigid limbs
- Dystonia – varying muscle tone that is sometimes too tight and sometimes too loose
- Mixed – the trunk of the body may be floppy while the arms and legs are rigid
- Muscle spasms – involuntary muscular contractions
- Fixed joints – joints that are fused together and hinder proper range of motion
- Abnormal neck tone – decreased hypotonic or floppy neck or increased hypertonic or rigid neck
- Ankle/foot clonus – spastic feet movements
- Wrist clonus – spastic hand movements
- Crawls in awkward ways
- Difficulty sucking, difficulty eating, difficulty swallowing
- Lies in awkward positions
- Favors one side of the body
- Poor coordination and balance
- Involuntary, slow writing movements
- Hearing and eyesight problems
When a child has CP the exact cause is not always known. Many times it is caused by problems during pregnancy because the fetus's brain is either damaged or doesn't develop properly. Infections, maternal health problems, genetic disorders, or other factors could be culprits that disrupt normal brain development. Very rarely, problems during labor and delivery arise causing CP such as the infants head being traumatized or birth asphyxia.
Cerebral palsy is more common in premature babies than those carried to term, especially those with birth weights less than 3 pounds. This includes low birth weight babies and pregnancies that produce multiple births. Brain damage during infancy or early childhood also causes CP after birth. Here are other ways it can occur:
- Lead poisoning
- Bacterial meningitis or other infections
- Poor blood flow to the brain
- Being shaken as an infant or shaken baby syndrome
- Being in a car accident
Diagnosis & Tests
It is important to diagnose and treat cerebral palsy as soon as possible. There is no test to determine if a child has CP, but there are ways to screen for it and then have a doctor make the diagnosis. First, it is important to make sure the child is meeting their developmental milestones. This is also called developmental monitoring or surveillance. Basically, parents track a child’s growth and development over time and make sure to take children to their wellness visits at 9 months, 18 months, and 24 to 30 months.
During the wellness visit, the pediatrician will also check that the child is meeting their developmental milestones. They do this by questioning the parents about any concerns about the child’s development, updating their developmental history, and observing the child during the routine exams to watch their muscle movement. If there are concerns about the child’s development during monitoring, a developmental screening test should be administered.
A developmental screening test is a short test that screens for specific developmental delays such as motor or movement delays. Sometimes the developmental screening tests are interviews or questionnaires that parents fill out. Others are physical tests the doctor uses to screen the child. The pediatrician will be looking at specific functions:
If the pediatrician rules out other conditions that may cause developmental delays, and they are still concerned that it may be cerebral palsy, they may want a neurologist to perform one of many available brain imaging scans to ensure an accurate diagnosis.
Treatment & Therapy
There is no cure for cerebral palsy, but treatment usually improves a child's skills. The earlier treatment begins, the better chance the child has of conquering developmental disabilities, and they learn techniques to accomplish tasks that challenge them. Treatments include physical therapy and occupational therapy, speech therapy, or anticonvulsant drugs to control seizures, drugs to relax muscle spasms and alleviate pain, or a combination of the these treatments.
Sometimes surgery is required to correct physical abnormalities or release tension in muscles. Some children will need braces, other orthotic devices, wheelchairs, and rolling walkers to aid them in movement. Communication problems can be addressed with computers with attached voice synthesizers.
Prevention & Prophylaxis