Cerebral palsy

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at February 15, 2016
StartDiseasesCerebral palsy

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.

Contents

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

Signs of CP usually begin to appear within the first three to five years of life. Most signs are not apparent at birth unless it’s a severe case. Parents usually begin to suspect their infant is not developing motor skills in a timely manner. Infants with cerebral palsy are usually slow to reach developmental milestones, like learning to roll over, sit, crawl, smile, or walk. This is called developmental delay. Here is a list of symptoms one might observe:

Causes

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:

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

Genetic CP can only be prevented if parents adopt or foster a child when they know they are a genetic carrier for the gene that causes CP. Certain measures can be taken to prevent congenital and acquired CP such as:

  • Maintaining a healthy pregnancy
  • No smoking or drinking
  • Healthy diet
  • Attend doctor’s appointments
  • Childproofing living areas
  • Keeping immunizations updated
  • Keeping children away from others with contagious illnesses
  • Knowing the signs of jaundice
  • Knowing how to stop lead poisoning