Cerebral Palsy

Cerebral palsy is a neurological condition that begins in the first few months of life. It involves problems in the function of the brain including the ability to hear, see, learn, move and think. Movement problems are the mainstay of cerebral palsy and are almost always involved in the disease. There are several different kinds of cerebral palsy, including ataxic cerebral palsy, spastic cerebral palsy, hypotonic cerebral palsy, mixed cerebral palsy and dyskinetic cerebral palsy. The symptoms vary according to the type of cerebral palsy that is present in the affected individual.

There can be mild or severe symptoms of cerebral palsy. It can involve only one limb or body function or it can include both sides of the body and all four limbs. Just the legs can be involved or just the arms can be involved.

The symptoms occur between the ages of three months to two years of age. It can show up as a delay in motor function, spasticity of the extremities or problems with other areas of development. The most common type of cerebral palsy is spastic cerebral palsy. The major symptoms seen in spastic cerebral palsy include tight muscles that do not move much with effort or with pushing on them, walking on their toes, having an abnormal gait that includes having the arms tucked in near the sides of the body or the knees and having the knees touching or crossed, called a scissors gait, stiff and contracted joints that do not straighten out well, muscle paralysis or weakness or symptoms that affect one side of the body or perhaps just the arms or just the legs.

Other types of cerebral palsy have different symptoms. They can include abnormal movements, tremors, loose or floppy muscles, unsteady gait and loss of coordination. Symptoms unrelated to movement include learning disabilities, low intelligence, problems with speech, hearing problems, visual disturbances, joint or muscle pain, and seizures. The individual can be mildly disabled or severely disabled from the disease.

Digestive problems can occur due to difficulty swallowing, sucking or feeding in small infants. There can be difficulties with vomiting, constipation, drooling, delayed growth, irregular breathing, and incontinence of bowel or bladder. These can be seen primarily in infants and in children who have the disease.

Cerebral palsy is caused by a low level of oxygen in the brain that occurs sometime in utero or at birth. It occurs at a slightly higher risk in premature infants, who often suffer from hypoxia. You can also get cerebral palsy when bleeding occurs within the brain, from a head injury, and from infections occurring in the mother during pregnancy. Infantile infections such as meningitis or encephalitis can contribute to cerebral palsy and there can be cerebral palsy from severe jaundice in infancy. Damage to the brain any time before the age of two years can contribute to getting cerebral palsy.

The treatment of cerebral palsy includes many different healthcare providers including a primary care doctor, a neurologist, an occupational therapist, a speech therapist, a physical therapist and other specialty doctors. These healthcare specialists help to make sure that the symptoms are as little as possible and that things like contractures are as minimal as they can be. Children can be taught how to function with splints and braces and how to use walkers or wheelchairs. Medications can be given that reduce the spasticity and calm the muscles. There is usually an intensive educational plan that strives to get the student into regular classrooms as soon as possible, despite their illness. Nutritional deficits are managed, including swallowing difficulties. This might include the use of a tube that directly feeds the child from an opening in the skin, called a stoma.

The patient may need to take anticonvulsant therapy for seizures, the use of Botulinum toxin to release muscles from their spasticity. Tremors are reduced as well with botulinum toxin. Surgery can control reflux disease, can put in feeding tubes and can release contractures of the various joints involved in spasticity and contractures.