Cerebral palsy is a general term covering a broad range of physical disabilities present from birth or early life. It is a non-progressive and noninherited condition that most obviously affects body movement and posture, but that may also interfere with other bodily functions resulting in multiple disabilities.
The degree of severity may vary widely. In some affected children the condition is so mild as to be hardly apparent; in others, the damage may be so severe that they cannot do anything for themselves.
Cerebral palsy primarily affects the movement of the legs, but in the most severe cases, the arms are also paralyzed. It is thought cerebral palsy occurs in around 1:400 births.
What are the causes of cerebral palsy?
Cerebral palsy results from damage to, or maldevelopment in, the portion of the brain which controls posture and movement.
This impairment in muscle coordination may be caused before or at birth or in the early years of childhood.
Specific causes of cerebral palsy include:
- Inadequate oxygen supplies to the brain during fetal life.
- Smallness for the age of development before birth.
- Poor fetal blood supply from the placenta (placental insufficiency).
- Partial separation of the placenta before birth.
- Bleeding within the uterus before birth (antepartum hemorrhage).
- Inherited metabolic disorders.
- Fetal infection.
- Fatal poisoning.
- Blood group incompatible with the mother (Rhesus factor incompatibility).
- Defects present at birth (congenital malformations).
- Compression of the umbilical cord during birth.
- Prolonged or severe labor.
- Premature birth.
- Low blood sugar (hypoglycemia) early in life.
- Breathing difficulties, especially among premature babies (respiratory distress syndrome).
- Low body temperature (hypothermia).
- Early brain hemorrhage.
How many types of cerebral palsy are there?
A person with spasticity has disordered control of movement, muscle weakness and often disturbance of growth and development. Spasticity may affect both limbs on one side of the body (hemiplegia), both the lower limbs (paraplegia) or all four limbs (diplegia and quadriplegia).
Athetosis results in frequent involuntary movements which mask and interfere with normal movements of the whole body.
A person with ataxia has an unsteady gait and difficulty in balancing. Spastic cerebral palsy is the most common form. Typically, the legs remain outstretched and permanently crossed or have a strong tendency to rub firmly together in a scissor like action when the child tries to walk.
This is the effect of constant spasm in the muscles which stay tightly contracted, so controlled movements are difficult or impossible.
Normally, when one muscle group contracts, the opposing group relaxes, but in spastic cerebral palsy, there is no relaxation.
Sometimes only one side of the body is affected, and occasionally only one
Other effects of brain injury may include
Degrees of deafness.
Problems with perception or understanding.
A combination of these. About 50% of children with cerebral palsy are mentally normal.
However, the other 50% have some degree of mental retardation: 25% being affected in a mild to moderate degree and.25% being severely retarded.
How is cerebral palsy diagnosed and treated?
It is not always possible to diagnose cerebral palsy at birth, but babies who are found to be normal at birth and during the first year of life rarely develop the condition.
Affected children may be seen to be obviously spastic or unable to move
It may take much longer than usual for the heart rate, breathing, muscle tone, response to stimulation, and skin color to reach normal after birth.
In milder cases, there may be a little immediate sign of problems and the first indication may be the development of controlled movements or walking difficulties.
However, much can be done, by way of special educational and physical
What is the outlook for those with cerebral palsy?
In children with severe cerebral palsy, especially with frequent seizures and mental retardation, the outlook is not okay. Up to half die before the age of 10, usually from infection.
However, in almost 30% of cases of mild cerebral palsy, the problem with walking has gone by the age of seven. In general, the outlook depends on the degree to which mental function is affected.