Cerebral Palsy - Causes, Symptoms, Diagnosis & Treatment
Health Education

Cerebral Palsy

Dr.Surya Rao Poodipeddi profile Authored by Dr.Surya Rao Poodipeddi on 12 Sep 2014 - 15:11.

Cerebral palsy is a condition affecting infants before they are born, during their birth or after they are born including those children before they are 5 years old, characterized by poor muscle control, plasticity (tightness of the affected muscles), paralysis and other neurological (connected to the nervous system) deficiencies most of which are attributed to brain injury.

It cannot be said that cerebral palsy is a disease. Neither can it be called a progressive disorder. It invariably affects those parts of the brain, which have control over the movements of the muscles. The parts affected are vulnerable to injury in premature and young infants. Usually the condition affects 1 to 2 in every 1000 infants born and is 10 times more common in premature and very small infants.

Depending on the nature of involvement cerebral palsy can be divided into 4 distinct types:

  • Spastic type: It is a variety in which the muscles become stiff and weak occurring in more than 70 percent of all cases of cerebral palsy.
  • Choreoathetoid type: In this variety the muscles have a tendency to move slowly without any normal control and 20% of infants suffer from this type of cerebral palsy.
  • Ataxic type: Seen in 10 percent of the cases this variety exhibits typical ataxic gait because of poor co-ordination and shaky movements.
  • Mixed type: In this variety there is a combination of spastic and choreoathetoid symptoms and is seen in many children.

Depending on what type of cerebral palsy the child suffers from the infant may have paralysis of all four limbs (paraplegia), paralysis of half the side of the body (hemiplagia) and paralysis of only the legs (diplagia). In some infants emotions may trigger uncontrollable movements, which often disappear during sleep. The child may have the typical ataxic gait with severe lack of co-ordination of movements and the child may even walk with legs wide apart. Whatever may be the type of cerebral palsy the child may have difficulty in speech if the muscles responsible for speech are affected, below normal intelligence (low IQ), or even severe mental retardation and convulsions like in the spastic variety.

Though the exact cause for this condition is not known different types of injury to the brain are attributed as the possible cause. Birth injuries and insufficient supply of oxygen before, during, or after birth account for 10 to 15 % of all cases of cerebral palsy. Premature babies have poorly developed blood vessels that might rupture into the substance of the brain leading to brain damage and poor supply of oxygen to the parts of the brain controlling muscular activity, which explains more prevalence of this condition in the premature babies.

Newborn babies have high levels of bilirubin particularly in a condition called Karnicterus, which is considered responsible to cause brain damage. Another common cause attributed is infection that easily invades an infant with inadequate immune power. Infections like meningitis, sepsis, trauma during delivery and any condition that can cause severe dehydration are considered notorious to lead to cerebral palsy.

Symptoms depend on the extent and severity of involvement; they could range from a simple and barely noticeable clumsiness to severe spasticity involving arms and legs which in some cases might lead to confinement of the child to a wheel chair.

Definitive diagnosis in early infancy is not possible unless the alert mother or inmates notice poor muscle development, improper or lack of co-ordination in the infant. Specific type of involvement cannot be identified till the child is at least 18 months old. Though laboratory tests have no role in the diagnosis of cerebral palsy the doctors prefer to have them done just incase there is some other cause for this condition. CT Scan and MRI are the two investigations, which are always done with a view to finding a lesion in the brain and assess the extent of involvement.

Unfortunately, as of now there is no known cure at least in the allopathic system of medicine and still unfortunate is the fact those problems, which results from this condition are life-long.

However, there is a ray of hope to give as much comfort to the child as possible with compassion, sympathy and kind attitude towards the unfortunate victims. The best one can think of is to try and give as much independence to the child as possible without endangering any risks. This can be achieved through physiotherapy, occupational therapy, orthopedic surgery if warranted and speech therapy depending on the symptoms presented in each variety of this condition

Many children with cerebral palsy grow normally and attend school if they don’t have severe physical and intellectual deficiencies. Those with established unfavorable symptomatolgy need extensive physiotherapy and special education.

The final outcome of this condition depends once again on the type and extent of involvement. More than 90% of children with cerebral palsy will survive to taste adulthood. Those unfortunate few who are severely affected and are absolutely helpless and incapable of self-care have a substantially shortened life expectancy.

Relentless research continues to achieve a breakthrough both in prevention and cure for this malady and who know some day such a breakthrough might help thousands if innocent infants afflicted with this condition.

*Disclaimer This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.