Cerebral Palsy (CP) is a term used to describe a group of chronic conditions impairing control of body movement and muscle coordination. It is caused by a problem with development of or damage/injury to specific motor areas in the brain. This can occur before, during or shortly after birth, or during infancy. Injuries to the brain’s motor areas disrupt the ability to adequately control movement and posture and can profoundly impact development and function. Symptoms can include: difficulties in walking, gross motor skills, fine motor skills, such as writing, grasping objects, or speaking, to name a few. Cognitive abilities can be affected but most individuals with CP have normal intelligence. Symptoms range from mild to severe.
“Cerebral” refers to the brain and “palsy” refers to muscle weakness and poor control. Cerebral palsy itself is not progressive: however, secondary conditions, such as muscle tightness, can improve, remain the same or worsen. CP varies from person to person.
Forms of Cerebral Palsy
Spastic: characterized by stiff, contracted muscles
Ataxic: characterized by lack of coordination and poor sense of balance, often causing falls and stumbles, due to and insult to the cerebellum
Athetoid: characterized by unintentional, uncontrolled movements of the limbs, head and eyes due to ever muscle tone
Mixed: occurs when two or more types of CP are present; the most common includes spastic and athetoid movements
In addition to the above characterizations, which parts of the body affected are also described:
Diplegia: “Di” meaning two”; muscles in the arms and legs are affected
Monoplegia: “Mono” meaning “one”; one limb is affected
Hemiplegia: “Hemi” meaning “half” ; one side of the body (left or right) is affected
Quadriplegia: “Quad” meaning “four”; all four limbs are affected
What causes Cerebral Palsy?
Approximately 70% of the time, CP results from events occurring before birth, which disrupt typical brain development. According to a 2003 report by the American College of Obstetricians and Gynecologists and the Academy of Pediatricians, only 10% of occurrences of CP are due to lack of oxygen reaching the fetus during labor and delivery. About 10% of babies develop brain injuries, due to brain infections or head injury, in the first few months or years of life that can also result in CP. In many cases, the cause is unknown.
Known causes include:
Infections during pregnancy such as rubella, cytomegalovirus (CMV), and toxoplasmosis
Insufficient oxygen to the fetus
Prematurity- premature babies weighing less than 3 1/2 pounds are up to 30 times more likely to develop CP than full term babies.
Asphyxia during labor and delivery
Blood diseases such as RH disease or blood clotting disorders
Other birth defects
Acquiring CP due to injury or brain infections
Who is affected?
Anyone may be affected by CP, regardless of the ethnic backround, economic standing or environment. According to the United Cerebral Palsy Association, the statistics indicate 1 in every 330 babies born have CP and premature birth is one of the primary causes. With Colorado Springs at an altitude of over 6000 feet, this community experiences a greater than national average of premature births, leading to higher rates of cerebral palsy.
What is the treatment for Cerebral Palsy?
A team of health care professionals typically assess the child’s needs to identify and appropriate treatment plan. These professionals may include: pediatricians/physicians, orthopedic surgeons, physical and occupational therapists, speech and language pathologists and social workers.
Physical therapists address the gross motor needs of the child including mobility, strength, balance and coordination. Occupational therapists address the fine motor skills, or hand skills, self-care skills and overall ability of the individual to function within his/her daily routine. Speech and language pathologists address the child’s language/communication, oral motor or feeding needs, as well as respiration.
Therapy may provide an opportunity to maximize the child’s functional potential by enhancing motor skills, such as sitting and walking, muscle strength, coordination, hand skills, self-care skills, such as dressing, grooming and eating, as well as communication. Braces, splints, or casts may also be used to improve function in the arms and legs. In addition, adaptive equipment and mechanical aids are available to improve and assist with functional independence in daily life. These include walkers, wheelchairs, communication devices, and adapted bicycles and scooters.
In situations of greatly increased muscle tightness, drug treatments including Botox or Baclofen, or surgery may be recommended.
What is the prognosis?
The outcomes of each person with CP vary depending on the severity of his/her underlying medical conditions. The availability of a variety of therapy programs, a team of health care professionals with a knowledge of cerebral palsy, and access to vast information on the internet all empower individuals, parents, and families with a knowledge and choice. These resources enable many individuals with CP to participate in the community and live independent, full lives.