What is Cerebral Palsy?
Cerebral palsy is a group of disorders resulting from brain damage
that occurs before, during or shortly after birth. It is
characterised by loss of movement and nerve functions. Those
affected by it have problems in mobility (crawling, creeping,
walking), use of hands (eating, writing, dressing) and
communication.
What are the causes?
There are many causes that may lead to this disorder. The signs of
the problem may be present at birth or they may be seen months or
years later. Many causes that can lead to the problem are:
* Lack of sufficient oxygen – a condition called hypoxia that may
damage the brain cells of the child.
* Infections in the mother such as rubella (German measles),
cytomegalovirus or toxoplasmosis in the first 4-5 months of the
pregnancy.
* Metabolic disorders in the mother such as diabetes, a heart
problem, severe asthma and thyroid disorders.
* Use of certain drugs during pregnancy without the doctors
consultation.
* Trauma to the head during labour or delivery, cerebral
haemorrhage, use of forceps.
* Prematurity and other complications at birth such as difficulty
in breathing or very low birth weight. However, mostly it is
difficult to identify the exact cause of the development of
cerebral palsy. In most cases the causation is some abnormality
around the time of conception.
What are the various kinds of cerebral
palsy?
The four types of cerebral palsy are:
1. Spastic cerebral palsy: This is the most common type. It may
affect a single limb, one side of the body (spastic hemiplegia),
legs (spastic diplegia), or both arms and legs (spastic
quadriplegia). There may be partial (paresis) or full loss of
movement (paralysis), abnormalities of sensation and defects of
hearing and vision. Epileptic fits, speech problems, mental
retardation are other associated problems.
2. Athetoid cerebral palsy: In this type unintentional or
uncontrolled movements are seen. The child’s muscles react in a
very abnormal fashion resulting in excessive and uncontrolled
darting or writhing movements.
3. Ataxic cerebral palsy: is characterised by a lack of
coordination and balance due to damage to specific parts of the
brain.
4. Mixed cerebral palsy: This occurs when two or more types are
present in the same person.
What are the signs and symptoms?
Early sucking difficulty with the breast or bottle.
Lack of normal muscle tone and slow development of milestones.
Unusual body postures.
Purposeless body movements and poor coordination.
Various degrees of mental retardation and speech impediments.
How is the problem diagnosed?
Early diagnosis is important so that the child can be given help
in the early years of development. Regular visits to the doctor
are thus important, who confirms the diagnosis with detailed
questions about the child's abilities, behaviour and observing the
child's muscle coordination and posture. The paediatrician may on
his discretion order the following tests such as the MRI, CTscan,
blood and urine tests, BERA and VEP to check the hearing and
vision, amongst other things. If there is the suspicion of
epileptic fits, EEG or electroencephalography to detect their
presence may be done.
What is the treatment?
There is no specific cure but the goal of treatment is to make the
child independent. This can be done by providing help through
physiotherapy, orthopaedic correction, braces, appropriate visual
help such as spectacles, hearing aids, medications and special
schooling if possible. The child can be sent to a normal school if
his physical disabilities or mental development allow. Medications
may include drugs to reduce muscle tension or control seizures.
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