What is Cerebral Palsy?
Cerebral palsy is a group of disorders that affect movement and muscle coordination.
In many cases, cerebral palsy also affects vision, hearing, and sensation.
This condition occurs due to damage to the immature and developing brain, and most often occurs before birth (during pregnancy).
However, cerebral palsy can also occur during the birth process, or in the first year after birth.
In general, cerebral palsy causes movement disorders associated with excessive reflexes, spasticity or flexibility of the limbs and body.
In addition, other signs include unusual postures, unintentional movements, unsteady walking, or a combination of all of these.
Cerebral Palsy Symptoms
The signs and symptoms of this disease can vary greatly from person to person.
Cerebral palsy can affect the entire body, or be limited primarily to one or two limbs, or one side of the body.
Common signs and symptoms include problems with movement and coordination, speech and eating, development, and other issues.
The following is an explanation of the symptoms of cerebral palsy from a number of aspects:
`1. Symptoms in movement and coordination
- Stiff muscles and excessive reflexes (spasticity), the most common movement disorder.
- Variations in muscle tone, such as being too stiff or too floppy.
- Stiff muscles with normal reflexes (rigidity).
- Lack of balance and muscle coordination (ataxia).
- Tremors or involuntary, jerky movements.
- Slow, wriggling movements.
- Favoring one side of the body, such as reaching with only one hand or dragging a foot while crawling.
- Difficulty walking, such as walking on toes, a crouched gait, a scissor-like gait with crossed knees, a wide-legged gait, or an asymmetrical gait.
- Difficulty with fine motor skills, such as buttoning clothes or picking up utensils.
2. Symptoms when talking and eating
- Delay in speech development.
- Difficulty speaking.
- Difficulty with sucking, chewing, or eating.
- Excessive salivation or difficulty swallowing.
- Developmental Disorders.
- Delays in reaching motor skill milestones, such as sitting or crawling.
- Learning difficulties.
- Intellectual disability.
- Delayed growth, resulting in smaller than expected size.
3. Other issues
Brain damage can cause other neurological problems, such as:
- Seizures ( epilepsy ).
- Difficulty hearing.
- Problems with vision and abnormal eye movements.
- Abnormal touch or painful sensations.
- Bladder and bowel problems, especially in children with cerebral palsy are more susceptible to bladder stones.
- Mental health conditions, such as emotional disorders and behavioral problems.
The brain disorder that causes this condition does not change over time, so symptoms usually do not get worse with age.
However, as the child gets older, some symptoms become more or less obvious.
Muscle shortening and muscle stiffness can worsen if not treated promptly.
Cerebral Palsy Risk Factors
There are a number of factors that can put a baby at increased risk of cerebral palsy, including:
- Premature birth (birth before reaching 37 weeks of gestation).
- Low birth weight (less than 2.5 kilograms).
- Breech birth occurs when the baby’s bottom or legs come out first
- Rh incompatibility, which occurs when the Rh type of the pregnant parents’ blood does not match the Rh type of their baby’s blood.
- Negative habits in mothers during pregnancy. For example, smoking, drinking alcohol or using drugs.
- The birth of twins or more (triplets), especially when one baby survives and the other dies at birth.
Causes of Cerebral Palsy
Cerebral palsy occurs due to abnormal brain development or damage to the developing brain.
This usually occurs before the child is born, but can also occur at birth or in early infancy.
In many cases, the cause of cerebral palsy is unknown. Many factors can cause problems with brain development, including:
- Gene mutations that result in genetic abnormalities or differences in brain development.
- Maternal infection that affects the developing fetus.
- Fetal stroke, a disruption of blood supply to the developing brain.
- Bleeding into the brain in the womb or during birth.
- An infection in a baby that causes inflammation in or around the brain.
- Traumatic head injuries in infants, such as from motor vehicle accidents, falls or physical abuse.
- Lack of oxygen to the brain is associated with difficult labor or delivery, although birth-related asphyxia is a much less common cause than historically thought.
Diagnosis Cerebral Palsy
A doctor will diagnose cerebral palsy by taking a complete medical history, performing a physical examination that includes a detailed neurological exam, and evaluating the symptoms.
In addition, to support the diagnosis, the doctor can also perform additional tests such as:
- Electroencephalogram (EEG). Aims to evaluate electrical activity in the brain.
- MRI. The purpose of this examination is to identify brain irregularities or injuries.
- CT scan. A CT scan creates clear cross-sectional images of the brain. It can also reveal brain damage.
- Ultrasonography (USG). Cranial ultrasound is a method of using high-frequency sound waves to obtain basic images of a young baby’s brain.
- Blood tests. Aim to rule out other conditions, such as bleeding disorders.
If a doctor confirms a diagnosis of cerebral palsy, they may refer the person to a specialist who can test for neurological problems.
Neurological examination can detect:
- Vision loss and disturbances, such as blurred vision in one or both eyes.
- Deaf condition.
- Speech delay.
- Intellectual disability.
- Movement disorders.
Cerebral Palsy Treatment
Children and adults with cerebral palsy require lifelong care with a medical care team.
In addition to a pediatrician or physical medicine and rehabilitation specialist (physiotherapist), and a pediatric neurologist to oversee the child’s medical care, the team includes a variety of therapists and mental health specialists.
Remember, there is no cure for cerebral palsy. However, there are many cerebral palsy treatment options that can help improve a person’s daily functioning, including:
1. Medicines
Medications that can reduce muscle tension can be used to improve functional ability, treat pain, and manage complications related to spasticity or other cerebral palsy symptoms.
- Muscle or nerve injections. To treat certain muscle tightening, your doctor may recommend injections of onabotulinumtoxinA (Botox), or other agents. You may need to repeat the injections every three months.
- Oral muscle relaxants. Medications such as baclofen, tizanidine, diazepam, or dantrolene are often recommended by doctors to relax the muscles.
- Medications to reduce saliva. One option is Botox injections into the salivary glands.
2. Therapy
Various therapies play an important role in treating cerebral palsy:
- Physical Therapy
Exercise and muscle training can help a child’s strength, flexibility, balance, motor development, and mobility.
Parents will also learn how to safely care for their child’s daily needs at home, such as bathing and feeding the child.
For the first 1 to 2 years after birth, both physical and occupational therapists work on issues such as head and trunk control, rolling over, and grasping.
Then, both types of therapists are involved in the wheelchair assessment.
Braces, splints or other supportive devices may be recommended for your child to help with function, such as improving walking and stretching stiff muscles.
- Speech and Language Therapy
A speech-language pathologist can help improve a child’s ability to speak clearly or communicate using sign language.
They can also teach you how to use communication devices, such as computers and voice synthesizers if communication is difficult for you.
Speech therapists can also address feeding and swallowing difficulties.
- Recreational Therapy
Some children benefit from regular recreational or competitive or adaptive sports, such as therapeutic horseback riding or skiing.
This type of therapy can help improve a child’s motor skills, speech, and emotional well-being.
Both adults and children benefit from regular physical activity and exercise for general health and fitness.
3. Operating Procedure
Surgery may be necessary to reduce muscle tension or correct bone deformities caused by spasticity.
This treatment includes:
- Orthopedic Surgery. Children with severe contractures or deformities may require surgery on the bones or joints to place their arms, spine, hips, or legs in the correct position.
- Cutting Nerve Fibers. If other treatments don’t help, the surgeon will cut the nerves that serve certain spastic muscles. One procedure that the doctor may perform is a selective dorsal rhizotomy. This relaxes the leg muscles and reduces pain, but can cause numbness.
4. Other Treatments
If necessary, your doctor may recommend medications and other treatments to treat some of the symptoms.
Medication may be recommended to treat seizures, pain, osteoporosis, mental health conditions, and problems with sleep, oral health, eating and nutrition, bladder incontinence, vision, or hearing.
Cerebral Palsy Prevention
You can’t prevent most cases of cerebral palsy, but you can reduce your risk.
If you are pregnant or planning to become pregnant, you can take the following steps to maintain your health and minimize pregnancy complications:
- Get vaccinated. Getting vaccinated against diseases, such as rubella, preferably before becoming pregnant, can prevent infections that can cause fetal brain damage.
- Get regular pregnancy checkups. Visiting your doctor regularly can help prevent premature birth, low birth weight, and infections.
- Avoid certain intakes. For example, alcohol, tobacco, and illegal drugs. Because some of these substances have been associated with the risk of cerebral palsy.
- Practice good public safety. Prevent head injuries in children by providing appropriate protection and supervision. For example, ensuring that children wear helmets when riding bicycles.
Cerebral Palsy Complications
Without proper treatment, people with cerebral palsy are at risk of experiencing complications, such as:
- Communication difficulties, such as speech and language disorders.
- Spinal problems, such as scoliosis, lordosis (swayback) and kyphosis (hunchback).
- Osteoarthritis. It is pressure on the joints or abnormal joint alignment due to muscle spasticity. If you want to know more about this disease.
- Contractures occur when muscles become locked in a painful position.
- Osteopenia, or poor bone density that can make bones break easily.
- Dental problems.
- Incontinence.
When to See a Doctor?
It is important to get a proper diagnosis for any movement disorder or developmental delay in your child.
See a neurologist if you have concerns about symptoms of loss of awareness of surroundings or unusual body or muscle movements, impaired coordination, difficulty swallowing, eye muscle imbalance, or other developmental problems.