cerebral palsy

What is cerebral palsy?

Cerebral palsy (CP) is a broad term that describes a group of neurological (brain) disorders. It is a life-long condition that affects the communication between the brain and the muscles, causing a permanent state of uncoordinated movement and posturing. CP may be the result of an episode that caused a lack of oxygen to the brain.

What causes cerebral palsy?

Many cases of CP have unknown causes. The disorder occurs when there is abnormal development or damage to areas in the brain that control motor function. It occurs in approximately two to three out of every 1,000 live births. Risk factors for CP include the following:

  • prematurity
  • very low birthweight (especially in babies weighing less than 1,000 grams, or 2.2 lbs.)
  • viruses
  • chemical/substance abuse during pregnancy
  • infection
  • bleeding in the brain
  • trauma
  • complications of labor and delivery

What are the symptoms of cerebral palsy?

The following are the most common symptoms of CP. However, each child may experience symptoms differently. The child may have muscle weakness, poor motor control, or have tightness, also called spasticity, of the arms or legs. Muscle stiffness in the form of stiff legs or clenched fists may also be seen. Cerebral palsy is usually classified according to the kind of motor function the child may have, including the following:

spastic diplegia (“di” – means two) – spastic movements of the arms or legs. Diplegia is also called paraplegia.

spastic quadriplegia (“quad” means four) – spastic movements in all four limbs (arms and legs).

spastic hemiplegia (“hemi” means half) – spasticity affecting one half, or side, of the body (such as right arm and right leg).

athetoid – involuntary (unable to control), purposeless, and rigid movement.

Children with CP may have additional problems, including the following:

  • seizures
  • vision, hearing, or speech problems
  • learning disabilities and behavior problems
  • mental retardation
  • respiratory problems
  • bowel and bladder problems
  • bone abnormalities, including scoliosis (a lateral, or sideways, curvature and rotation of the back bones, giving the appearance that the person is leaning to one side)

Babies with CP are often slow to reach developmental milestones, such as learning to roll over, sit, crawl, or walk. They may also have certain reflexes present that normally disappear in early infancy. The symptoms of CP may resemble other conditions. Always consult your child’s physician for a diagnosis.

Treatment of cerebral palsy:

Management includes focusing on preventing or minimizing deformities and maximizing the child’s capability at home and in the community. A child is best treated with an interdisciplinary team that may include the following healthcare providers:

  • nurse coordinator
  • neurosurgeon – a surgeon who specializes in operating on the brain and spinal cord.
  • neurologist – a physician who specializes in conditions of the brain, spinal cord, and nerves.
  • physical & occupational therapist
  • orthopaedic surgeon – a surgeon who specializes in conditions of the muscles, ligaments, tendons, and bones.
  • orthotist – an individual who specializes in making braces and splints.

Specific treatment will be determined by you’re the pediatric team based on:

  • your child’s age, overall health, and medical history
  • the extent of the disease
  • the type of CP
  • your child’s tolerance for specific medications, procedures, or therapies
  • expectations for the course of the disease
  • your opinion or preference

Management of CP includes non-surgical and surgical options. Non-surgical interventions may include:

  • rehabilitation
  • positioning aids (used to help the child sit, lie, or stand)
  • braces and splints (used to prevent deformity and to provide support or protection)
  • medications (used to help control seizures or to decrease spasticity in the muscles; the medications may be given by mouth or as an injection)

Surgical interventions may include:

  • orthopedic surgery for, hip dislocations, ankle and foot deformities, and contracted muscles
  • neurosurgery to remove spasticity including Botox injection, selective dorsal rhizotomy and intrachecal balcaofen pumps.

At Alimran Medical Center, we may recommend any of the following treatments:

Physiotherapy

Chiropractic

Steroid injection

  • Trigger point injections
  • Epidural steroid injections
  • Transforaminal injections

Ozone injection

Pulsed radiofrequency

Botox® injections

Acupuncture

Prolotherapy

Repetitive transcranial magnatic stimulation (rTMS)

Long-term outlook for the child with cerebral palsy:

Since CP is a life-long condition that is not correctable, management includes focusing on preventing or minimizing deformities and maximizing the child’s capabilities at home and in the community. Positive reinforcement will encourage the child to strengthen his/her self-esteem and promote as much independence as possible.

The full extent of the condition is usually not completely understood immediately after birth, but may be revealed as the child grows and develops.