Cerebral Palsy (CP) is a disorder in which abnormalities or damage in a baby's brain during infancy or early childhood permanently affects body movement and muscle coordination. Cerebral refers to the brain, and palsy refers to physical disorders.
Cerebral palsy (CP) is a movement disorder caused by damage to the brain before, during or soon after birth. The ability for people with CP to communicate effectively is often impaired by problems with speech and also gestures usually used in communication. Speech and language therapy aims to help people with CP maximize their communication skills. This can include ways of enhancing natural forms of communication, introducing aids such as symbol charts or devices with synthetic speech, and training communication partners.
There Are Multiple Types of CP
- Spastic CP, the most common type, in which there is increased muscle tone preventing effective movement.
- Athetoid or Dyskinetic CP is mixed muscle tone - both hypertonia and hypotonia mixed with involuntary motions.
- Mixed CP is a combination of the various types of CP, and is diagnosed when your child does not fit into one specific type.
- Ataxic results in poor coordination of movements.
- Hypotonic is when a baby has trouble holding his or her own head or body up without assistance, often described as floppy.
Between one-third and one-half of all children with CP have seizures, and are mentally retarded, having learning disabilities and problems seeing, hearing or speaking.
CP is one of the most common types of a long-lasting childhood disability: About 8,000 infants and 1.500 young children are diagnosed with the disease each year. The United Cerebral Palsy Association estimates that more than 750,000 Americans have CP.
What Causes CP?
Many causes of CP are still unknown. What is known, though is that CP can be caused by damage to a baby's brain while the brain is developing - either when the baby is in the womb, while they are being born or after birth.
Here are some examples of things that are known to be causes of CP:
- An infection during pregnancy, especially when a woman's water breaks and the baby isn't delivered within the following 24 hours.
- If your baby suffers a stroke within the womb.
- "Oxygen deprivation" when a baby's brain doesn't get enough oxygen during birth.
- An injury to a baby's head during birth or later.
- Bleeding in the brain or brain hemorrhaging.
- Severe jaundice.
- Brain infections like meningitis and encephalitis.
How Can I Tell If My Child Has CP?
If a child has CP, they will usually start to show signs of the disease before they reach the age of three. Regardless of age, if you see these signs in your child, you should contact your doctor immediately:
- They are not developing "motor skills" (for example, rolling over, sitting up or crawling) as fast as most children.
- Their muscles are too stiff and are very tight and do not stretch.
- They have an unusual posture or use one side of their body more than the other.
- They don't breastfeed well.
- Abnormal walk (gait): arms tucked in towards the sides, knees crossed or touching, legs make "scissors" movements, walk on the toes.
- Joints are tight and do not open up all the way (known as joint contracture).
- Muscle weakness or loss of movement in a group of muscles.
- Abnormal movements (twisting, jerking, or writhing) of the hands, feet, arms or legs while awake, which gets worse during periods of stress.
- Loss of coordination.
- Floppy muscles.
- Mental retardation however, CP babies can have normal intelligence.
- Speech problems (dysarthria).
- Hearing or vision problems.
- Small head size or the head circumference is not increasing normally.
Eating and digestive symptoms include:
- Difficulty sucking or feeding in infants, often needing a feeding tube.
- Problems swallowing (at all ages).
How Can a Doctor Tell if a Child Has CP?
There is no "test" for CP, but a doctor can tell whether a child has the disease by looking over the child's medical records and doing a physical and neurological exam. Sometimes, they also have to use brain imaging (MRI, CT, and ultrasound) to evaluate the child's brain, or take fluid samples from the child and test them in a lab. The more serious a child's case of CP is, the easier it is for a doctor to diagnose it. Most children with CP are diagnosed by the age of one, but some with less serious cases are not diagnosed until the age of three or four.
Some possible tests your doctor may order include:
- Blood tests (tests for metabolic and/or genetic disorders)
- CT or MRI scan of the brain
- Electroencephalogram (EEG)
- Hearing tests
- Vision testing
- Referral to a pediatric neurologist.
How Can CP be Treated?
CP cannot be cured, but it can be treated so that a person with the disease can use their muscles, do more on their own and improve the quality of their life. Treatment is based on a person's symptoms.
Here are some examples of treatments for CP:
- Surgery, which can help a person with CP use their muscles better.
- Medication such as Botox and Baclofen, can make muscles spasm less, minimize drooling and reduce tremors.
- Physical therapy exercises that can improve movement and increase strength.
- Speech therapy, which can help a person with CP communicate more clearly and/or swallow better.
- Psychological and social-work counseling can help a person with CP and their family deal with the person's disease and get the services they need.
- Occupational therapy
- Mobility aids such as wheelchairs, braces, splints, etc.
In an attempt to prevent or reduce the risk of CP, one should get proper prenatal care by frequently seeing their obstetrician. However, the disorder may not be preventable.