Cerebral palsy is a term used to describe a group of chronic conditions
affecting body movement and muscle coordination. It is caused by damage
to one or more specific areas of the brain, usually occurring during
fetal development; before, during, or shortly after birth; or during
infancy. Thus, these disorders are not caused by problems in the muscles
or nerves. Instead, faulty development or damage to motor areas in
the brain disrupt the brain's ability to adequately control movement
and posture.
"Cerebral" refers to the brain and "palsy" to
muscle weakness/poor control. Cerebral palsy itself is not progressive
(i.e., brain damage does not get worse); however, secondary conditions,
such as muscle spasticity, can develop which may get better over time,
get worse, or remain the same. Cerebral palsy is not communicable.
It is not a disease and should not be referred to as such. Although
cerebral palsy is not "curable" in the accepted sense,
training and therapy can help improve function. Cerebral palsy is
usually identified in childhood and is a life-long condition.
What Are
the Effects?
Cerebral palsy is characterized by an inability to fully control motor
function, particularly muscle control and coordination. Depending on
which areas of the brain have been damaged, one or more of the following
may occur: muscle tightness or spasticity; involuntary movement; disturbance
in gait or mobility, difficulty in swallowing and problems with speech.
In addition, the following may occur: abnormal sensation and perception;
impairment of sight, hearing or speech; seizures; and/or mental retardation.
Other problems that may arise are difficulties in eating, controlling
bladder and bowel functions, breathing because of postural difficulties,
maintaining healthy skin because of pressure sores, and learning disabilities.
What Are the Causes?
Cerebral is a group of disorders with similar problems in control
of movement, but with a variety of causes.
Congenital cerebral palsy results from brain injury during intra-uterine
life. It is present at birth, although it may not be detected for months.
It is responsible for about 70 percent of children who have cerebral
palsy. An additional 20 percent are diagnosed with congenital cerebral
palsy due to a brain injury during the birthing process. In most cases,
the cause of congenital cerebral palsy is unknown.
In the United States, about 10 percent of children who have cerebral
palsy acquire the disorder after birth. Acquired cerebral palsy results
from brain damage in the first few months or years of life and can
follow brain infections, such as bacterial meningitis or viral encephalitis,
or the results of head injury.
Risk factors for cerebral palsy include the following: premature birth;
low birth weight; inability of the placenta to provide the developing
fetus with oxygen and nutrients; lack of growth factors during intra-uterine
life; RH or A-B-O blood type incompatibility between mother and infant;
infection of the mother with German measles or other viral diseases
in early pregnancy; bacterial infection of the mother, fetus or infant
that directly or indirectly attack the infant's central nervous system;
prolonged loss of oxygen during the birthing process and severe jaundice
shortly after birth.
Are There Different Types of Cerebral Palsy?
Doctors classify cerebral
palsy into three principal categories—spastic,
athetoid, and ataxic,—according to the type of movement disturbance.
A fourth category can be a mixture of these types for any individual.
What Are the Early Signs?
Early signs of cerebral palsy usually appear before 18 months of age.
Infants with cerebral palsy are frequently slow to reach developmental
milestones, such as learning to roll over, sit, crawl, smile, or walk.
Some affected children have abnormal muscle tone. Decreased muscle
tone is called hypotonia; the baby may seem flaccid and relaxed, even
floppy. Increased muscle tone is called hypertonia, and the baby may
seem stiff or rigid. In some cases, the baby has an early period of
hypotonia that progresses to hypertonia after the first 2 to 3 months
of life. Affected children may also have unusual posture or favor one
side of their body.
How Is Cerebral Palsy Diagnosed?
Doctors diagnose cerebral
palsy by testing an infant's motor skills and looking carefully
at the mother’s and infant's medical
history. In addition to checking for those symptoms described above
-- slow development, abnormal muscle tone, and unusual posture
-- a physician also tests the infant's reflexes and looks for early
development of hand preference. The doctor may also order specialized
tests to learn more about the possible cause of cerebral palsy,
including CT scan, MRI, or ultrasonography.
How Many People Have Cerebral Palsy?
It is estimated that some 764,000 children and adults in the United
States manifest one or more of the symptoms of cerebral palsy. Currently,
about 8,000 babies and infants are diagnosed with the condition each
year. In addition, some 1,200 - 1,500 preschool age children are recognized
each year to have cerebral palsy.
Can it Be Prevented?
Measures of prevention are increasingly possible today. Pregnant women
are tested routinely for the Rh factor and, if Rh negative, they have
options of immunizations or exchange transfusions. A newborn baby with
jaundice can be treated with light therapy. Immunization against measles
is an essential preventive measure. Other programs are directed towards
the prevention of prematurity. Of great importance are optimal well
being prior to conception, adequate prenatal care, and protecting infants
from accidents or injury.
Can Cerebral Palsy Be Treated?
"Management" is a better word than "treatment." Management
consists of helping the child achieve maximum potential in growth
and development. A management program can be started promptly wherein
programs, physicians, therapists, educators, nurses, social workers,
and other professionals assist the family as well as the child. Certain
medications, surgery, and braces may be used to improve nerve and
muscle coordination and prevent or minimize dysfunction.
As individuals mature, they may require support services such as personal
assistance services, continuing therapy, educational and vocational
training, independent living services, counseling, transportation,
recreation/leisure programs, and employment opportunities, all essential
to the developing adult. People with cerebral palsy can go to school,
have jobs, get married, raise families, and live in homes of their
own. Most of all, people with cerebral palsy need the opportunity for
independence and full inclusion in our society.
Is Research Being Done on Cerebral Palsy?
Active national programs
of research are being vigorously pursued to prevent cerebral palsy
and improve the quality of life for persons with cerebral palsy.
The four organizations with major research programs are the United
Cerebral Palsy Research and Educational Foundation in the private
sector, and the National Institutes of Health, the Centers for
Disease Control and Prevention and the National Institute of Disability
and Rehabilitation Research in the government sector. For local information
contact ucpmn@cpinternet.com or
call 651-626-7588 or toll-free 1-800-328-4827 ext. 1437.
