Cerebral Palsy

WHAT YOU SHOULD KNOW

Cerebral palsy is a lifelong disorder of the nervous system. It affects muscle control, resulting in spasticity and paralysis. It can strike a child during pregnancy, at birth, or anytime during the first five years of life.

Causes

There is no single reason for this condition, but in most cases it is due to brain damage that occurs during pregnancy or around the time of birth. The damage is often due to an interruption of the oxygen supply to the brain for a period of more than four or five minutes. This, in turn, may stem from lung distress, neonatal pneumonia, or a birth injury that causes internal bleeding.

In some cases, cerebral palsy is the result of a genetic disorder or an abnormally formed brain. An infection in the mother, such as German measles, can also cause this disorder. During the first years of life, an injury, severe dehydration, or an illness such as meningitis can trigger the problem.

Signs/Symptoms

Delayed development of motor skills is the classic symptom of cerebral palsy. However, this condition usually cannot be diagnosed in early infancy and the amount of brain damage determines what type of problems the child will experience throughout life.

Symptoms span the range from barely noticeable clumsiness to spasticity so severe that it confines the child to a wheelchair. Despite the physical limitations, many with cerebral palsy enjoy average or above-average mental abilities.

There are four main types of cerebral palsy. The spastic form of the condition is the most common. In it, muscular stiffness and weakness result in uncontrolled jerky movements. The choreoathetoid form of the disease is characterized by slow, involuntary writhing. In the rarer ataxic form of cerebral palsy, the victim suffers from poor coordination, weakness, shakiness, and an unsteady gait. Mixed forms of the disease are common, often combining spasticity and choreoathetoid movements, and sometimes melding ataxic problems with choreoathetoid writhing.

Care

Although there is currently no cure for cerebral palsy, most children afflicted with the disorder grow normally and survive well into adulthood. A number of advances in the care of cerebral palsy now allow many sufferers more mobility than in years past. For example, neurological therapies, special educational programs, drug therapies, and mechanical aids—along with plenty of emotional support from parents and other caregivers—can all help a child with cerebral palsy obtain a fair degree of independence.

Neurological treatments include physical therapy to improve motor development and spare affected muscles from further weakening; occupational therapy to enhance eating, dressing, and toileting skills; and speech therapy to aid in communication.

In addition, drug therapy may be prescribed to prevent seizures and attacks of spasticity. Leg braces may be recommended by doctors to correct permanent muscle contractions. However, if such contractures are severe, they may require surgery.

Today, there are also a number of mechanical devices to make life a bit easier. Among them are special types of motorized wheelchairs, eating and writing utensils, and computers to enhance communication and help perform certain tasks.

Risks

Since basic activities such as walking and talking often pose difficulties, most children with cerebral palsy need help with everyday tasks. Seizures afflict about one in four victims. The child may have crossed eyes, and hearing may also be affected. Children with cerebral palsy may also suffer from speaking, chewing, and swallowing difficulties. If the child has spastic quadriplegia (spasticity which effects both arms and both legs), he could develop a partial dislocation of the hip joint.

Additional complications that often accompany cerebral palsy are mental retardation, learning disabilities, and attention deficit-hyperactivity disorder. It's important to remember, however, that although a child may have difficulty with speaking and movement, his mental and learning abilities may be quite normal.

WHAT YOU SHOULD KNOW

Fortunately, there are innumerable measures you can take to help a child with this disorder. Here are just a few of the basics.

• Begin a physiotherapy regimen as soon as possible after cerebral palsy has been diagnosed. This helps alleviate joint problems brought on from sitting or lying in one position for too long—a common problem among cerebral palsy victims because of the muscle spasms they suffer.
• Have the child lie on his side or stomach as much as possible. Lying on the back may promote stiffness and muscle spasms.
• Change the child's position every 20 to 30 minutes.
• Encourage normal play with toys as much as possible.
• Stimulate intellectual growth by talking and reading to the child frequently, just as you would to a child without cerebral palsy. Educational television and video programs may also help to educate, stimulate, and entertain.
• Show the child how to use his hands to explore the surrounding world. For example, provide a number of objects with different sizes, shapes, and textures for the child to hold and feel.
• Use a wedge cushion for support while the child plays with toys and other objects. This helps him lift his head, straighten his back, reach forward, and use his hands. This measure is especially important for a child who is not yet ready to sit up.
• Regularly massage the child's feet to prevent them from becoming stiff and rigid.
• For more information, contact the United Cerebral Palsy Association at 800-USA-5UCP or visit their website at www.ucpa.org.

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