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Article Provided by The ARC of Georgia
Fact
Sheet (adapted from the United Cerebral Palsy web site)
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 palsy 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 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
cognitive disabilities
Other
problems that may arise are difficulties in feeding, bladder and bowel
control, problems with breathing because of postural difficulties,
skin disorders because of pressure sores, and learning disabilities.
Congenital cerebral palsy, results from brain injury during
intra-uterine life. It is present at birth, although it may not be
detected for months. In most cases, the cause of congenital cerebral
palsy is unknown.
On the other hand, 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 --
most often from a motor vehicle accident, a fall, or child abuse.
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.
Helpful Information
What are the early signs?
Early signs of cerebral palsy usually appear before 18 months of age
and parents are often the first to suspect that their infant is not
developing motor skills normally. Infants with cerebral palsy are
frequently slow to reach developmental milestones, such as learning to
roll over, sit, crawl, smile, or walk. This is sometimes called
developmental delay.
Some affected children have abnormal muscle tone. The baby may seem
flaccid and relaxed, even floppy (hypotonia). The baby may seem stiff
or rigid (hypertonia). 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.
The doctor also tests the infant's reflexes and looks for early
development of hand preference.
The next step in diagnosing cerebral palsy is to rule out other
disorders that can cause movement problems. Most important, doctors
must determine that the child's condition is not getting worse.
Cerebral Palsy is not progressive. If a child is continuously losing
additional motor skills, the problem more likely springs from
elsewhere.
The doctor may also order specialized tests to learn more about the
possible cause of cerebral palsy:
-
computed
tomography, or CT scan
-
Magnetic
resonance imaging, or MRI
-
ultrasonography
Finally,
physicians may want to look for other conditions that are linked to
cerebral palsy, including seizure disorders, mental impairment, and
vision or hearing problems.
When the doctor suspects a seizure disorder, an electroencephalogram,
or EEG, may be ordered.
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.
This should be started as early as possible with identification of the
very young child who may have a developmental brain disorder. A
program can then be started where doctors, therapists, teachers,
nurses, social workers, and other professionals assist. Certain
medications, surgery, and braces may be used to improve nerve and
muscle coordination.
As your child grows up, he or she 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. Most of all, people with
cerebral palsy need the opportunity for independence and full
inclusion in our society.
Terms You Might Hear
Spastic cerebral palsy: In this form
of cerebral palsy, which affects 70 to 80 percent of patients, the
muscles are stiffly and permanently contracted. Doctors will often
describe which type of spastic cerebral palsy a patient has based on
which limbs are affected, i.e spastic diplegia (both legs) or left
hemi-paresis (the left side of the body). The names given to these
types combine a Latin description of affected limbs with the term
plegia or paresis, meaning paralyzed or weak. In some cases, spastic
cerebral palsy follows a period of poor muscle tone (hypotonia) in the
young infant.
Athetoid, or dyskinetic cerebral palsy:
This form of cerebral palsy is characterized by uncontrolled, slow,
writhing movements. These abnormal movements usually affect the hands,
feet, arms, or legs and, in some cases, the muscles of the face and
tongue, causing grimacing or drooling. The movements often increase
during periods of emotional stress and disappear during sleep.
Patients may also have problems coordinating the muscle movements
needed for speech, a condition known as dysarthria. Athetoid cerebral
palsy affects about 10 to 20 percent of patients.
Ataxic cerebral palsy: This rare form
affects the sense of balance and depth perception. Affected persons
often have poor coordination, walk
unsteadily with a wide-based gait, placing their feet unusually far
apart, and experience difficulty when
attempting quick or precise movements, such as writing or buttoning a
shirt. They may also have intention tremor. In this form of tremor,
beginning a voluntary movement, such as reaching for a book, causes a
trembling that affects the body part being used and that worsens as
the individual gets nearer to the desired object. The ataxic form
affects an estimated 5 to 10 percent of cerebral palsy patients.
Mixed forms: It is not unusual for
patients to have symptoms of more than one of the previous three
forms. The most common mixed form includes spasticity and athetoid
movements but other combinations are also possible.
Intraventricular or intracranial
hemorrhages: bleeding within the brain.
Computed tomography (CT):
A sophisticated imaging technique that uses
X rays and a computer to create an anatomical picture of the brain's
tissues and structures.
Magnetic resonance imaging (MRI):
An imaging technique that uses a magnetic
field and radio waves, rather than X rays. MRI gives better pictures
of structures or abnormal areas located near bone than CT.
Ultrasonography: A technique
that bounces sound waves off the brain and uses the pattern of echoes
to form a picture, or sonogram, of its structures.
It can be used in infants before the bones of the skull harden
and close. This technique can detect cysts and structures in the
brain, is less expensive, and does not require long periods of
immobility.
Electroencephalogram (EEG):
This uses special patches called electrodes placed on the scalp to
record the electrical currents inside the brain. This recording can
help the doctor see telltale patterns in the brain's electrical
activity that suggest a seizure disorder.
Resources
Cerebral Palsy – A Guide For Care
United Cerebral
Palsy web site
KidSource Online
National Easter Seal Society, Inc.
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The impact of a
disability can always be lessened to some degree by early intervention. |
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