Description

Cerebral palsy is a group of conditions that affect movement and posture. It is caused by damage that occurs in the developing brain, most often before birth.

The symptoms appear during infancy or preschool age and range from very mild to severe. Children with cerebral palsy may have exaggerated reflexes. The arms, legs, and trunk may appear floppy. Or they may have stiffness in the muscles, known as spasticity. Symptoms can also include spot, posture, and movements that cannot be controlled, a walk that is not stable or some combination of these.

Cerebral palsy can make it difficult to swallow. It can also cause eye muscle imbalance, in which the eyes do not focus on the same object. People with the condition that would have reduced the range of motion in the joints due to muscle stiffness.

The cause of cerebral palsy and its effect on the function vary from person to person. Some people with cerebral palsy can walk, while others need help. Some people have an intellectual disability, but others do not. Epilepsy, blindness or deafness can also affect some people with cerebral palsy. There is No cure, but treatments can help improve function. The symptoms of cerebral palsy can vary during the development of the child, but the condition does not get worse. The condition usually remains the same over time.

Symptoms

The symptoms of cerebral palsy can vary greatly. In some people, the cerebral palsy affects the entire body. In others, the symptoms may only affect one or two members or one side of the body. The general symptoms include problems with movement and coordination, speech, and the power, development, and other issues.

The movement and coordination

The movement and the coordination symptoms may include:

  • Stiffness of the muscles and exaggerated reflexes, known as spasticity. This is the most common movement of the condition related to cerebral palsy.
  • Variations in muscle tone, such as being either too stiff or too loose.
  • Stiffness in the muscles, with regular reflections, known as stiffness.
  • The lack of balance and muscle coordination, known as ataxia.
  • The sudden movements that can not be controlled, known as tremors.
  • Slow, writhing movements.
  • In favor of one of the sides of the body, as is only to be attained with only one hand or dragging a leg while crawling.
  • Difficulty walking. People with cerebral palsy can walk on your toes and squat down when you walk. They may also have a scissors-like walking with knees crossing. Or you can have a great walk or a ride that is not constant.
  • Problems with fine motor skills, such as buttoning clothes or picking up the kitchen utensils.

Speaking and eating

These symptoms related to speaking and eating may occur:

  • Delays in the development of speech.
  • Difficulty speaking.
  • Problems with sucking, chewing or eating.
  • Drooling or difficulty swallowing.

Development

Some children with cerebral palsy have these symptoms related to the development:

  • Delays in reaching motor skills milestones, such as sitting or crawling.
  • Learning disabilities.
  • Intellectual disability.
  • Growth retardation, resulting in a smaller size than you would expect.

Other symptoms

The damage to the brain can contribute to other neurological symptoms, such as:

  • The seizures, which are symptoms of epilepsy. Children with cerebral palsy can be diagnosed with epilepsy.
  • Hearing problems.
  • Problems with vision and the changes in the eye movements.
  • Pain or difficulty to feel sensations such as touch.
  • The bladder and bowel issues, including constipation and urinary incontinence.
  • Mental health conditions, such as emotional and behavioral problems.

The brain condition that causes cerebral palsy does not change with time. The symptoms do not tend to worsen with age. However, as the child grows, some of the symptoms may be more or less clear. And muscle shortening and muscle rigidity may worsen if not treated aggressively.

When to see a doctor

Please contact your child's health care professional and get a diagnosis quickly if your child has symptoms of a stroke condition. Also consult a health professional if your child has developmental delays.

See your health care professional if you have concerns about the episodes of loss of consciousness or erratic body movements or posture. It is also important to contact your child's healthcare provider if your child has difficulty swallowing, difficulty coordinating the muscles of the eyes, imbalance or other problems of development.

Causes

Cerebral palsy is caused by the irregular brain development or damage in the developing brain. This generally happens before a child is born, but can occur at birth or in early childhood. Often, the cause is not known. There are many factors that can lead to changes in the development of the brain. Some of them are:

  • The changes in the genes that result in genetic disorders or differences in the development of the brain.
  • Maternal infections that affect the unborn baby.
  • Stroke, which interrupts the blood supply to the developing brain.
  • Bleeding in the brain in the womb or as a newborn.
  • Baby from infections that cause inflammation in or around the brain.
  • Traumatic head injury a baby, as for example in a motor vehicle accident, fall or physical trauma.
  • The lack of oxygen to the brain related to a hard labor or childbirth, although this cause is less common than previously thought.

Risk factors

A number of factors that are associated with an increased risk of cerebral palsy.

Maternal health

Certain infections or exposure to toxic substances during pregnancy can significantly increase cerebral palsy risk to the baby. The inflammation caused by an infection or fever may cause harm to the fetus's developing brain.

  • Cytomegalovirus. This virus causes symptoms similar to the flu. If a mother is your first active infection during pregnancy, can cause birth defects.
  • German measles, known as rubella. This viral infection can be prevented with a vaccine.
  • Herpes. This infection can be transmitted from mother to child during pregnancy, affecting the uterus and the placenta.
  • Syphilis. This is a bacterial infection that is usually transmitted by sexual contact.
  • Toxoplasmosis. This infection is caused by a parasite found in contaminated food, soil, and feces of infected cats.
  • Zika virus infection. This infection is transmitted through mosquito bites and can affect the brain development of the unborn baby.
  • Intrauterine infections. This includes infections of the placenta or fetal membranes.
  • Exposure to the toxins. An example is the exposure to methylmercury.
  • Other conditions. Other conditions that affect the mother, which may slightly increase the risk of cerebral palsy include thyroid conditions, pre-eclampsia, or seizures.

Childhood disease

The diseases in which a newborn baby that can greatly increase the risk of cerebral palsy include:

  • Bacterial meningitis. This bacterial infection that causes inflammation of the membranes that surround the brain and spinal cord.
  • Viral encephalitis. This viral infection can also cause inflammation of the membranes that surround the brain and spinal cord.
  • Severe or without treatment of jaundice. The jaundice appears as a yellowing of the skin and eyes. The condition occurs when certain by-products of "use" the blood cells are not filtered into the bloodstream.
  • Bleeding in the brain. This condition is commonly caused by the baby to have a stroke in the womb or in early childhood.

Factors of pregnancy and birth

The potential contribution of each is limited, but these pregnancy and the birth of the factors that can increase the risk of cerebral palsy risk:

  • The low birth weight. Babies who weigh less than 5.5 pounds (2.5 kg) are at increased risk of developing cerebral palsy. This risk increases as the birth weight of the drops.
  • Multiple babies. The Cerebral palsy risk increases with the number of babies who share the uterus. The risk may also be related to the likelihood of premature birth and low birth weight. If one or more of the babies die, the survivors of the risk of cerebral palsy increases.
  • The preterm birth. Premature babies have a higher risk of cerebral palsy. Before the baby is born, the greater the cerebral palsy risk.
  • Complications of childbirth. Events during labor and delivery may increase the risk of cerebral palsy.

Complications

Muscle weakness, spasticity, muscle, and problems with coordination may contribute to the complications in childhood or in adulthood, including:

  • The contracture. A contracture of muscle tissue is a muscle shortening due to the severe muscle stiffness. This may be the result of spasticity. The contracture may slow down the growth of bones, because the bones are bent, and result in changes in the joints, dislocation or partial dislocation. These may include a dislocation of the hip, a curvature of the spine or other changes in the bone.
  • Malnutrition. Problems with swallowing and feeding can make it hard to get enough nutrition, especially for a baby. This can affect the growth and weaken the bones. Some of the children or adults in need of a feeding tube to get enough nutrition.
  • Mental health conditions. People with cerebral palsy can have mental health conditions, such as depression. The Social isolation and the challenges of coping with disability can contribute to depression. Behavioral problems may also occur.
  • The lung and heart diseases. People with cerebral palsy can develop heart disease, lung disease, and respiratory conditions. Difficulty swallowing can result in respiratory problems, such as aspiration pneumonia. Aspiration pneumonia occurs when a child swallows the food, drink, saliva, or vomit into the lungs.
  • Osteoarthritis. The pressure on the joints or poor alignment of the joints of the spasticity of the muscle may lead to this painful disease of the bones.
  • Osteoporosis. Fractures due to low bone density can result from lack of mobility, poor nutrition, and anti-epileptic drugs.
  • Other complications. These can include sleep conditions, chronic pain, deterioration of the skin, the intestine and the problems with oral health.

Prevention

Often, the cerebral palsy can't be prevented, but you can reduce the risks. If you are pregnant or plan to become pregnant, take these steps to minimize complications in the pregnancy:

  • Make sure that you are vaccinated. Get vaccinated against diseases such as rubella can prevent an infection. It is better to ensure that you are fully vaccinated before getting pregnant.
  • Take care of yourself. The healthier you are heading to a pregnancy, the less likely you'll develop an infection that results in cerebral palsy.
  • Search early and continuous prenatal care. Consult your health care provider regularly during pregnancy. Proper prenatal care can reduce the health risks for you and your unborn baby. See your health care professional regularly can help prevent premature birth, low birth weight and infections.
  • Avoid the consumption of alcohol, tobacco, and illegal drugs. These have been linked to cerebral palsy risk.

Rarely, cerebral palsy can be caused by brain damage that occurs in childhood. Good security practice in general. Prevent head injuries by providing your child with a child safety seat, bicycle helmet, safety bed rails and the appropriate supervision.

Diagnosis

The symptoms of cerebral palsy may be more apparent over time. A diagnosis can not be made until a couple of months to a year after birth. If the symptoms are mild, the diagnosis may be delayed more.

If cerebral palsy is suspected, a healthcare professional assesses your child's symptoms. The health professional also fixes the your child's medical history, performs a physical examination and oversees the growth and development of the child during appointments.

Your child may be referred to specialists trained in the treatment of children with brain and nervous system conditions. Specialists include neurologists pediatric, pediatrics physical medicine and rehabilitation specialists, and specialists in child development.

Your child may also need a series of tests to make a diagnosis and rule out other possible causes.

The brain scans

Brain-imaging tests can reveal areas of damage or irregular development of the brain. These tests may include the following:

  • The magnetic resonance imaging. A magnetic resonance imaging (MRI uses radio waves and a magnetic field to produce detailed 3D or cross-sectional images of the brain. An mri can often identify changes in the brain of your child. This test is painless, but it is very noisy and can take up to an hour to complete. It is likely that your child will receive a sedative or general anesthesia, soft in advance.
  • Ultrasound of the skull. This can be done during childhood. A cranial ultrasound uses high-frequency sound waves to produce images of the brain. An ultrasound does not produce a detailed image, but it can be used because it is fast, and can provide valuable preliminary assessment of the brain.

Electroencephalogram (EEG)

If your child is suspected of having seizures, an EEG can assess the condition. Seizures can occur in a child with epilepsy. In an EEG, a series of electrodes attached to the scalp of the child. The EEG records the electrical activity of the brain of your child. The changes in brain wave patterns are common in epilepsy.

Laboratory tests

Tests of blood, urine, or skin can be used for detecting genetic or metabolic conditions.

Additional tests

If your child is diagnosed with cerebral palsy, your child probably refers to the specialists to having tests for other conditions. These tests can be seen in:

  • Of the vision.
  • The hearing.
  • Speech.
  • The intellect.
  • Development.
  • Movement.
  • Other medical conditions.

The type of cerebral palsy is determined by the movement main condition is present. However, multiple movement conditions can occur together.

  • Spastic cerebral palsy. This is the most common type. This causes stiff muscles and exaggerated reflexes.
  • Dyskinetic cerebral palsy. This makes it difficult to control the voluntary muscles.
  • Cerebral palsy ataxic. People with this type of problems with balance and coordination.

After a diagnosis of cerebral palsy, your health care professional may use a rating scale of the tool, such as the Gross Motor Function Classification System. This tool measures the function, mobility, posture and balance. This information can help in the selection of treatments.

Treatment

Children and adults with cerebral palsy may require lifelong care with a health care team. Your child's health care professional and of physical medicine and rehabilitation specialist doctor can monitor your child's care. Your child may also see a pediatric neurologist, therapists and mental health specialists. These experts give special attention to the needs and problems that are more common in people with cerebral palsy. They work together with your child's health care professional. Together, you can develop a plan of treatment.

There is No cure for cerebral palsy. However, there are many treatment options that can help your child's daily functioning. The selection of the care depends on your child's specific symptoms and needs, which can change over time. Early intervention can improve outcomes.

Treatment options may include medications, therapies, surgical procedures and other treatments as needed.

Drugs

Drugs that may decrease muscle stiffness can be used to improve functional skills. You can also treat pain and manage the complications associated with spasticity or other symptoms.

  • Muscle or nerve injections.For the treatment of hardening of a muscle-specific, your health care professional may recommend injections of onabotulinumtoxinA (Botox), or other agent. The injections are repeated approximately every three months. Side effects may include pain at the injection site and mild flu-like symptoms. Other side effects include problems with breathing and swallowing.
  • Oral muscle relaxants.Medications such as baclofen (Fleqsuvy, Ozobax, Lyvispah), tizanidine (Zanaflex), diazepam (Valium,Diazepam Intensol) or dantrolene (Dantrium) are often used to relax the muscles. Sometimes baclofen is pumped into the spinal cord through a tube, known as intrathecal baclofen. The pump is surgically implanted under the skin of your stomach.
  • Medications to reduce drooling. One option is Botox injections into the salivary glands.

Muscle or nerve injections. For the treatment of hardening of a muscle-specific, your health care professional may recommend injections of onabotulinumtoxinA (Botox), or other agent. The injections are repeated approximately every three months.

Side effects may include pain at the injection site and mild flu-like symptoms. Other side effects include problems with breathing and swallowing.

Oral muscle relaxants. Medications such as baclofen (Fleqsuvy, Ozobax, Lyvispah), tizanidine (Zanaflex), diazepam (Valium,Diazepam Intensol) or dantrolene (Dantrium) are often used to relax the muscles.

Sometimes baclofen is pumped into the spinal cord through a tube, known as intrathecal baclofen. The pump is surgically implanted under the skin of your stomach.

Talk with your healthcare provider about the benefits and risks of medicines.

Therapies

A variety of therapies play an important role in the treatment of cerebral palsy:

  • The physical therapy.Muscle training and exercises that can help your child to strength, flexibility, balance, motor development and mobility. A physical therapist also teaches you how to take care of your child the necessities of daily life in the home. This may include bathing and feeding your child. The therapist can provide guidance about how you can continue to the muscle training and exercise with your child at home between therapy visits. During the first 1 to 2 years after birth, both physical and occupational therapists who work in areas such as the head and trunk control, rolling, and grasping. Later, both types of therapists are involved in a wheelchair in the assessments. Orthotics, splints, or other devices support can be recommended. They can help with function, such as the improvement of walking, and stretching of the muscles rigid.
  • Occupational therapy. Occupational therapists work to help your child gain independence in daily activities at home, at school and in the community. Adaptive equipment recommended for your child can include walkers, wide based on the sticks, standing and seating systems or electric wheelchairs.
  • Speech and language therapy. Speech-language pathologists can help improve your child's ability to speak clearly or to communicate through sign language. Can also teach the use of communication devices, such as a computer and a speech synthesizer, if the communication is difficult. Speech therapists also may solve problems with eating and swallowing.
  • Recreational therapy. Some children benefit from regular or adaptive recreational or competitive sports, such as horseback riding or skiing. This type of therapy can help improve your child's motor skills, speech, and emotional well-being. Both adults and children benefit from regular physical activity and exercise for general health and fitness.

The physical therapy. Muscle training and exercises that can help your child to strength, flexibility, balance, motor development and mobility. A physical therapist also teaches you how to take care of your child the necessities of daily life in the home. This may include bathing and feeding your child. The therapist can provide guidance about how you can continue to the muscle training and exercise with your child at home between therapy visits.

During the first 1 to 2 years after birth, both physical and occupational therapists who work in areas such as the head and trunk control, rolling, and grasping. Later, both types of therapists are involved in a wheelchair in the assessments.

Orthotics, splints, or other devices support can be recommended. They can help with function, such as the improvement of walking, and stretching of the muscles rigid.

Surgical procedures

Surgery may be necessary to decrease muscle stiffness or correct the bone changes caused by spasticity. These treatments include:

  • Orthopaedic surgery. Children with muscle tissue shortening, known as contractures, you may need surgery. Surgery in the bones or joints can place the arms, the spine, hips or legs in the correct position. Surgical procedures can also lengthen and lengthen the muscles, or the position of the tendons that are shortened. These corrections can decrease pain and improve mobility. The procedures can also make it easier to use a walker, braces or crutches.
  • The cut of the nerve fibers, known as sdr. This procedure can be done when walking or moving is hard and painful, and other treatments have not helped. The surgeons cut the nerves of the specific portion of the spastic muscles. This relaxes the muscle in the legs and reduces the pain. But it can cause numbness.

Other treatments

The medications and other treatments may be recommended for seizures, pain, osteoporosis, or mental health problems. The treatments may also be needed to help with sleep, oral health, food and nutrition, bladder incontinence, vision or hearing.

Adults with cerebral palsy

As a child with cerebral palsy becomes an adult, health care needs can change. Children with cerebral palsy need general health screening is recommended for all adults. But they also need ongoing medical care for conditions that are more common in adults with cerebral palsy. These may include:

  • Problems with vision and hearing.
  • The maintenance of muscle tone.
  • The seizure of management.
  • The pain and fatigue.
  • The dental problems.
  • Orthopedic problems, such as contractures, arthritis, and osteoporosis.
  • The lung and heart diseases.
  • Mental health problems, such as depression.

Alternative medicine

Some children and adolescents with cerebral palsy with the use of complementary and alternative medicine. Alternative therapies are not tested and have not been adopted in routine clinical practice. If you are considering a complementary and alternative medicine or therapy, talk with your child's health care professional about potential risks and benefits.

Coping and support

When a child is diagnosed with a condition of disability, the family faces new challenges. Here are some tips to take care of your child and to yourself:

  • Encourage your child's independence. I encourage any effort at independence, no matter how small. At any age, your child's participation in the social life, education, employment, recreation and other activities of the community can help them to participate in society. You can also have a positive effect on the quality of life.
  • Be an advocate for your child. You are an important part of your child's health care team. Don't be afraid to speak in the name of the child or to the hard questions of healthcare professionals, therapists, and teachers.
  • Find support. A circle of support can make a big difference in helping you and your family cope with cerebral palsy and its effects. As a parent, you can feel the pain and guilt about the condition of your child. Your doctor can help you locate support groups, organizations, and counseling services in your community. Your child may also benefit from family support programs, school programs and counseling.
  • Access to the services. The early intervention and special education services are available for children under 21 years of age through the Education of Individuals with Disabilities. Services for adults with disabilities are also available. Talk with your health care team about how to access programs and services in your area.

The resources of the community, and the support of adults

Care for your adult loved one with cerebral palsy may include planning for current and future lifestyle needs, such as:

  • Guardianship.
  • Living arrangements.
  • Social and leisure participation.
  • Employment.
  • Financial support.

Preparing for your appointment

If your child has cerebral palsy, the health professional may ask about your child's symptoms and when they started. The health professional may also ask if there were risk factors during pregnancy or childbirth.

What you can do

Before your appointment, make a list of:

  • The symptoms that concern you, and when they began.
  • All the drugs, vitamins, and other supplements that your child takes, including doses.
  • Your child's medical history, including other conditions.
  • The information on pregnancy and childbirth .
  • Questions for the health care professional.

Invite a family member or friend with you, if possible, to help you remember the information that you receive.

Questions to ask a health care professional may include:

  • What tests will my child need?
  • When will we know the results of the tests?
  • What specialists will we see?
  • How will you monitor my child's health and development?
  • You can suggest educational materials and local support services with respect to the cerebral palsy?
  • Can my child be seen by the specialists in cerebral palsy clinic?

Do not hesitate to ask questions during your appointment.

What to expect from your doctor

Your healthcare provider is likely to ask questions such as:

  • What are your concerns about your child's growth and development?
  • How well does your child eat?
  • How does your child respond to touch?
  • You are watching favoring of one side of the body?
  • Is your child's achievement of certain development milestones, such as rolling over, pushing up, sitting up, crawling, walking or talking?
  • Do you have any medical condition during your pregnancy or delivery?
Symptoms and treatment of Cerebral palsy