Cerebral Palsy

Cerebral palsy is one of the most common disorders in the United States. Each year, between 8,000 and 10,000 people are diagnosed with cerebral palsy. That accounts for around 800,000 people currently suffering from the disorder. Cerebral palsy is also a quite intricate disorder, with various types and a myriad of signs and symptoms, ranging from mild to severe. Although it’s a common disorder, parents, understandably, don’t want their children to develop cerebral palsy. If your child already has cerebral palsy or you suspect they may, it’s important to understand what the disorder is, what causes it, the signs to look for, and ultimately, the best treatment options.

Cerebral Palsy

What is Cerebral Palsy?

Cerebral palsy is a disorder that affects the brain and causes motor deficiency. Cerebral refers to the part of the body affected, and palsy refers to paralysis, as there an area of the brain that’s dormant or paralyzed, which leads to either partial or complete muscle paralysis. The brain damage usually happens before, during, or shortly after birth and can end up being a lifetime disability for the affected child.

Sometimes cerebral palsy is a term that includes a number of different movement-and-brain-related disabilities, but generally there are three kinds of cerebral palsy: spastic cerebral palsy, athetoid cerebral palsy, and ataxic cerebral palsy. Spastic cerebral palsy includes stiffness and a problem moving limbs. Athetoid cerebral palsy involves involuntary, uncontrolled, and sometimes abnormal movements. Ataxic cerebral palsy includes problems with a sense of balance, depth-perception, or walking.

The vast majority of cerebral palsy cases are considered “congenital”, meaning that the brain damage occurred before or during childbirth.  The primary causes of congenital cerebral palsy include:

  • Low birth weight (less than 5.5 pounds)
  • Prematurity (born before 37 weeks)
  • Multiple births (twins, triplets, etc.)
  • Assisted reproductive technology (ART)
  • Maternal infections while pregnant
  • Maternal health conditions (seizures, thyroid problems, etc.)
  • Complications during birth (uterine rupture, placenta previa, umbilical cord problems, disrupted oxygen supply, etc.)
  • Infant jaundice or kernicterus

A smaller percentage of cerebral palsy cases are considered “acquired”, meaning that the brain damage occurs 28 days or more after birth.  The primary causes of acquired cerebral palsy include:

  • Infant infections (meningitis, encephalitis, etc.)
  • Brain injury (head injury due to auto accident, abuse, or other trauma)
  • Restricted blood flow to the brain (clotting problem, cerebrovascular accidents, stroke, bleeding in the brain, etc.)

What Causes Cerebral Palsy?

Although cerebral palsy develops due to a brain malformation or injury before, during, or shortly after birth, there is still a lot of mystery as to how, exactly, an infant develops it. Some doctors and scientists believe that an infant gets cerebral palsy from a maternal infection before the delivery (any kind of infection that could disturb normal growth and development of the brain). Other doctors and scientists believe that brain injuries sustained as an infant can turn into cerebral palsy, which is directly related to medical malpractice as it’s during birth or just after birth that these infants generally have a brain injury.

Cerebral palsy can also occur if the child has been deprived of oxygen for too long, dropped, pulled out forcefully, had an instrument-related injury (such as a forceps injury or a vacuum extraction injury), or simply has endured a labor that lasted longer than 18 hours (especially if the child is one baby of multiple births). These birth-related malpractice injuries can be enough to cause a brain damage which then develops into cerebral palsy.

What are the Signs and Symptoms of Cerebral Palsy?

Cerebral palsy is marked by spastic movements, a lack of muscle control, sometimes the inability to use muscles, and is often determined by abnormal, slow, writhing movements that the child cannot control. Additionally, muscle tone varies between floppy and stiff, which also could result in the use of some muscles over others. Other signs that your child may have cerebral palsy includes missing developmental milestones and/or intellectual disabilities.

According to the Centers for Disease Control and Prevention (CDC), some of the clinical signs and symptoms of cerebral palsy include:

  • Muscle Tone: As previously mentioned, a person with cerebral palsy has limited muscle control, or may have a complete loss of muscle control. This in turn may make what seems like simple tasks extremely difficult. For example, sitting down, walking, tying shoes, and grasping objects may prove to be exhausting and hard for those with cerebral palsy.
  • Reflexes: People with cerebral palsy may have abnormal reflex responses such as asymmetrical or symmetrical tonic reflex, palmer grasp reflex, and spinal gallant reflexes. Moro reflexes may be present in some infants, but generally clear up with 5 months of age.
  • Coordination and Control: Both coordination and control is limited with those who have cerebral palsy, and it usually more pronounced when stressed or overwhelmed. Common issues with coordination and control include spastic movements, walking with a wide gait, walking with toes pointed inward or outward, dragging one leg while walking, and waddling when walking.
  • Oral Motor Problems: Many people with cerebral palsy will experience difficulties with communication because of the spastic movements of face muscles. This also can affect breathing, eating, closing the mouth, and swallowing.

What Kind of Tests Can Confirm Cerebral Palsy?

Tests that confirm cerebral palsy include blood tests, a cranial ultrasound that can help the doctors see an image of the brain tissue, an MRI that allows physicians to see resonance and density in relation to the brain tissue, and a CT scan, which is an in-depth, 3D scan of the baby’s brain.

Cognitive assessments and medical observations are also used to help confirm cerebral palsy. Additionally, evaluations of the child’s mobility, speech and language, hearing, vision, gait, and feeding and digestion are utilized to determine the disorder.

Keep in mind that sometimes a diagnosis of cerebral palsy takes time. Depending on factors like malformations and congenital issues, diagnosis can take up to several years after a brain injury takes place to complete. Furthermore, there isn’t a single test that can completely confirm or completely exclude cerebral palsy. Instead, a combination of a series of tests, observations, assessments, and evaluations are used to help diagnose the disorder.

Can Cerebral Palsy Cause Other Disabilities?

Cerebral palsy is a condition that develops as a result of a brain injury, and other areas of the brain can also be affected. Some children with cerebral palsy have trouble with hearing, sight, and speech problems. Children may also have problems with bladder control and problems with muscles. Children with cerebral palsy should be regularly observed by an occupational therapist to prevent other problems.

Cerebral palsy often causes mental health issues in children afflicted by the disability. Many children with cerebral palsy have behavioral problems, even those with mild levels of physical limitations. Persons with CP-associated learning disabilities, chronic or severe pain, or epilepsy are more likely to develop psychological disorders that appear in early childhood and can last into their adult years. According to the Scientific World Journal, children with cerebral palsy often suffer from attention deficit hyperactivity disorder (ADHD), anxiety, worry, conduct problems such as temper tantrums and disobedience, and socialization problems such as preferring to be with adults instead of peers and deep feelings of loneliness.

In addition, some children with cerebral palsy may have a tendency to overreact emotionally to new situations, especially challenging ones. Parents should consult with their child’s physician, who may recommend mental health screening to diagnose and treat mental health conditions as soon as possible.

What Kind of Care is Involved with Cerebral Palsy?

Once a child has been diagnosed with cerebral palsy, the parents are typically introduced to a team of professionals who can help clearly explain what the child needs. This meeting will likely draw up what’s called a Life Care Plan. A Life Care Plan is an itemized list of needs that the child will have during certain time frames of his or her life, involving accommodations that need to be made in the home.

The plan may include a list of accessories that the child needs (such as wheelchairs, walkers, braces, etc.), the kinds of therapy the child needs and how often they should go, special educational accommodations that may include IEPs (Individualized Educational Plans), a 504 educational plan, and licensed in-home care. Parents are never expected to walk through caring for a child with cerebral palsy alone, which is why there is a tight network of medical staff and support groups available for help.

It’s also important to remember that children will more than likely live with cerebral palsy for a lifetime, and will continue to need several medical services and care even throughout adulthood. However, the extent of care they will need will depend upon the severity of the disorder. Children with mild forms of cerebral palsy may go on to obtain successful careers and maintain their own homes while others with severe cases of cerebral may need a permanent, full-time caregiver.

Is There a Cure for Cerebral Palsy? What Treatments Are Available?

Currently there is no cure for cerebral palsy, but extensive research and studies are ongoing. In the meantime, there are a few procedures and treatments that can make your child more comfortable. Orthopaedic surgery can help diminish spastic movements, and physical therapy can help children attempt to control motor skills. Occupational therapy can help with daily living skills such as eating, tying shoes, social interaction, and learning to be more independent as time goes on.

In many instances, medication may be prescribed to help control the disabilities. There are a wide variety of medicines that help people with cerebral palsy. The most common types include:

  • Antispastic medication, such as baclofen and valium
  • Antidepressant medication, such as Lexapro and Paxil
  • Anti-inflammatory medication, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids
  • Stool softeners
  • Anticonvulsant medication, such as gabapentin and topiramate

Can Cerebral Palsy Be Prevented?

Since the cause of cerebral palsy is not always known, be sure to follow all of your doctor’s instructions during pregnancy, such as taking regular walks (if applicable), eating nutritious food, keeping your vaccinations up to date, and abstaining from drugs or alcohol use while pregnant. While cerebral palsy may be caused in other forms, such as birth injuries due to negligent medical care, the best thing you can to take preventative measures is to take care of yourself while pregnant.