What is cerebral Palsy?

The word “cerebral” refers to the brain’s cerebrum, which is the part of the brain that regulates motor function. “Palsy” describes a paralysis of voluntary movement in certain body parts.

Cerebral Palsy is considered a neurological disorder caused by a non-progressive brain injury or malformation that occurs while a child’s brain is under development. Cerebral Palsy primarily affects body movement and muscle coordination.

Though Cerebral Palsy can be defined, having Cerebral Palsy does not define the person that has the condition.

Cerebral Palsy is loss or impairment of motor function which is actually caused by brain damage. The brain damage is caused by brain injury or abnormal development of the brain that occurs while a child’s brain is still developing — before birth, during birth, or immediately after birth.

Cerebral Palsy affects body movement, muscle control, muscle coordination, muscle tone, reflex, posture and balance. It can also impact fine motor skills, gross motor skills and oral motor functioning.

Individuals with Cerebral Palsy were most likely born with the condition, although some acquire it later. It was once thought that Cerebral Palsy was caused by complications during the birthing process. While this does happen, it is now widely agreed that birthing complications account for only a small percentage, an estimated 10 percent, of Cerebral Palsy cases. Current research suggests the majority of Cerebral Palsy cases result from abnormal brain development or brain injury prior to birth or during labor and delivery. Accidents, abuse, medical malpractice, negligence, infections, and injury are some known risk factors that may lead to Cerebral Palsy.

Cerebral palsy, when is it noticed?

The term cerebral palsy refers to a group of neurological disorders that appear in infancy or early childhood and permanently affect body movement, muscle coordination, and balance. CP affects the part of the brain that controls muscle movements.  The majority of children with cerebral palsy are born with it, although it may not be detected until months or years later. The early signs of cerebral palsy usually appear before a child reaches 3 years of age. The most common are a lack of muscle coordination when performing voluntary movements (ataxia); stiff or tight muscles and exaggerated reflexes (spasticity); walking with one foot or leg dragging; walking on the toes, a crouched gait, or a “scissored” gait; and muscle tone that is either too stiff or too floppy. Other neurological symptoms that commonly occur in individuals with CP include seizures, hearing loss and impaired vision, bladder and bowel control issues, and pain and abnormal sensations. A small number of children have CP as the result of brain damage in the first few months or years of life, brain infections such as bacterial meningitis or viral encephalitis, or head injury from a motor vehicle accident, a fall, or child abuse. The disorder isn’t progressive, meaning that the brain damage typically doesn’t get worse over time. Risk factors associated with CP do not cause the disorder but can increase a child’s chance of being born with the disorder. CP is not hereditary.

About Cerebral Palsy

Cerebral palsy is one of the most common congenital (existing at or before birth) disorders of childhood. About 700,000 children in Nigeria have the condition. For every child affected by the illness, there are about five other people around the child who are affected in one way or the other.

The three types of CP are:

spastic cerebral palsy — causes stiffness and movement difficulties

athetoid cerebral palsy — leads to involuntary and uncontrolled movements

ataxic cerebral palsy — causes a problem with balance and depth perception

Since cerebral palsy affects muscle control and coordination, even simple movements — like standing still — are difficult. Other functions that also involve motor skills and muscles — such as breathing, bladder and bowel control, eating, and talking — also may be affected when a child has CP. Cerebral palsy does not get worse over time.

Truths about cerebral palsy

  1. Every case of cerebral palsy is unique to the individual. One person may have total paralysis and require constant care, while another with partial paralysis might have slight movement tremors but require little assistance. This is due in part by the type of injury and the timing of the injury to the developing brain.
  2. Cerebral palsy is non-life threatening. With the exception of children born with a severe case, Cerebral Palsy is considered to be a non-life-threatening condition. Most children with Cerebral Palsy are expected to live well into adulthood.
  3. Cerebral palsy is incurable. Cerebral Palsy is damage to the brain that cannot currently be fixed. Treatment and therapy help manage effects on the body.
  4. Cerebral palsy is non –progressive. The brain lesion is the result of a one-time brain injury and will not produce further degeneration of the brain.
  5. Cerebral palsy is permanent. The injury and damage to the brain is permanent. The brain does not “heal” as other parts of the body might. Because of this, the Cerebral Palsy itself will not change for better or worse during a person’s lifetime. On the other hand, associative conditions may improve or worsen over time.
  6. It is not contagious or communicable. In the majority of cases, Cerebral Palsy is caused by damage to the developing brain. Brain damage is not spread through human contact. However, a person can intentionally or unintentionally increase the likelihood a child will develop Cerebral Palsy through abuse, accidents, medical malpractice, negligence, or the spread of a bacterial or viral infection.
  7. The impairment caused by Cerebral Palsy is manageable. In other words, treatment, therapy, surgery, medications and assistive technology can help maximize independence, reduce barriers, increase inclusion and thus lead to an enhanced quality of life.
  8. The effects of Cerebral Palsy are long-term, not temporary. An individual diagnosed with Cerebral Palsy will have the condition for their entire life.
  9. Cerebral palsy is manageable: The impairment caused by Cerebral Palsy is manageable. In other words, treatment, therapy, surgery, medications and assistive technology can help maximize independence, reduce barriers, increase inclusion and thus lead to an enhanced quality of life.
  10. Every case is unique. Every case of Cerebral Palsy is unique to the individual. One person may have total paralysis and require constant care, while another with partial paralysis might have slight movement tremors but require little assistance. This is due in part by the type of injury and the timing of the injury to the developing brain.

Causes of Cerebral Palsy

The exact causes of CP aren’t always known. But many cases are the result of problems during pregnancy when a fetus’ brain is either damaged or doesn’t develop normally. This can be due to infections (bacteria meningitis), maternal health problems, a genetic disorder, or something else that interferes with normal brain development. Rarely, problems during labor and delivery can cause CP.

Premature babies — particularly those who weigh less than 3.3 pounds (1,510 grams) — have a higher chance of having CP than babies that are carried to term. So do other low-birthweight babies and multiple births, such as twins and triplets.

Brain damage in infancy or early childhood also can lead to CP. For example, a baby or toddler might suffer damage because of lead poisoning, bacterial meningitis, poor blood flow to the brain, being shaken as an infant (shaken baby syndrome), or being in a car accident.

Diagnosing Cerebral Palsy

CP may be diagnosed very early in an infant known to be at risk for developing the condition because of premature birth or other health problems. Health care professionals, usually watch kids closely after birth so that they can identify and address any developmental delays or problems with muscle function that might suggest CP.

In a baby carried to term with no other obvious risk factors for CP, it may be difficult to diagnose the disorder in the first year of life. Often doctors aren’t able to diagnose CP until they see a delay in normal developmental milestones (such as not reaching for toys by 4 months or not sitting up by 7 months), which can be a sign of CP.

Muscle tone that is too tight or too loose, poorly coordinated movements, and the presence of infant reflexes beyond the age at which they are expected to disappear also can be signs.

Children with CP have varying degrees of physical disability. Some have only mild impairment, while others are severely affected. This depends on the extent of the damage to the brain. For example, brain damage can be very limited, affecting only the part of the brain that controls walking, or it can be much more extensive, affecting muscle control of the entire body.

These include but not limited to sleep disorders, osteoporosis (weak, brittle bones), behavior problems, Seizures, speech and communication problems, and intellectual disabilities are more common among children with CP. Many have problems that can require ongoing therapy and devices such as braces or wheelchairs.

Can cerebral palsy be prevented?

There are some things people can do to minimize the risk. However, in many cases cerebral palsy cannot be prevented. The pregnant mother should:

Make sure all her vaccinations are up-to-date

Go to all her antenatal appointments

Abstain from drinking alcohol throughout the whole pregnancy

Abstain from smoking throughout the whole pregnancy

Take regular exercise throughout the whole pregnancy (check with the doctor what you can do)

Eat a healthy diet throughout the whole pregnancy

Identify potential Rh incompatibility (usually for second and subsequent pregnancies)

What is the treatment for cerebral palsy?

In much of Western Countries, when a child is diagnosed with cerebral palsy the family will be introduced to a team of health professionals and services who will be involved with looking after the child’s needs. They will include the GP, a paediatrician, a health visitor, a social worker, a physical therapist (physiotherapist), a speech and language therapist, an occupational therapist, and a clinical psychologist. The clinical psychologists’ work actually focuses on the areas of assessing ability and behaviour. To plan rehabilitation plans and treatment gains for rehabilitation specialists.

Finally, cerebral palsy treatment depends entirely on the needs of the person. The aim is to help the child achieve as much independence as possible throughout his/her life. Furthermore, clinical psychologists guide the patient and his/her family through the stresses and demands presented by cerebral palsy.

The need for and types of therapy change over time. Adolescents with CP may need counselling to cope with emotional and psychological challenges. Types and acceptable education (special or conventional), vocational training, recreation, and leisure programs.

Adults may benefit from attendant care, special living accommodations, and transportation and employment assistance services, depending upon individual intellectual and physical capabilities.