Cerebral Palsy
Overview
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Cerebral palsy is a group of motor conditions that cause physical disability in human development, chiefly in the various areas of body movement. Cerebral palsy is caused by damage to the motor control centers of the developing brain and can occur during pregnancy, during childbirth or after birth up to about age three. Cerebral palsy is divided into four major classifications to describe different movement impairments. These classifications also reflect the areas of the brain that are damaged. The four major classifications are: spastic, ataxic, athetoid/dyskinetic and mixed. Spastic cerebral palsy is the most common type of overall cerebral palsy, occurring in 80% of all cases. People with this type of CP are hypertonic and have what is, essentially, a neuromuscular mobility stemming from an upper motor neuron lesion in the brain as well as the corticospinal tract or the motor cortex. This damage impairs the ability of some nerve receptors in the spine to properly receive gamma amino butyric acid, leading to hypertonia in the muscles signaled by those damaged nerves. Ataxia-type symptoms can be caused by damage to the cerebellum. The forms of ataxia are less common types of cerebral palsy, occurring in less than 10% of all cases. Athetoid cerebral palsy or dyskinetic cerebral palsy is mixed muscle tone – both hypertonia and hypotonia mixed with involuntary motions. People with dyskinetic cerebral palsy have trouble holding themselves in an upright, steady position for sitting or walking, and often show involuntary motions. For some people with dyskinetic CP, it takes a lot of work and concentration to get their hand to a certain spot. Because of their mixed tone and trouble keeping a position, they may not be able to hold onto objects, especially small ones requiring fine motor control. About 10% of individuals with CP are classified as dyskinetic CP but some have mixed forms with spasticity and dyskinesia. The damage occurs to the extrapyramidal motor system and/or pyramidal tract and to the basal ganglia.
Causes and Symptoms
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Causes:
While in certain cases there is no identifiable cause, typical causes include problems in intrauterine development such as exposure to radiation and infection, asphyxia before birth, hypoxia of the brain, and birth trauma during labor and delivery, and complications in the perinatal period or during childhood. Cerebral palsy is also more common in multiple births. After birth, other causes include toxins, severe jaundice, lead poisoning, physical brain injury, shaken baby syndrome, incidents involving hypoxia to the brain, and encephalitis or meningitis. The three most common causes of asphyxia in the young child are choking on foreign objects such as toys and pieces of food, poisoning, and near drowning.
Symptoms:
There are many symptoms related to cerebral palsy. Variations in muscle tone — either too stiff or too floppy, stiff muscles and exaggerated reflexes (spasticity), and stiff muscles with normal reflexes (rigidity) are some. Others are lack of muscle coordination (ataxia), tremors or involuntary movements, slow, writhing movements (athetosis), delays in reaching motor skills milestones, such as pushing up on arms, sitting up alone or crawling, favoring one side of the body, such as reaching with only one hand or dragging a leg while crawling, difficulty walking, such as walking on toes, a crouched gait, a scissors-like gait with knees crossing or a wide gait, excessive drooling or difficulty with swallowing, difficulty with sucking or eating, delays in speech development or difficulty speaking, and difficulty with precise motions, such as picking up a crayon or spoon.
While in certain cases there is no identifiable cause, typical causes include problems in intrauterine development such as exposure to radiation and infection, asphyxia before birth, hypoxia of the brain, and birth trauma during labor and delivery, and complications in the perinatal period or during childhood. Cerebral palsy is also more common in multiple births. After birth, other causes include toxins, severe jaundice, lead poisoning, physical brain injury, shaken baby syndrome, incidents involving hypoxia to the brain, and encephalitis or meningitis. The three most common causes of asphyxia in the young child are choking on foreign objects such as toys and pieces of food, poisoning, and near drowning.
Symptoms:
There are many symptoms related to cerebral palsy. Variations in muscle tone — either too stiff or too floppy, stiff muscles and exaggerated reflexes (spasticity), and stiff muscles with normal reflexes (rigidity) are some. Others are lack of muscle coordination (ataxia), tremors or involuntary movements, slow, writhing movements (athetosis), delays in reaching motor skills milestones, such as pushing up on arms, sitting up alone or crawling, favoring one side of the body, such as reaching with only one hand or dragging a leg while crawling, difficulty walking, such as walking on toes, a crouched gait, a scissors-like gait with knees crossing or a wide gait, excessive drooling or difficulty with swallowing, difficulty with sucking or eating, delays in speech development or difficulty speaking, and difficulty with precise motions, such as picking up a crayon or spoon.
Diagnosis and Cures
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Diagnosis:
Physiotherapy programs are designed to encourage the patient to build a strength base for improved gait and volitional movement, together with stretching programs to limit contractures. Occupational therapy helps adults and children maximize their function, adapt to their limitations and live as independently as possible. Speech therapy helps control the muscles of the mouth and jaw, and helps improve communication. Conductive education is a unified system of rehabilitation for people with neurological disorders including cerebral palsy, Parkinson's disease and multiple sclerosis, amongst other conditions. Biofeedback is a therapy in which people learn how to control their affected muscles. Massage therapy is designed to help relax tense muscles, strengthen muscles, and keep joints flexible. Other forms of therapy are surgery, orthotics, and several types of medication.
Cures:
Cerebral palsy cannot be cured. But a variety of treatments can help people with CP to maximize their abilities and physical strength, prevent complications, and improve their quality of life. New symptoms can appear or become worse over time because of how a child grows and develops.
Physiotherapy programs are designed to encourage the patient to build a strength base for improved gait and volitional movement, together with stretching programs to limit contractures. Occupational therapy helps adults and children maximize their function, adapt to their limitations and live as independently as possible. Speech therapy helps control the muscles of the mouth and jaw, and helps improve communication. Conductive education is a unified system of rehabilitation for people with neurological disorders including cerebral palsy, Parkinson's disease and multiple sclerosis, amongst other conditions. Biofeedback is a therapy in which people learn how to control their affected muscles. Massage therapy is designed to help relax tense muscles, strengthen muscles, and keep joints flexible. Other forms of therapy are surgery, orthotics, and several types of medication.
Cures:
Cerebral palsy cannot be cured. But a variety of treatments can help people with CP to maximize their abilities and physical strength, prevent complications, and improve their quality of life. New symptoms can appear or become worse over time because of how a child grows and develops.