Cerebral palsy is a neurological disorder of movement, posture or muscle tone that is caused by a non-progressive malfunction or damage to the brain that occurs in the developing, immature brain, most often during pregnancy or soon after birth.
Signs and symptoms start to show up during infancy or pre-school years. In general, the disorder affects muscle coordination and causes impaired body movement related with rigidity or floppiness of the trunk and limbs, unsteady walking, abnormal reflexes, involuntary movements, abnormal posture, or a combination of these.
Individuals with cerebral palsy commonly have eye muscle imbalance, whereby the eyes cannot be able to focus on the same object and may also have problems swallowing. Cerebral palsy patients also may suffer a reduced range of motion at different joints of their bodies as a result of muscle stiffness.
The effects that this disorder can have on functional abilities vary greatly. Some affected individuals can’t walk while others can. Some individuals may show intellectual disabilities, while others show near-normal or normal intellectual capacity. Deafness, blindness or epilepsy also may be present.
As previously mentioned, the signs and symptoms of cerebral palsy can vary greatly. Coordination and movement problems associated with this disorder may include:
- Exaggerated reflexes and stiff muscles (spasticity)
- Involuntary movements or tremors
- Muscle tone variations, like being either too floppy or too stiff
- Incoordination of muscles (ataxia)
- Stiff muscles, but with normal reflexes
- Writhing, slow movements (athetosis)
- Walking difficulties, such as a crouched gait, walking on toes, an asymmetrical gait or a wide gait
- Delays in achieving motor skills milestones, like pushing up on arms, crawling or sitting up alone
- Favoring only one side of the body, like dragging a leg when crawling or reaching with only one hand
- Problems with swallowing or excessive drooling
- Difficulty speaking speech development delays
- Difficulty with eating or sucking
- Precise motions difficulties, such as picking up a spoon or crayon
Cerebral palsy-related disability may primarily be limited to one side of the body or limb, or it may affect the entire body. The disorder that causes cerebral palsy does not change with time. Therefore, the symptoms don’t usually worsen with age. Nonetheless, muscle rigidity and muscle shortening may worsen if not aggressively.
Brain abnormalities linked with cerebral palsy can also contribute to other neurological issues. Cerebral palsy patients may also have:
- Intellectual disabilities
- Difficulty with hearing and vision
- Abnormal pain perceptions
- Mental health conditions
- Urinary incontinence
- Oral diseases
Causes of Cerebral Palsy
Cerebral palsy is brought about by a combination of events either after, during, or before birth that can cause an injury in the developing brain of a child.
Cerebral palsy has no single cause. The cause remains unknown for a majority of babies born with the disorder. What medical researchers now know is that only a very insignificant percentage of cerebral palsy cases are as a result of birth complications (for example, lack of oxygen or asphyxia). Today, it is accepted that this disorder usually develops from a series of “causal pathways,” i.e. a combination of events, which when combined can accelerate or cause damage to the immature brain.
For example, even though prematurity is the most significant risk factor for the disorder, it is the casual pathways/combination of events that caused the premature birth, which may have led to cerebral palsy, and not the premature birth itself.
In 8 out of 10 cerebral palsy cases in the United States, the brain damage leading to the disorder occurs either before one month of age or in the uterus (when the mother is expectant).
The most common cause of cerebral palsy occurring after one month of age in babies is stroke. The stroke may arise from heart or surgical complications or occur spontaneously.
Risk factors don’t cause cerebral palsy. But, the presence of certain risk factors can lead to a greater chance of children being born with the disorder.
Some cerebral palsy risk factors have been identified. They include:
· blood clotting issues (thrombophilia)
· low birth weight (smaller for gestational age)
· premature birth of fewer than 36 weeks
· a placenta inability to provide the developing fetus with nutrients and oxygen
· A-B-O blood type or RH incompatibility between baby and mother
· infection of the mother with viral diseases, such as German measles in early pregnancy
· Prolonged oxygen loss during the birthing process or pregnancy, or severe jaundice soon after birth.
· bacterial infection of the baby or fetus, or mother that indirectly or directly attacks the central nervous system of the infant
Is cerebral palsy hereditary/genetic?
Familial cerebral palsy is not common, approximately 1 percent of individuals with this disorder will have a sibling who is also affected.
It is even not common in twins – 90% of co-twins won’t have cerebral palsy even when one has the condition.
However small these statistics are, they are significant enough to suggest that there could be some genetic/hereditary factors that play a part in cerebral palsy.
Researchers believe that hereditary disposition to certain characteristics, that is, heart problems or prematurity, may kick-start a chain of events or causal pathways that can result in cerebral palsy in a child.
When to see a doctor
It is important to get a speedy diagnosis for possible delays or any movement disorder in your child’s development. Take your child to a doctor if you have any concerns or questions about episodes of abnormal bodily movements or loss of awareness of surroundings, eye muscle imbalance, abnormal muscle tone, swallowing difficulties, impaired coordination, or other developmental issues.
Cerebral palsy has no cure. However, there is a range of treatments available to help treat most of the symptoms. Adults and children with the disorder require long-term help and care with a team of medical professionals that may include; pediatricians, pediatric neurologists, orthopedic surgeons, physical therapists, speech-language pathologists and special education teachers, among others.
Medications that can reduce muscles tightness may be used to treat pain, improve functional abilities and manage complications associated with spasticity, and a host of other cerebral palsy symptoms.
It is of great importance to talk about medication treatment risks with your medical care provider and discuss whether drug treatment is appropriate for the needs of your child. Medication selection usually depends on whether cerebral palsy affects the whole body (generalized) or only some muscles (isolated).
If it’s the entire body that is affected, oral drug treatments may include dantrolene (Dantrium), baclofen (Gablofen) and diazepam (Valium) to help relax stiff, contracted muscles. If it’s certain muscles that are affected by cerebral palsy, the doctor may recommend onabotulinutoxinA (Botox) injected directly into the nerve, muscle or both to improve drooling.