CEREBRAL PALSY

Cerebral palsy is a term used to define a combination of neurological conditions that affect movement. It is the most common type of childhood disability. The condition makes it tough to move some parts of the body.

Due of destruction to certain parts of the brain, intentional or unintentional actions or both can be affected.

Cerebral palsy is not transmittable, it does not essentially affect intelligence or mental ability, and it is not progressive, so it does not get poorer with age. Some people discover that symptoms improve over time.

Folks with cerebral palsy tend to have a normal lifespan, and in many cases, a good quality of life can be expected.

CAUSES

The movement of muscle takes place in a part of the brain called the cerebrum. The cerebrum is the superior part of the brain. Injury to the cerebrum earlier, throughout, or in 5 years of birth may cause it.

The cerebrum is responsible for memory, ability to learn, and communication skills. Due to this some people with cerebral palsy have issues with communication and learning. The Cerebrum damage can sometimes affect vision and hearing.

Previously, it was supposed that the lack of oxygen during birth is the reason for brain damage.

However, during the 1980s, research showed that fewer than 1 in 10 cases of cerebral palsy stem from oxygen deprivation during birth.

Mostly, the damage happens before birth, possibly in first 6 months of pregnancy.

There are three possible causes for this:

Abnormal development of the brain

Trouble in brain development can affect the way the brain communicates with the body’s movement and other functions.

During the first 6 months of pregnancy, the brain of the embryo or fetus is mainly weak.

Destruction can stem from changes in the genes primarily for brain development, some infections such as toxoplasmosis, a parasite infection, herpes and herpes-like viruses, and head distress.

Periventricular leukomalacia (PVL)

PVL is a type of destruction that affects the brain’s white matter due to lack of oxygen in the womb.

It may happen if the mother has an infection during pregnancy, such as rubella or German measles, low blood pressure, premature delivery.

Intracranial hemorrhage

Sometimes, bleeding inside brain occurs when a fetus faces a stroke.

Bleeding in brain will stop the supply of blood to vital brain tissue, and this tissue can become damaged or die. The runaway blood may clot and harm surrounding tissue.

Various factors may cause a stroke in fetus during pregnancy:

• Disruptions in arterial blood flow to the fetal brain.
• A blood clot in the reproductive structure which blocks the flow of blood.
• Inflammation of the reproductive structure.
• Clotting disorder in the fetus.
• Untreated pregnancy-induced hypertension in the mother.
• Pelvic inflammatory infection in the mother.

During delivery, the risk is increased by the following factors:

• Emergency cesarean.
• The second stage of labor is prolonged.
• Vacuum extraction is used during delivery.
• Fetal or neonatal heart anomalies.
• Umbilical cord abnormalities.

Anything that increases the risk of preterm birth or low birth weight also raises the risk of cerebral palsy.

Factors that influence to a higher risk of cerebral palsy include:

• Multiple births, for example, twins.
• Damaged placenta.
• Sexually transmitted infections (STIs).
• Intake of alcohol, illegal drugs, or toxic substances during pregnancy.
• Malnourishment during pregnancy.
• Random malformation of the fetal brain.
• Small pelvis in the mother.
• Breech delivery.

BRAIN DAMAGE AFTER BIRTH

A small amount of cases occur due to damage after birth. This may occur because of an infection such as meningitis, a head injury.

When damage happen, it will be soon after the birth. With time, the human brain develops more strong and able survive more damage.

SYMPTOMS

A new born with cerebral palsy might have movement problems, which includes poor muscle tone.

Features can include:

• Overdeveloped or underdeveloped physiques, prominent to stiff or floppy actions.
• Poor organization and balance, known as ataxia.
• Involuntary, slow writing movements.
• Firm physiques that contract strangely, known as spastic paralysis.
• Crawling in an unusual way.
• Lying down in uncomfortable positions.
• Preferring one side of the body over other.
• Limited range of movement.

Other signs and symptoms include:

• Hearing and eyesight problems.
• Problems controlling bladder and bowel movements.
• Slobbering, and problems with feeding, sucking, and swallowing.
• Being easily startled.

Symptoms generally start to show during the first 3 years of life.

TYPES OF CEREBRAL PALSY

Four kinds of cerebral palsy: Spastic, Athetoid-dyskinetic, ataxic, and hypotonic.

Spastic cerebral palsy

There are three types of spastic cerebral palsy.

Spastic hemiplegia: An adolescent with spastic hemiplegia will naturally have spasticity, or physique rigidity, on one side of body. It is generally hand and an arm, but it might include a leg. The side which is affected may not develop properly. There might be speech problems. Intelligence is not unaffected.

Spastic diplegia: The lower limbs are influenced, and the upper body has no spasticity or only a little. The leg and hip muscles are rigid. Legs overlap at the knees, making walking more difficult. The overpass of the legs when upright is often referred as scissoring.

Spastic quadriplegia: The legs, arms, and body are influenced. This is the most serious form of spastic cerebral palsy. It may involve cognitive deficits. Walking and talking will be difficult. Seizures may occur.

Athetoid or dyskinetic cerebral palsy

Also known as athetoid dyskinetic cerebral palsy, it is the second most common type. Brainpower is usually normal, but physique problems affects the whole body. Weak or tight physique causes random and uncontrolled body movements.

The kid will have issues in walking, sitting, maintaining posture, and speaking clearly since the tongue and vocal cords are hard to control. Some children slobber if they have difficulties controlling facial muscles.

Ataxic cerebral palsy

Stability and synchronization are most influenced. Activities which need fine skills will be hard, such as tying shoelaces, buttoning up shirts, and cutting with scissors. Balance difficulties may the issue for child to walk with their feet far apart.

Hypotonic cerebral palsy

It results from a damage to the cerebellum. Strength problems appear earlier. The infant’s head and body will be loose. The infant will rest with their elbows and knees loosely extended, instead of flexed. There may be breathing difficulties.

DIAGNOSIS

Every parent who is worried about their child’s growth should see their doctor.

The doctor will ask the parents about the baby’s past and growth and the mother’s medical history during her pregnancy.

The doctor will examine the child and observe their position, movements, physique, and they will check the child’s impulses.

Ruling out other conditions

Other situations with similar signs may need to be checked, like a tumor.

Medical tests that may help with diagnosis include:

• Blood tests
• Head ultrasound
• MRI or CT scan

At the age of 2 to 3 years, a more broad diagnosis of cerebral palsy is usually possible, but the brutality is not generally fully evaluated until the age of 4 to 5 years.

An analysis of cerebral palsy requires regular valuations, to make judgements and determine what the growing needs and issues are.

It takes time to make a complete and confident diagnosis, as a careful assessment must be carried out several times.

TREATMENT

There is no medication for cerebral palsy, but treatment might help to manage symptoms and increase independence.

When a child has a diagnosis of cerebral palsy, a group of health experts will help to look after their needs. The group will include a doctor, a pediatrician, a speech therapist, and an educational psychologist.

An individual attention plan will address the needs of the child and the family. It will be revised and reviewed, as the child gets older.

Treatment depends entirely on needs of individual. The goal is to help the child attain as much independence as probable.

PREVENTION

It is not possible to prevent cerebral palsy, but some activities can help to reduce the risk.

A woman who is thinking to get pregnant should guarantee that all her vaccinations are up-to-date.

During pregnancy, it is important to:

• Attend all antenatal appointments.
• Do no consume alcohol, tobacco, and illegal drugs.
• Do regular exercise, according to the physician’s advice.
• Eat healthy food.

–SurgeryXchange is an online platform for medical second opinions and advisory services for hospital admission.

 To know more click here.