Cerebral palsy (CP) is a group of disorders that affect a person’s ability to move and maintain their balance and posture.
According to the Cerebral Palsy Alliance Research Foundation, approximately 17 million people around the world have cerebral palsy.
The disorder is typically diagnosed during the first or second year after birth. If a child’s symptoms are mild, it could be difficult to make a diagnosis until the child is a few years older. CP is no longer considered a disease but rather a chronic, non-progressive neurological disorder.
What causes cerebral palsy?
CP is associated with developmental brain injuries that happen during foetal development, birth, or within the first two to three years of life.
The disorder is characterised by a disruption of motor skills and includes symptoms like spasticity, paralysis, mental retardation, seizures, vision and/or hearing problems.
A small percentage of CP stems from brain damage that happens more than 28 days after birth, called acquired cerebral palsy. Factors like a brain infection, such as meningitis, or a serious head injury, increase the risk for acquired CP.
However, most CP cases are related to brain damage that happened before or during birth and are called congenital CP.
Signs and symptoms
- Birth defects like a small head, stiff jaw, irregular shaped spine, drooling, crying, poor sucking or swallowing reflexes etc.
- Delayed or abnormal movements of body parts or the whole body.
- Stiffness or floppiness.
- Uncoordinated movements or a slight limp.
Diagnosis
If your doctor suspects your child has cerebral palsy, your child will undergo a physical evaluation to check for symptoms. The doctor will also review your child’s medical history. You are likely to be referred to a specialist who treats children with brain and nervous system conditions (paediatric neurologist).
To help rule out other possible causes, the doctor may do a series of tests to confirm a diagnosis. This will be done along with the help of brain scans which reveal any damaged areas or abnormal development in the brain.
These tests may include:
Magnetic resonance imaging (MRI). An MRI is usually the preferred imaging test. It uses radio waves and a magnetic field to produce detailed 3D or cross-sectional images of your child’s brain. An MRI can often identify any cuts or abnormalities in your child’s brain.
Cranial ultrasound. This can be performed during infancy. A cranial ultrasound uses high-frequency sound waves to get images of the brain. An ultrasound doesn’t produce a detailed image, but it may be used a preliminary assessment of the brain.
CP management
Physical therapy and rehabilitation
Physical therapy is one of the most important parts of treatment. It involves exercises and activities that can maintain or improve muscle strength, balance, and flexibility. A physical therapist helps the child learn skills like sitting, walking, or using a wheelchair. Other types of therapy include occupational, recreational and speech and language therapy.
Treatment
Certain medications can help relax stiff or overactive muscles and reduce abnormal movement. They may be taken by mouth, injected into affected muscles, or infused into the fluid surrounding the spinal cord through a pump implanted near the spinal cord.
Orthotic devices
To improve movement and balance, braces, splints, and casts can be placed on affected limbs. Wheelchairs, rolling walkers, and powered scooters can also help with movement and posture.
Assistive devices and technologies
These include special computer-based communication machines, Velcro-fastened shoes, or crutches, which can all help to make daily life easier.
Surgery
Your child may need surgery if symptoms are severe. A surgeon can place arms or legs in better positions or correct or improve an abnormally curved spine. Sometimes, if other treatments have not worked, a surgeon can cut certain nerves to treat abnormal, spastic movements.
Not all therapies will be suitable for everyone with cerebral palsy. It’s important for parents, patients, and healthcare specialists to come up with the best treatment plan for the patient.
Good to know
In most cases, cerebral palsy can’t be prevented, but you can reduce the risks. If you’re pregnant or planning to become pregnant, follow these steps to keep healthy and minimise any complications.
- Get vaccinated against diseases like rubella to help prevent an infection that could cause foetal brain damage.
- Take prenatal vitamins, including folic acid and omega 3 fatty acids to aid in brain and spine development
- Take good care of yourself. The healthier you are going into your pregnancy, the less likely you are to develop an infection that may result in cerebral palsy.
- Go for regular doctor visits during your pregnancy. This is a good way to reduce health risks and will also help prevent premature birth, low birth weight and infections for you and your unborn baby.
- Ensure good child safety at all time. Prevent head injuries by providing your child with a car seat, bicycle helmet, safety rails on beds and appropriate supervision.