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Cerebral Palsy

Cerebral Palsy

Cerebral palsy is a medical condition caused by a permanent brain injury that occurs before, during, or shortly after birth.

 

The primary characteristic of cerebral palsy is a lack of muscle control and movement. Cerebral palsy is not a progressive disease, however, the effects have been known to change over time.

 

Although the cause of cerebral palsy is not known for certain, there is evidence that links it to both the health history of the mother and child, and accidents causing brain damage. The diagnosis of cerebral palsy is often made immediately after birth, but it can also be made later in childhood.

 

Cerebral palsy may cause a number of symptoms, including seizures, spasms, visual and hearing problems, hyperactivity, and learning disorders.

 

There is not a cure, however several therapies are available for the treatment of cerebral palsy. Although living with cerebral palsy can be difficult, it is certainly possible to be successful while coping with the disorder.

 

Types of Cerebral Palsy

Spastic cerebral palsy is the most common form, affecting approximately 70 percent of cerebral palsy patients. This form is characterized by stiff and permanently contracted muscles. This has a jerky, unpredictable effect on movement, causing difficulty in moving from position to position. Spastic cerebral palsy consists of these subcategories: (the last two are rare)

  • Diplegia – Both arms or both legs are affected
  • Hemiplegia – Either the right arm and leg or left arm and leg are affected
  • Quadriplegia – All arms and legs are affected
  • Monoplegia – Only one arm or leg affected
  • Triplegia – Three arms or legs affected

 

Ataxic Cerebral Palsy

Ataxic cerebral palsy is much less common than spastic, affecting approximately 5 to 10 percent of cerebral palsy patients. The main effect of this type is on the child's sense of depth perception and balance. This is often accompanied by poor coordination, and children affected by ataxic cerebral palsy can display an abnormal gait when walking, as well as difficulty with precise movement. Another characteristic of ataxic cerebral palsy is the intention tremor. These tremors are initiated by a voluntary movement, such as reaching for a light switch, and become more severe as the individual gets closer to the objective.

 

Athetoid Cerebral Palsy

Athetoid cerebral palsy affects about 10 to 20 percent of patients. The primary characteristic is slow, uncontrolled movement. In most cases, this affects the arms, legs, hands and feet, and in rare cases, the musculature of the face and tongue, which can cause drooling and grimacing. These effects often become more severe in stressful and/or emotional times, and can also disappear entirely during sleep. Many children also have problems coordinating the muscles that are used in speech, resulting in a condition known as dysarthria.

 

Symptoms

Speech
Just as patients have problems with muscle control in their arms and legs, they also have difficulties controlling their tongue, mouth, lips, jaw, and breath flow. As a result, they might have problems with speech. The most common speech problem is called dysarthria. This condition causes speech to be slow and slurred and, in some cases, hypernasal (too much air flow through the nose) or hyponasal (not enough air flow through the nose).

 

Drooling
There are a number of treatments available to combat the problem of drooling:

  • Surgery
  • Anticholinergics, or drugs that reduce saliva flow
  • Biofeedback that allows patients to know when they are drooling

 

Eating
Cerebral palsy can effect the muscle groups involved in the face and jaw, which can lead to difficulty eating. In severe cases, this can result in malnutrition, and poor growth and development.

 

Incontinence
Incontinence is more commonly known as poor bladder control. This can take a number of forms, including Enuresis, or bed wetting, urination during physical activity, or a slow leak from the bladder.

 

Treatment options

Physical therapy

There are three goals to physical therapy. First, a therapist will attempt to prevent muscle atrophy, or the deterioration of muscle tissue from lack of use. The second goal is to avoid the contraction of muscles caused by the condition. Third, a skilled therapist can work with a patient to improve motor skills through a program of special exercises.

 

Behavioral therapy

A behavioral therapist will act as a coach to the patient to improve physical, mental and communicative skills. The therapy itself varies greatly depending on the individual's needs, age, and level of disability. Some of the techniques used will discourage negative or destructive behavior, while others emphasize self-sufficiency.

 

Drug therapy

Drugs are usually prescribed for cerebral palsy patients to control seizures caused by the condition. These drugs vary widely, as the source of the seizures can be attributed to a number of different causes. Different combinations of these drugs also may be required in each individual case. Another application of drug therapy is to control the spasticity caused by cerebral palsy, these drugs work by inhibiting chemical processes in the central nervous system.

 

Surgery

Surgery is recommended in patients suffering from extreme muscle contractions that do not respond well to other forms of treatment. These muscle contractions can be corrected by surgically lengthening the tendons and muscles involved.

 


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Brain and neurology guide: conditions and treatments