Cerebral Palsy

What is Cerebral Palsy?

Cerebral palsy refers to several disorders that restrict the ability of an individual to move and maintain posture or balance. It is among the most common motor disorders to affect children. It occurs due to abnormal brain development or damage that limits the ability to control muscles.

People with Cerebral Palsy may have trouble swallowing food or have imbalanced eye muscles. Therefore, the eyes fail to focus on the same object. The condition also restricts the motion range at various joints due to the stiffness of muscles. So, some people with this condition may walk while others may require assistance. Intellectual disabilities may also manifest in people with this condition.

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Cerebral palsy refers to several disorders that restrict the ability of an individual to move and maintain posture or balance. It is among the most common motor disorders to affect children.

Cerebral Palsy Symptoms:

The severity and specific symptoms of Cerebral Palsy can vary widely from person to person. Here's a brief overview of common symptoms associated with the condition:

Muscles and Limbs:

• Stiff Muscles (Spasticity): Muscles can be tight and resistant to movement, making it difficult to bend or stretch limbs.
• Involuntary Muscle Contractions: Uncontrolled muscle contractions, known as muscle spasms, can cause jerky movements.
• Muscle Weakness: Weak muscles may lead to difficulty sitting up, walking, or lifting objects.
• Joint Contractures: Prolonged muscle stiffness can result in joints becoming permanently bent or fixed in an abnormal position.

Balance and Coordination:

• Lack of Balance: Individuals with cerebral palsy may struggle with maintaining balance, leading to frequent falls.
• Poor Coordination: Performing synchronized actions, such as reaching for objects or coordinating hand-eye movements, can pose difficulties.
• Gait Abnormalities: Abnormal walking patterns like toe-walking, crouched gait, scissoring legs, or asymmetrical gait are common.

Fine Motor Skills:

• Difficulty with Fine Motor Skills: Tasks requiring precision, like buttoning clothes or using utensils, may require substantial effort.
• Impaired Hand Control: Limited control of hand and finger movements can affect activities like writing or grasping objects.
• Swallowing Problems: Challenges with sucking, chewing, swallowing, and handling food may affect eating and nutrition.

Development and Growth:

• Developmental Delays: Milestones like sitting up, crawling, or walking may be reached later.
• Intellectual Disabilities: Some individuals with cerebral palsy may have intellectual or cognitive impairments.
• Delayed Growth: Slower growth can result in smaller stature than typical for their age.

Other Symptoms:

• Seizures (Epilepsy): Cerebral palsy can be associated with epilepsy, leading to recurrent seizures.
• Sensory Issues: Abnormal touch or pain sensations may be experienced.
• Hearing and Vision Problems: Difficulty hearing, vision abnormalities, and abnormal eye movements may occur.

Causes of Cerebral Palsy:

Cerebral palsy occurs due to brain damage of the fetus or an infant. Although the exact cerebral palsy cause is difficult to point out, various factors can lead to this condition.

• Hemorrhage: Bleeding in the brain
• Deficiency of oxygen: Lack of oxygen supply to the brain before, during, or post-birth.
• Pre and postnatal Factors: Exposure to alcohol and drugs at the prenatal stage
• Failure to detect the fetus's heart rate, treat infections, detect prolapsed umbilical cord, and an inappropriate C-section may also lead to the condition. 
• Damage to the parts of the brain responsible for motor functions frequently results in children grappling with improper posture, muscular disparities, and impaired movement.
•  Birth injury: Some children may develop cerebral palsy resulting from medical negligence during childbirth.
• Sustaining head injuries during birth or the first years of infancy.
• Mercury poisoning from fish
• Viral or bacterial infections like meningitis
• Toxoplasmosis due to eating raw or uncooked meat

When to see a Physiotherapist for Cerebral Palsy

Physiotherapy for the condition differs from children to adults. Those with incorrect posture and retarded physical activities need therapy. The therapy plan includes muscle relaxation techniques and exercises to improve movement and balance, and it also improves motor skills and prevents them from worsening. Activities, pressure and equipment, massages, and heat treatment allow people with cerebral palsy to stay independent. The therapy improves

Strength: Therapies focus on building muscle strength to improve motor skills and functional independence in daily activities for individuals with cerebral palsy.

Stamina: These therapies enhance endurance and stamina, allowing individuals to engage in physical activities for longer durations and promoting a more active lifestyle.

General Health: Comprehensive care includes therapies that address overall health, emphasizing nutrition, proper medical management, and overall well-being to optimize the quality of life.

Posture: Targeted interventions work on posture control and alignment to reduce muscle imbalances and prevent skeletal deformities that can be common in cerebral palsy.

Flexibility: Therapies for flexibility involve stretching exercises to improve range of motion and reduce muscle tightness, helping individuals achieve greater mobility.

Gait: Gait training therapies focus on improving walking patterns and mobility, thereby improving balance and coordination while walking.

Coordination: Specialized exercises and therapies aim to improve fine and gross motor coordination, helping individuals with cerebral palsy perform everyday tasks with greater ease and precision.

Risks of Cerebral Palsy:

The risks or complications of Cerebral Palsy are:

Contractures: Prolonged muscle tightness and spasticity can lead to joint contractures, where the joints become permanently fixed in a flexed or extended position, limiting mobility.

Spasticity: Increased muscle tone and stiffness can cause difficulties in movement and coordination, impacting an individual's functional abilities.

Difficulty in Feeding: Children with cerebral palsy may experience challenges in feeding due to muscle control issues, which can lead to malnutrition or aspiration.

Communication Issues: Many individuals with cerebral palsy may have difficulty with speech and communication, requiring alternative communication methods or assistive devices.

Fractures: Reduced bone density and increased risk of falls can make individuals with cerebral palsy more susceptible to bone fractures.

Pain: Chronic pain can result from muscle spasms, joint deformities, or other related issues, affecting the overall quality of life.

Osteoporosis: Reduced weight-bearing activities and muscle function can lead to decreased bone density, potentially resulting in osteoporosis.

Bowel Obstruction: Gastrointestinal issues like bowel obstruction can occur due to altered muscle function and mobility challenges.

Vomiting and Constipation: Gastrointestinal motility problems can lead to vomiting and chronic constipation.

Osteopenia: Similar to osteoporosis, osteopenia refers to decreased bone density, which can increase the risk of fractures.

Drooling: Impaired control of facial and oral muscles can lead to excessive drooling in some individuals with cerebral palsy.

These complications underscore the multifaceted nature of cerebral palsy and the importance of a comprehensive care approach that includes physical therapy, medical management, and support services to address and mitigate these risks.

How to prevent cerebral palsy?

There is no definite method to prevent cerebral palsy from developing during the onset of pregnancy, delivery, or immediately after birth, but several things can reduce the chances of children developing this condition.

During pregnancy:

·   Treat medical conditions such as diabetes, hypertension, eating disorders, or STIs.

·   Avoid smoking, taking drugs, or drinking alcohol

·   Stay updated with the vaccines to get protection against diseases

·   Talk to a doctor for stress relief when living or working near toxic substances.

When expecting:

·   Get regular prenatal care to protect against premature birth or low birth weight.

·   Staying protected against infections and calling the doctor for fever or sickness.

·   Checking the blood group of both

After childbirth:

·   Checking the baby for jaundice

·   Getting the recommended vaccines for the bay to protect against meningitis

During growth period:

·   Preventing head injury or blows

·   Installing safety gates on the stairs

·   Putting window guards

·   Children must wear helmets when riding a bike

·   Fastening a baby or using safety seats in the car

Treatments for cerebral palsy:

Children or adults with the condition require medication and long-term care. The treatment options are:

Medications:

Medicines reduce muscle tightness, treat painful conditions, prevent complications due to spasticity, and improve functional abilities.

Physical therapy:

Physiotherapy includes exercises and muscle training to improve strength, balance, flexibility, mobility, and motor development.

Speech and language therapy:

Speech and language therapy improves the ability to communicate using sign language. Communication devices also ease the ability to convey the message.

Recreational therapy:

Children also benefit from competitive or recreational activities like therapeutic skiing or horseback riding.

Surgical procedures:

Surgery may be essential to reduce muscle tightness and correct bone abnormalities. Orthopedic surgery can cure joint deformities and position legs and arms in suitable positions. In severe cases, dorsal rhizotomy reduces pain and relaxes the muscles when other treatment options fail.

Educational and Behavioral Support:

Children with Cerebral Palsy often benefit from educational and behavioral interventions that address learning challenges, social skills, and cognitive development.

Psychological and Emotional Support:

Individuals with CP and their families may benefit from counseling or support groups to cope with the emotional and psychological aspects related to the condition.

Early Intervention:

Early intervention programs for infants and young children with CP can be critical in addressing developmental delays and providing therapies to improve outcomes.

Related conditions:

Cognitive and behavioral issues may be seen in some children with the condition. Besides, ADHD or Attention Deficit Hyperactivity Disorder, and behavioral or emotional challenges can be connected to the disorder. Respiratory difficulties, speech impairment, digestive issues, epilepsy, learning, and intellectual challenges are also common.