Cerebral Palsy

Cerebral Palsy is a term for a neurological or brain disorder that affects posture and movement. It is causes a loss of muscle control and coordination. People suffering from Cerebral Palsy have damage to the part of the brain that controls muscle tone. Muscle tone is the amount of resistance to movement in a muscle. During fetal life, birth and infancy damage is done to the motor areas of the brain. This can come in the form of radiation or lack of oxygen. Diagnosis of cerebral palsy does not occur until the age of about two or three in children. One out of 500 children is affected with the disorder. In the United States there are approximately 500,000 people that suffer from Cerebral Palsy.

There are four classifications of Cerebral Palsy which are; Spastic Cerebral Palsy which effects 70-80 percent of cases, Ataxic Cerebral Palsy 5 - 10 percent, Athetoid/ Dyskinetic 10 - 20 percent and Mixed Form Cerebral Palsy, which is a combination of one or more of the other types.

Spastic Cerebral Palsy is the most common form of Cerebral Palsy. In many individuals, limbs are in a weakened state or even paralyzed, which leads to under development of muscles in those limbs. Spasticity is the term that refers to increased tone or tension in a muscle. Spacticity negatively affects muscles and joints of the extremities, causing irregular movements that are particularly harmful in growing children. The known adverse effects of spasticity include inhibition of movement, inhibition of longitudinal muscle growth, inhibition of protein synthesis in muscle cells, limited stretching of muscles in daily activities, development of muscle and joint deformities.

Ataxic Cerebral Palsy is not an extremely common form of Cerebral Palsy. Symptoms of this type may be; impaired coordination and depth perception, shaky and unsteady movements, and a weak sense of balance. Writing and motions that require precise coordination are difficult in this type of CP.

Athetoid/Dyskinetic Cerebral Palsy is often portrayed by slow uncontrollable movements. These movements usually affect the muscles in hands, legs, feet, and with some people the throat or face. Uncontrollable movements of the throat or face may often result in grimacing or drooling. Speech disorders are also common with this type of Cerebral Palsy. This type of Cerebral Palsy is commonly characterized by either too loose or too tight of muscle variation. In many cases children have trouble learning how to control their body and have difficulty sitting, walking, swallowing in addition to affecting their speech.

Muscles throughout the body of an individual with Cerebral Palsy, may be weak and unable to make voluntary movements, and may have trouble controlling involuntary movements. A person with Cerebral Palsy may also have speech, sight, or hearing impairment, seizures, mental retardation, difficulties with perception and sensation, lack of bowel or bladder control, and difficulty feeding. According to Freeman Miller M.D. et al, "for some children, one of these other kinds of problems may dominate, and the Cerebral Palsy will be a relatively minor issue. For example, a child with CP who is able to walk and who has few physical limitations but is severely retarded mentally, the focus of care will be on the mental disability rather than on the Cerebral Palsy." (43)

The area of the body affected by Cerebral Palsy may classify the type. Diplegia is the classification when both legs and arms are affected. Monoplegia is the classification when only one leg or one arm is affected. Quadriplegia is the classification when the whole body is affected. In this case mental retardation as well as other medical issues may be presenting. Hemiplegia is the classification of one side of the body and not the other. The last classification is Triplegia which is when three limbs are affected. (Gilman, 10)

It is important to mention that patients with CP do not have deformities of the extremities at birth but develop them over time. Spasticity of muscles, along with the limitations on stretching and use of muscles in daily activities, is a major cause of deformities.

There is no one specific cause of Cerebral Palsy. It can be caused by an injury in early childhood, during birth or during incubation in the mothers' womb. No matter what form of Cerebral Palsy an individual has or how it was caused, it is not contagious. According to the National Institute of Neurological and Communicative Disorders and Stroke, "numerous conditions are risk factors for Cerebral Palsy, not necessarily leading to it, but increasing the risk that a child will have it." Some of the main risk factors are those which would be inflicted by the mother while pregnant such as smoking, the use of drugs and medications, drinking, sexually transmitted diseases and other infections. Researches have also suggested that cerebral palsy can result from incorrect cell development early in pregnancy. Prematurity and low birth weight have also been linked to Cerebral Palsy

Diagnosing a child with Cerebral Palsy can be very difficult. This is primarily due to the fact that there is almost no way of knowing during pregnancy whether or not a child will suffer from Cerebral Palsy. When it does come time to diagnose it is usually based on their movements and development. For example muscle tone is an indicator, if the muscles appear to be too floppy off too stiff as well as prematurely developed it can be a sign of Cerebral Palsy. Another tool for doctors in diagnosing Cerebral Palsy is a child's reflexes and to see if they have developed a right or left hand preference. This tool is commonly used for infants under 12 months because it is common for them not to develop a hand preference until that time. Because it can be difficult to find the cause of Cerebral Palsy, doctor's often have to rule out other medical conditions before considering Cerebral Palsy.

Another way for doctors to tell if an infant might have Cerebral Palsy is by doing a test that displays the babie's Moro Reflex. This is where an infant under 6 months is place on its back with its leg tilted above its head. The natural reaction is for the baby to reach for its leg but after 6 months this reflex should be