Cerebral Palsy

By Dr Ananya Mandal, MD

Cerebral palsy is a term that encompasses several neurological conditions that affect a child's movement and coordination. It mainly occurs due to damage to the brain that may occur before, during or soon after birth.

Causes of cerebral palsy

Known possible causes of cerebral palsy include infection in early pregnancy, difficult or premature birth, bleeding within the baby’s brain or abnormal brain development of the baby.

Complications during labour are an important factor in only a minority of cases, around one in 10. The major cause remains oxygen starvation to the baby’s brain during pregnancy or delivery. There might be genetic problems too that may contribute to cerebral palsy.

The most common cause of cerebral palsy is something that damages the brain while the baby is developing within the uterus. This can be found in 80 per cent of those affected and include genetic problems, malformations of the brain and maternal infection such as rubella or toxoplasmosis.

Infections when a baby is young (especially encephalitis or meningitis) can also lead to cerebral palsy. In many cases, no single cause can be pinpointed and cerebral palsy is caused due to complex interaction of factors.

Symptoms of cerebral palsy

There are varying degrees of impairment in cerebral palsy. Symptoms vary according to the severity of brain damage. While some children may have difficulty in walking and performing daily tasks, others may be profoundly disabled and require lifelong care. 

The children may have other associated neurological and brain problems such as:

  • epilepsy
  • learning difficulties
  • mental retardation
  • blindness
  • deafness
  • impaired speech
  • delayed growth
  • deformed spine
  • urinary incontinence
  • dribbling and drooling or slackness of the mouth

Types of cerebral palsy

Based on type of movement disorder, cerebral palsy can be classified as spastic type with intermittent increased tone and pathological reflexes, athetoid type with increased activity (hyperkinesias), ataxic type with loss of orderly muscular co-ordination and mixed type.

On the basis of paralysis and loss of function of limbs, cerebral palsy can be classified as monoplegic (one limb), diplegic (two limbs), hemiplegic (one arm and a leg of the same side), triplegic (three limbs), quadriplegic (four limbs) and double hemiplegia.

Classification can also be according the timing of the brain injury as before birth or prenatal (the most common), natal (during birth), or postnatal (after birth).

Risk factors and prevalence

It is estimated that 1 in every 400 children in the UK is affected by cerebral palsy. At least 1,800 babies from all social backgrounds and ethnic groups are diagnosed with the condition each year.

Prognosis of cerebral palsy and treatment

Cerebral palsy has no cure but is usually not a progressively worsening condition. There is severe impairment in daily living activities of the child as he or she grows up.

There are a range of treatments that can help relieve symptoms and increase a child's sense of independence and self-esteem. These include physiotherapy, occupational therapy and medication to relieve muscle stiffness and spasms.

Reviewed by April Cashin-Garbutt, BA Hons (Cantab)

Sources

  1. http://www.nhs.uk/conditions/Cerebral-palsy/Pages/Introduction.aspx
  2. http://www.bbc.co.uk/health/physical_health/conditions/cerebralpalsy1.shtml
  3. http://www.patient.co.uk/doctor/cerebral-palsy.htm
  4. http://pediatrics.uchicago.edu/chiefs/ClinicCurriculum/documents/RomantsevaCP.pdf
  5. http://www.cdc.gov/ncbddd/cp/facts.html

Further Reading

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