CEREBRAL PALSY

Definition

"Cerebral palsy" is a general term that describes a group of disorders that appear during the first few years of life and affect a child's ability to coordinate body movements. These disorders are caused by damage to a child's brain early in the course of development. The damage can occur during fetal development, during the birth process or during the first few months after birth.
Cerebral palsy ranges from mild to severe. Physical signs of cerebral palsy include weakness and floppiness of muscles or spasticity and rigidity. In some cases, neurological disorders — such as mental retardation or seizures — also occur in children with cerebral palsy.
Cerebral palsy isn't curable. However, getting the right therapy for your child can make a big difference. Today, children with cerebral palsy benefit from a wide range of treatment options and innovations.



There are three major types of cerebral palsy:

* Spastic cerebral palsy. Most children with cerebral palsy have spastic cerebral palsy. This form of the condition causes muscles to stiffen, which makes movement difficult. It can affect both legs (spastic diplegia), or it can affect one side of the body (spastic hemiplegia). In the most severe cases, all four limbs and the trunk are affected (spastic quadriplegia).



* Athetotic cerebral palsy. About one in five people with cerebral palsy have this form, which is also referred to as extrapyramidal cerebral palsy. It affects the entire body and often causes uncontrolled, slow movements.



* Ataxic cerebral palsy. This is the least common of the major types of cerebral palsy. It affects balance and coordination.

Some children have signs and symptoms of more than one type of cerebral palsy, which may be referred to as a mixed form of the condition.
In general, children with cerebral palsy exhibit a wide variety of signs and symptoms, ranging from mild to severe. Cerebral palsy symptoms don't worsen with age. They may include:

* Lack of muscle coordination when performing voluntary movements (ataxia)
* Stiff muscles and exaggerated reflexes (spasticity)
* Asymmetrical walking gait, with one foot or leg dragging
* Variations in muscle tone, from too stiff to too floppy
* Excessive drooling or difficulties swallowing, sucking or speaking
* Tremors
* Difficulty with precise motions, such as writing or buttoning a shirt

Some children with cerebral palsy have severe mental retardation, but others are extremely bright. Many need a wheelchair and extensive, lifelong care, but some require little or no special assistance.
Causes
Cerebral palsy results from an abnormality in or injury to the cerebrum — the largest area of the brain, which controls sensation and voluntary motor function. Although cerebral palsy affects movement, the underlying problem originates in the brain, not in the muscles themselves.
A small number of children with cerebral palsy acquire the disorder after birth. In these cases, doctors can sometimes pinpoint a specific reason for the neurological problem. For example, cerebral palsy can develop after an illness during early infancy, such as bacterial meningitis — an infection and inflammation of the membranes and fluid surrounding the brain and spinal cord. It can also be the result of a head injury.
However, doctors don't completely understand the cause of most cases of cerebral palsy, which are present at birth (congenital). For many years, doctors and researchers believed that cerebral palsy was caused by a lack of oxygen during birth. Now they believe that only a small number of cases are caused by problems during labor and delivery.
Some possible causes
Doctors and researchers have now identified many possible causes of congenital cerebral palsy, including:

* Maternal infection during pregnancy, such as rubella or other viral infections
* Severe jaundice in newborns, which may be caused by infection, severe bruising or problems with red blood cells due to ABO or Rh incompatibility — two incompatibilities between the blood of the mother and her fetus
* Abnormal brain development before birth, resulting from genetic causes or metabolic disorders
* Disturbance to brain circulation before birth, caused by an artery spasm or blood clot, similar to a stroke in adults