BRAIN AWARENESS WEEK: CEREBRAL PALSY
Most of us have heard of, or know someone with, cerebral palsy, but how much do you really know about the condition? We at London Doctors Clinic guide you through the basics of the condition, including what early signs to look out for in children, and how cerebral palsy can be avoided.
What Is Cerebral Palsy?
You might not realise, but cerebral palsy is not just one specific condition. Rather, the term refers to a group of complicated conditions which happen before or during the birth of the person affected. In rarer cases, the condition can occur in early childhood if the brain is damaged before it has reached a certain level of maturity.
The group of problems that make up cerebral palsy occur due to brain injury or malformation while the brain is still under development, classifying this condition as a neurological disorder.
Although cerebral palsy can be defined, having the condition does not define the person with cerebral palsy. It is important to appreciate that although the condition doesn’t change or improve throughout the lifespan of the person, many people who are affected have normal lifespans, and live happy and fulfilled lives, becoming more able to manage and overcome their difficulties as they get older.
What Causes Cerebral Palsy?
Many times, the exact cause is unknown. However, it is clear that anything that damages the brain while it is still forming can lead to cerebral palsy. Therefore, the risk of a child developing this condition increases if a pregnant woman smokes, drinks excess alcohol, has poorly controlled diabetes or contracts rubella (German measles).
Premature babies who experience complications are more likely to develop cerebral palsy than full-term babies.
Therefore, while the specific cause may be unknown, it is important that pregnant women take certain precautions during their pregnancy:
- Do not smoke
- Do not drink alcohol to excess
- Have regular check-ups
- If you have a condition such as diabetes, have frequent check-ups and adhere carefully to any treatment regime
- Ensure that you are up to date with your routine vaccinations
In some cases, cerebral palsy may be the result of a lack of oxygen to the brain during labour and delivery, and this can happen if the birth is especially difficult or unsupervised.
Children can also develop cerebral palsy in their first two years of life as the brain is still developing. They may suffer a head injury or contract a serious brain infection, such as meningitis, resulting in cerebral palsy.
As cerebral palsy refers to complicated conditions that occur before or during the birth of the affected person, it is important that pregnant women take certain precautions during their pregnancy
Cerebral Palsy Classification and Symptoms
Generally speaking cerebral palsy is characterised by involuntary jerking movements, a poor sense of balance, spastic muscles and speech impairment.
Many forms of cerebral palsy are now recognised and it is described either:
(a) in terms of the part of the body affected:
- Hemiplegia: affecting one side of the body.
- Diplegia: affecting the whole body.
- Quadriplegia: affecting both arms and legs.
(b) in terms of how the body is affected:
- Spasticity: difficulty moving limbs and problems with posture and general movements.
- Athetosis: involuntary movements such as twitches or spasms.
- Ataxia: difficultly coordinating muscle groups and problems with balance, walking, etc.
Many people have a mixture of the conditions above, as well as other associated difficulties. The associated difficulties include difficulties with:
- General/specific learning disabilities
- Speech & understanding the spoken word
- Visual perception
Does My Child Have Cerebral Palsy?
Symptoms can be confusing and there is some debate about the age of onset of symptoms. Some think the onset of symptoms must be before the age of two to be considered cerebral palsy, while others think age five is the cut-off point.
What should I look for if I am concerned?
There are a number of things you can look out for, that may be symptoms of cerebral palsy:
- A baby who is over two months old and feels stiff or floppy, arches their back or stretches out their neck when you pick them up
- A delay in the appearance of developmental milestones within the first two years, such as walking or talking at the appropriate times.
- Remember, different children develop at different stages, therefore the ages provided on developmental charts are estimates
- Overuse of one side of the body, possibly coupled with non-use of the other side
- e.g using one hand to reach for things
- Many infants with cerebral palsy have low muscle tone, and will be floppy.
- This is usually noticeable before other problems, such as movement, become evident.
There is no single test for cerebral palsy. A diagnosis is usually made only after the child has been carefully observed and certain tests have been carried out. Your child’s pre and post birth medical history will be combined with the risk factors for cerebral palsy that your child was exposed to. Your child will undergo extensive examination to rule out other causes of their problems. Tests may include a neurological exam in which things like posture and reflexes are examined.
If you are concerned about cerebral palsy, there are a number of things you can look out for
Cerebral Palsy Treatment
Cerebral palsy is not curable, but there are lots of supportive measures available that can immensely improve the quality of life of the person affected. Some of these measures include:
- Physical therapy: this can help to stretch and relax spastic muscles, and strengthen the body generally
- Occupational therapy: an occupational therapist can help your child to learn necessary skills for living, and provide adapted equipment and aids to make life easier to cope with
- Speech and language therapy: this type of therapy may be used if your child suffers from speech, language, or swallowing difficulties
- Medications: these can reduce the tightness of muscles and may be used to improve function, treat pain and manage complications related to spasticity or other cerebral palsy symptoms. The medication chosen will depend on whether one group of muscles or the whole body is affected
- Special education: this determines the educational needs of the person, and allows the person affected to learn in an environment that supports their difficulties
What Is The Prognosis For People With Cerebral Palsy?
This depends on the severity of the cerebral palsy. Some people may have a mild form which is hardly noticeable. For example, they may have minor problems with muscle tone or appear clumsy.
Others may have severe problems as a result of their cerebral palsy. They may be unable to control movement of any part of their body, which can result in major complications such as problems breathing. Where such complications exist, the person may have a shorter life expectancy.
While cerebral palsy may be accompanied with mental handicap this is not always the case. It is difficult to tell if children with this disorder are mentally disabled due to damage to the brain, or if the difficulties associated with the condition (e.g loss of muscle tone) are the cause of an inability to communicate normally.
Children with only moderate disability generally have a normal life expectancy and most can lead a relatively independent and normal life, given certain supports.
If you have any queries about today's topic and would like to discuss them with a medical professional, book an appointment with one of our private doctors at London Doctors Clinic. We have nine London clinics (with the opening of our Paddington clinic this week), so should never be too far away when you need to find a doctors surgery or "doctor near me"!
By Melissa Dillon