Cerebral palsy is a neurological disorder that affects basic functions, including movement, speech, and posture. Between 500,000 and 700,000 Americans have it in varying degrees. There are several types including: spastic, in which movement is stiff and difficult, athetoid, in which movement is involuntary or uncontrolled; ataxic, in which balance and depth perception are abnormal, and mixed, a combination of types. Cerebral palsy is caused by brain and nervous system damage sustained before birth, during labor, or shortly after birth. Depending upon the area and extent of the damage, symptoms may include spasms, tics, gait abnormalities, seizures, and poor muscle tone. Sight, hearing, speech, and intellect also may be affected.
Diagnostic Studies And Procedures
The disorder may be obvious at birth, or it may not become apparent for several months. Early diagnosis is important, however, so that therapy can begin as soon as possible. If cerebral palsy is suspected, a pediatric neurologist should be consulted for diagnostic tests to determine the extent and location of brain damage and to rule out other disorders. Tests are likely to include electroencephalography to measure the brain’s electrical activity; electromyography, or EMG, to measure electrical activity in the muscles during movement; and a CT scan to look for brain abnormalities. Blood and urine samples will also be studied to rule out other disorders that produce similar symptoms.
Medical Treatments
Planning of treatment should involve a team of health professionals, including physical, speech, and occupational therapists; a psychologist; a neurologist; and an orthopedist. Because there is no cure for cerebral palsy, the goal is to help the child achieve as much independence as possible. Seizures can often be controlled with anticonvulsant medications. Orthopedic treatment may include braces, splints, and casts to prevent contractures and other deformities of the arms and legs. Some children need orthopedic surgery to cut contracted muscles and tendons, thus allowing them to stretch, or to fuse together certain bones to stabilize joints. Such surgery can enable a child to walk or to maintain balance better.
Alternative Therapies
Several allied health professions and alternative practices play an important role in helping children with cerebral palsy to develop their full potential.
Dance And Music Therapies
These approaches can help children to improve their coordination, build muscle tone and strength, and gain self confidence. It is important, however, that the instructor be specially trained to work with handicapped children. Massage Therapy. This is beneficial in alleviating spasms and reducing muscle contractions. The therapist should consult the child’s primary care doctor in planning the therapy.
Physical, Occupational, And Speech Therapy
Professionals in these fields specialize in teaching living skills. Physical therapists use exercise and relaxation techniques to teach children how to walk with the aid of braces, crutches, and other devices, or how to transfer from a wheelchair to a bed and chair. They also show parents how to incorporate therapy into the child’s daily routine. Occupational therapists help a child develop useful skills such as typing or mastery of special devices to perform routine tasks. Speech therapists teach communication skills, including sign language for children who are unable to speak.
Self Treatment
Cerebral palsy is a life long condition that usually demands adaptation and training in order to achieve self sufficiency. The earlier a diagnosis is made, the sooner a child can receive special education services. Many children with cerebral palsy attend regular public schools, but others require special classes, and the more disabled may need developmental day care programs that are geared especially to their needs. Parents can do a great deal to provide a home environment that stimulates the child to learn and to explore. Regular exercise, beginning in infancy, is critical to achieving as much movement control as possible. Initially, passive exercises performed by parents or other caregivers are used, but at an early age, the child should be encouraged to participate in and eventually perform appropriate exercises. Toilet training is usually delayed and difficult to achieve if the nerves that affect bowel and bladder control are damaged. talking to other parents who have been through this stage may yield helpful tips. Special large handled eating utensils, toothbrushes, and dressing aids, such as those used by people with severe arthritis, are valuable in learning to perform basic self care. A large number of cerebral palsy cases could be prevented by improved prenatal care. Several types of infections, including toxoplasmosis, genital herpes, rubella, and cytomegalovirus, increase the risk of cerebral palsy. A woman with any of these diseases should consult an obstetrician who specializes in high risk pregnancies. Some studies indicate smoking and alcohol use during pregnancy also increase the risk.
Other Causes of Palsy
A head injury, brain tumor, stroke’, and brain infection are among the possible causes of palsy.