Cerebral Palsy: Information on Causes, Diagnosis & Treatments
Cerebral palsy (CP) is a group of mild to severe disorders that affect normal body movement involving muscle tone, muscle coordination, reflex, balance, gait, and posture. The condition occurs when the developing brain is damaged during pregnancy, during delivery, or shortly after birth. While the condition affects every affected person differently, it is usually permanent and can either improve or worsen as the individual ages.
Typically, those who are afflicted by the condition suffer learning, visual, speech, hearing, and intellectual impairments. Many have epileptic events. The condition can be brought on by factors other than complications that occur during the birthing process, which account for an estimated 10 percent of all cases.
Recent studies suggest that most cases of cerebral palsy occur because of an abnormality in developing brain or some type of brain injury that occurs before birth, labor, or delivery. Other causes of the condition include infections, negligence, medical malpractice, and accident.
Cerebral Palsy Causes
Cerebral palsy is usually caused by a combination of events that occur prior to birth that damages the newborn's developing brain. Like most conditions, cerebral palsy can be caused by numerous risk factors including a lack of oxygen (asphyxia). Accepted study results indicate that cerebral palsy develops because of a series of events that occur in a sequence, which is either causing or accelerating the neurological damage to the baby's developing brain.
The most common cerebral palsy causes include:
- Viral or bacterial infections
- Hemorrhaging involving bleeding in the brain
- Prenatal exposure to alcohol and drugs
- Prenatal exposure to mercury poisoning and toxoplasmosis when the mother consumes mercury latent fish and undercooked/raw meats respectively
- Head injury caused during the birthing process or during infancy
- Damage to brain tissue white matter (periventricular leukomalacia)
- Brain hemorrhage (intracranial hemorrhage)
- Intrapartum Asphyxia (hypoxic ischemia encephalopathy) where the brain is deprived of oxygen
- Cerebral Dysgenesis that involves abnormal brain development or malformation
Typically, the affected individual will display signs of physical impairment, especially muscle movement dysfunction. However, the extent and location of the impairment differ widely between individuals. Some are affected in the face, legs, arms, or all over.
There are numerous indicators that a child is suffering from cerebral palsy. However, not all indicators are visible when the child was born, as some will begin to become more obvious during the developing years. However, the most common symptoms associated with cerebral palsy and babies include:
- Underdeveloped muscle tone typically identified when the baby "flops" when picked up
- The inability to hold their head up when being supported in a sitting position or lying on their stomach
- Poor muscle control that affects the posture and reflexes
- Muscle stiffness or spasms
- Difficulties in swallowing or feeding
- Delayed muscle development where the child is unable to rollover or sit up six months after birth
Fortunately, many cases involving cerebral palsy never progress beyond the original damage caused to the brain as the child grows older. However, based on the severity of the condition, toddlers and children may be challenged within the first few years of life as their bodies develop physically. The most common cerebral palsy symptoms associated with toddlers and children include:
- The inability to walk unassisted by 12 or 18 months
- The inability to speak simple sentences by two years of age
It is common for children without cerebral palsy to be unable to reach normal milestones. However, concerned parents are usually more aware of their child's behavior than their pediatrician. Because of that, they should talk to the doctor about the possibility that their child or toddler has some form of cerebral palsy.
Diagnosing Cerebral Palsy
Medical scientists have yet to develop a singular test to accurately diagnose cerebral palsy in newborn children. However, an accurate diagnosis can be made through a comprehensive evaluation to determine if the brain has fully developed within the first several years of life. The pediatrician may be able to determine that the child's growth factor has been delayed because they had missed one or more age-appropriate milestones during the development phases. The doctor will likely monitor common indicators to verify or rule out cerebral palsy. These include:
- Determining the child reach development milestones for typical weight and height
- The development of the child's reflexes and muscle tone
- Determining if the child's movement and posture are normal
- Determining if the child can maintain focus or hear their caregiver
To verify or rule out these factors, the pediatrician will test the child's reflexes, posture, muscle tone, and coordination. This may include ordering tests like CT (computerized tomography) scans, MRI (magnetic resonance imaging) scans, cranial ultrasounds and others that provide an image of the child's brain.
Diagnosing cerebral palsy is crucial to maintaining a quality of life. By understanding the child's health status, the pediatrician can develop effective intervention and treatment plans and direct the parents on how to secure benefits that improve the child's life.
Diagnosing the condition typically begins with the primary care physician followed by a pediatrician or other specialists. Many children who suffer from cerebral palsy were born at a low birth weight or prematurely and will be closely monitored at the hospital. Emergency room doctors may suspect the child is a victim of shaken baby syndrome or child abuse that affects his or her neurological development.
It typically takes months or years to accurately confirm a diagnosis of cerebral palsy which can be an emotional journey for the parents. During that time, the doctor may misdiagnose the condition even if the child is undergone early intervention, extensive treatments, ongoing therapies, and access to benefit programs.
A misdiagnosis of the condition can occur if the child has not been properly monitored and tested to ensure an accurate confirmation is made. Even after a cerebral palsy diagnosis is confirmed, the parents should consider obtaining a second opinion to verify the condition and review treatment options.
Treating the Condition
There is no one form of treatment that can provide all the medical attention a child on the to handle their cerebral palsy condition. Typically, a professional support team and community-based support services working in unison can ensure that the child's needs are being met to enhance their quality of life. The team might consist of a pediatrician, pediatric neurologist, orthopedic surgeon, occupational therapist, physical therapist, speech-language pathologist, mental health specialist, developmental therapist, recreational therapist, special education teacher, and social worker.
The doctor may prescribe one or more drugs that lessen muscle tightness to improve functional abilities and manage complications derived from cerebral palsy symptoms. These medications are used to control or improve symptoms including:
- Isolated Spasticity where a single muscle group spasms and produces one or more side effects including pain, severe weakness, mild flu-like condition, or bruising.
- Generalize Spasticity that typically affects the entire body. The drug may be able to relax contracted stiffened muscles. However, these tend to have serious side effects during long-term use including drooling, weakness, or drowsiness.
In recent years, doctors have found great success in stem cell therapy in the treatment of cerebral palsy. However, it is still in the experimental phase.