Cerebral Palsy

Overview

Cerebral palsy refers to a group of disorders that affect brain and nervous system functions.Cerebral palsy is caused by abnormal brain development and affects movement, muscle tone, balance, and posture. People with cerebral palsy may be unsteady when walking, have jerky motions, and an abnormal posture, although symptoms vary widely. Cerebral palsy is usually diagnosed before a child is 2 years old and is a lifelong illness. Treatment, however, can greatly improve functioning and quality of life for people with cerebral palsy.

Symptoms and Diagnosis

Symptoms of cerebral palsy vary from person to person, but always include problems with movement and posture. There are four types of cerebral palsy defined by the type of movement disorder involved: spastic, dyskinetic, ataxic, and mixed. Spastic cerebral palsy is the most common form of the disorder and is characterized by increased muscle tone, which causes stiffness and awkward movements. Spastic cerebral palsy can affect the legs, arms, or the entire body, although some forms only affect one side of the body. Dyskinetic cerebral palsy causes difficulty controlling the hands, arms, feet, legs, and sometimes the face and tongue. People with this type of cerebral palsy may have jerky or slow movements and trouble sucking, swallowing, and talking. Ataxic cerebral palsy causes problems with balance and coordination. People with ataxic cerebral palsy may be unsteady when walking and have a hard time controlling quick movements. Mixed cerebral palsy is when someone has symptoms of more than one type of cerebral palsy, with the most common combination being spastic-dyskinetic. Other neurological problems may also occur, including vision and hearing problems, intellectual disabilities, seizures, mental health conditions, and urinary incontinence.

Cerebral palsy is usually diagnosed before a child turns 2 years old. Signs to watch for in infants younger than 6 months include floppiness or stiffness, overextending the back and neck, or stiff legs that cross or scissor. Babies older than 6 months may not roll over and can havedifficulty bringing hands together or to the mouth. Children older than 10 months may crawl in a lopsided way or not be able to crawl on all fours.

Diagnosing cerebral palsy in a child involves a physical exam and a series of tests to rule out other medical conditions.MRIs and CT scans can reveal any lesions or abnormalities in the brain, although MRI is preferred. A cranial ultrasound of the child’s brain is quick and inexpensive but does not provide the detail of an MRI or CT scan. In addition to imaging tests, doctors will order blood tests to rule out other conditions and to check for genetic or metabolic issues. Children diagnosed with cerebral palsy usually need additional evaluations to assess impairments in vision, hearing, speech, and intellectual abilities.

Causes

Cerebral palsy is caused by abnormal brain development, usually before a child is born. Disruptions in brain development may result from random gene mutations, maternal infection during pregnancy, fetal stroke, infant infections that affect the brain, or traumatic head injury. Certain illnesses during pregnancy increase the risk of having a baby with cerebral palsy, including rubella, chickenpox, cytomegalovirus, toxoplasmosis, syphilis, and exposure to toxins. Newborn babies may also get illnesses that raise the risk of cerebral palsy, including bacterial meningitis, viral encephalitis, and severe jaundice. Complications with pregnancy and birth also increase the chances of having a baby with cerebral palsy. Premature babies, babies with low birth weight, and breech births (feet-first) all have a higher risk of cerebral palsy. Additionally, cerebral palsy risk increases with the number of babies in the uterus. Continue reading for Prevention and Treatment Information . . .

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