What is cerebral palsy?
Cerebral palsy is a permanent condition which describes a range of permanent movement difficulties caused by a non-progressive injury to the immature brain. It is the most common cause of physical impairment in children affecting posture and movement as a result of brain damage which has occurred during pregnancy, around the time of birth or within the first two years after birth. The damage affects the messages moving to and from the brain, and the way in which the brain interprets the information it receives. Cerebral palsy can also affect sensation, vision, hearing, perception, cognition, communication, and eating and drinking.
Put simply it can make ordinary activities that most of us take for granted difficult to do. These can include walking, talking, dressing and fine motor skills such as writing and doing buttons. In some children, all of these functions are affected, but other children may only have one of these difficulties.
The overall prevalence of CP is around 2 per 1000 live births.
What causes it?
Cerebral palsy can be caused by many things, which result in either a bleed in the brain (haemorrhage) or lack of oxygen to the brain (anoxia). Examples of these are: infections before and after birth , traumatic birth, problems in utero (in the womb), abnormal brain development, head injury.
What can increase the chances of cerebral palsy?
The following factors can increase the baby’s risk of having cerebral palsy:
- Premature birth (less than 37 weeks gestation)
- Traumatic birth
- Twins or multiple births
- Baby of low birth weight (less than 2.5 pounds)
- Substance abuse in mother
- Mother’s age being under 20 or over 40 years
A combination of the above factors (such as being a twin with low birth weight) can further increase the risk of cerebral palsy.
Is there a cure?
There is no cure for cerebral palsy, because the damage to the brain is irreparable but therapy can encourage the brain to develop alternative pathways. While there is no cure, therapy can help children and their families manage the problems that cerebral palsy presents. This can change the clinical presentation (symptoms) of the condition working towards the child’s full potential within their daily lives.
What does cerebral palsy look like?
No two people will be affected by their cerebral palsy in the same way. It is important to ensure treatments and therapy are tailored to the child’s needs. Tone is the term used to describe the relative stiffness/floppiness of muscles. Cerebral palsy can be classified in a variety of ways and is often based on the intended use however the Surveilance of Cerebral Palsy in Europe has become widely accepted as useful in classifying according to neurological findings:
Neurological features by subtype:
|SPASTIC CP||Bilateral spastic|
Pathological reflexes increased reflexes, e.g. hyperreflexia pyramidal signs, e.g. Babinski response resulting in abnormal pattern of movement and posture
|Involuntary, uncontrolled recurring, occasionally stereotyped movements, primitive reflex patterns predominate, muscle tone is varying|
|ATAXIC CP||Loss of orderly muscular coordination, so that movements are performed with abnormal force, rhythm and accuracy|
All the CP subtypes listed have in common an abnormal pattern of movement and posture.
Is it similar to a stroke in adults?
A stroke (bleed or blockage to the brain), in a baby or toddler, can be one of the causes of cerebral palsy. It happens before the brain has had the chance to fully develop. A stroke in an adult or older child happens when the brain has nearly/fully developed and therefore after the person has learned how to control movements and interact with the environment. Therapy therefore, is very different for an adult stroke patient as it involves relearning skills. The baby or toddler with cerebral palsy has no/limited prior experience of typical movement and therapy, therefore, focuses on learning new skills.
Does it lead to other complications?
Other complications may occur and can include the digestive system (reflux and constipation), the urinary system (bladder infections, kidney infections), the skin (pressure areas), the musculo-skeletal system (dislocations and deformities), respiratory complications, and the sensory system. Please remember that these difficulties do not necessarily affect every child.
Is it progressive?
The damage to the brain is not progressive, but the child may have increasing difficulties as they grow and mature. Limited movement can result in contractures (shortening) of muscles and deformities of joints/bones. This means that certain functional activities can become more difficult. Difficulties secondary to cerebral palsy may have an impact on health and well-being, such as pain, epilepsy, constipation.
Is it life-limiting?
Cerebral palsy is not life limiting as the initial damage to the brain doesn’t change. However, some of the associated problems that some children present with can lead to a shortened life expectancy. This is only in a minority of children.
Is every child with cerebral palsy the same?
No, just like able-bodied children, every child with cerebral palsy is different, with their own, unique set of abilities and difficulties.