Different Therapies to Improve Cerebral Palsy
Different Therapies to Improve Cerebral Palsy

When you see children and any other person with some different deformity and different walking patterns. They have some amount of brain damage. This condition is called “Cerebral Palsy”. This disease is common in children. It is more common in boys than girls.

What is Cerebral Palsy

Cerebral palsy is one of the diseases which affects a person’s ability to move and maintain balance and posture. 

Cerebral palsy consists of two words, ‘Cerebral’ means having to do with the brain and ‘Palsy’ means weakness or problems with using muscles. CP is caused by abnormal brain development that affects a person’s ability to control their muscles. Cerebral palsy is the most common motor disability disorder in childhood.

Some Important points on CP

  • A cerebral palsy is a group of neurological disorders and disabilities. It is not caused by one condition, all can cause some degree of disability in movement, posture, and balance.
  • It is most common in children. 1 in approx. 345 kids have CP.
  • About 80% of children have spastic cerebral palsy which has increased muscle tone.
  • More than half of children diagnosed with CP can walk independently. 
  • Most children with CP have other conditions also. Epilepsy is a common co-occurring condition. 
  • The main cause of CP is brain damage that occurs in the fetus or during birth.

Causes of Cerebral Palsy

Cerebral palsy is caused by an abnormality and disruption in brain development. There are several other factors that cause cerebral palsy-

  1. Gene mutations that lead to abnormal development 
  2. Maternal infection that affects the developing fetus
  3. Fetal stroke is a disruption of blood supply to the developing brain
  4. Bleeding into the brain in the womb or a newborn
  5. Infant infection that causes inflammation in and around the joint
  6. Traumatic head injury to an infant from a motor vehicle accident or fall
  7. Lack of oxygen to the brain is related to difficult labor or delivery or birth-related asphyxia.

Symptoms of Cerebral Palsy

Movement and Coordination Problems with Cerebral Palsy include:

Variation in muscle tone is either too stiff or too floppy

  • Stiff muscles with exaggerated reflexes.
  • Stiff muscles with normal reflexes 
  • Lack of balance and muscle coordination
  • Tremors and involuntary movement 
  • Slow and writhing movement 
  • Delays in motor skills milestones, such as pushing up on arms, sitting up or crawling
  • Difficulty walking such as walking on toes, a crouched gait, a scissors-like gait with knees crossing, a wide gait, or an asymmetrical gait.
  • Excessive drooling or problems with swallowing
  • Delays in speech development or difficulty in speaking 
  • Learning difficulties 
  • Seizures
  • Difficulty with fine motor skills such as buttoning of clothes or picking up utensils.
  • Cerebral palsy can affect the whole body or it might affect the one side of the body.
  • Difficulty hearing or seeing
  • Intellectual disability
  • Abnormal touch or pain perceptions
  • Oral disease
  • Mental health conditions
  • Urinary incontinence

Risk factors

3 types of risk factors

  1. Maternal Health
    • Cytomegalovirus 
    • German measles
    • Herpes
    • Syphilis 
    • Toxoplasmosis
    • Zika virus infection
  2. Infant Illness
    • Bacterial meningitis 
    • Viral encephalitis
    • Severe jaundice 
    • Bleeding into the brain
  3. Pregnancy and Birth
    • Breech presentation
    • Low birth weight
    • Multiple babies
    • Premature birth

Complications

  1. Contracture
  2. Premature aging
  3. Malnutrition
  4. Mental health conditions
  5. Heart and lung disease
  6. Osteoarthritis 
  7. Osteopenia

Prevention

  1. Make sure you’re vaccinated: Getting vaccinated against diseases such as rubella, before getting pregnant, might prevent infection but that can cause foetal brain damage.
  2. Take care of yourself: The healthier you are heading into a pregnancy, the less likely you will be prevented from an infection that results in  cerebral palsy. 
  3. Seek early and continuous prenatal care: Regular visit to your doctor during pregnancy is a good way to prevent health risk to you and your unborn baby. Visits your doctor regularly can help prevent premature birth, low birth weight and infections.
  4. Practice good child safety: Prevent head injuries by providing your child with a car seat, bicycle helmet, safety, rails on beds and supervision.
  5. Avoid alcohol, tobacco and illegal drugs: These have been linked to cerebral palsy.

Diagnosis

  1. MRI: It uses radio waves and a magnetic field to produce detailed 3D or cross sectional images of your child’s brain.It can often identify lesions or abnormalities in your child’s brain.  
  2. Cranial Ultrasound: It uses high frequency sound waves to produce images of the brain. This can be performed during pregnancy. It can provide preliminary assessment of the brain.
  3. Electroencephalogram(EEG): If your child has seizures, an EEG can evaluate the condition further. Seizures can develop in  children with epilepsy. In an EEG, a series of electrodes are attached to your child’s scalp.
  4. Other Tests: 
    1. Vision
    2. Hearing
    3. Speech
    4. Intellect
    5. Development
    6. Movement

Cerebral Palsy Classification

CP is classified according to the Gross motor function classification system (GMFCS).

There are five levels of the GMFCS increase with decreasing mobility.

  • Level 1: It is characterized by being able to walk without limitations. 
  • Level 2: A person with level 2 can walk long distances without limitations, but they can’t run or jump.
  • Level 3: A person with level 3 can sit with little support and stand without any support. 
  • Level 4: A person with level 4 can walk with the use of assistive devices.
  • Level 5: A person with level 5 needs support to maintain their head and neck position.

Treatment

3 types of Treatment

  1. Assistive Aids
    • Eyeglasses
    • Hearing aids
    • Walking aids
    • Body braces
    • Wheelchairs
  2. Medications
    • Diazepam
    • Dantrolene
    • Baclofen
    • Tizanidine
    • Botulinum toxin A
  3. Therapies
    • Physical Therapy: Muscle training and exercises can help your child’s strength, flexibility, balance, motor development and mobility. For the first one or two years after birth, both physical and occupational therapists provide support with issues such as head and trunk control, rolling, and grasping.
    • Occupational therapy: Occupational therapists work to help your child gain independence in daily activities and routines in the home, the school and the community.
    • Speech and Language Therapy: speech language pathologists can help improve your child’s ability to speak clearly or to communicate using sign language. They can also address difficulties with eating and swallowing.
    • Recreational therapy; Some children benefit from regular or adaptive recreational or competitive sports activities such as therapeutic horseback riding or skiing.
    • Social Service Consultations
    • Counseling or Psychotherapy

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