Cerebral palsy is a complex disorder that affects a person’s ability to move, to maintain balance and posture. The word “cerebral” indicates a condition involving the brain, and “paralysis” means “weakness”, difficulty in controlling muscles.
Cerebral palsy occurs when the central nervous system does not develop normally or the brain is damaged, which affects the ability to control one’s muscles. The manifestations of the disease are varied, and correspond to the severity of the condition of a child with cerebral palsy: from the need for outside help throughout his life to the ability to walk using special means, or even completely independently.
According to Dr Ratnav Ratan, one of the best pediatric orthopedics in Gurgaon, Cerebral palsy (cerebral palsy) does not progress over time, however, individual symptoms may change throughout life: if a child with cerebral palsy is not treated, muscle contraction and muscle “stiffness” may increase.
In all cases, infantile cerebral palsy (cerebral palsy) is manifested by movement disorders. Many also develop concomitant pathological conditions: seizures, problems with hearing, vision, speech, mental retardation, etc. Cerebral palsy (CP) is one of the most common causes of disability in childhood: the prevalence in Ukraine and Europe is 2-3 per 1000 live newborns, and among deeply premature babies it reaches 40-100 per 1000 live newborns.
Types of cerebral palsy
There are four main types of cerebral palsy, depending on the violation of muscle tone:
1. Spastic form – Spastic cerebral palsy is the most common, accounting for 80% of all cases. The muscle tone is increased, they are constantly in a state of contraction, which makes it difficult to work.
2. Atactic form – a violation of balance and coordination. Children with atactic cerebral palsy have difficulties with balance and coordination. This is manifested by problems with walking, as well as with fast movement, or action that requires concentration and control (for example, writing).
3. Dyskinetic form – uncontrolled motor activity. With dyskinetic cerebral palsy, uncontrolled movements of the arms or legs are observed; they can be slow and flexible or fast and choppy. Usually, this creates a burden on the motor activity of children, first of all, they experience difficulties with sitting and walking. Sometimes the muscles of the face and tongue are affected, resulting in problems with swallowing and speaking. One of the subtypes of this form of cerebral palsy is dystonic. Its manifestations include the inconstancy of muscle tone when a period of complete relaxation is replaced by a period of strong tension. Changes can occur just every few days or several times a day.
4. Mixed form – it is impossible to distinguish the signs of only one form of cerebral palsy, which is more prevalent, but symptoms of different types appear simultaneously. A frequent combination is a spastic-dyskinetic type.
Cerebral palsy is also classified according to the following criteria:
– Concerning the affected parts of the body:
• Hemiplegia (affection of one half of the body – right or left).
• Diplegia (paralysis affecting both halves of the body, but mostly the legs).
• Tetraplegia (damage to the arms and legs).
– Movement disturbances
Risk factors and causes of the development of cerebral palsy
Cerebral palsy occurs as a result of damage to the child’s nervous system – intrauterine (80% of cases), or after birth (20%). Due to the action of various factors, the child’s brain is damaged, in particular, the areas responsible for movement.
None of these factors necessarily lead to the onset of the disease, but their presence increases the risk of cerebral palsy.
The most common risk factors include:
• Prematurity and low birth weight of a newborn child;
• Hypoxia of the baby in utero, during or immediately after birth
• Infectious lesions of the child’s brain;
• Disorders of the child’s blood coagulation system ;
• Damage to the child’s brain due to trauma or cerebral hemorrhage;
• Viral and infectious diseases of the mother and fetus during pregnancy;
• Diseases of the thyroid gland in the mother
• The impact of chemicals and bad habits during pregnancy (including occupational hazards, smoking, drug use)
• Hemolytic disease in a newborn;
• Gene mutations ;
• Complications during pregnancy and childbirth (a rarer cause of cerebral palsy than is commonly believed. These include 5 to 10% of cases).
Cerebral palsy symptoms
Sometimes the symptoms of cerebral palsy can be detected immediately at birth, namely during the time when the doctor examines the child and assesses her condition, but most often the diagnosis is made only at the age of one or two years. Cerebral palsy can be accompanied by symptoms that vary greatly between patients, depending on the type of disease.
The main sign that can lead to the idea of a threat of cerebral palsy is movement disorders that manifest themselves during the development of the child (especially important skills such as the ability to keep the head, roll over from back to stomach, sit, crawl, stand and walk are taken into account).
• Changes in muscle tone from complete relaxation to intense tension.
• Strong muscle tension + increased reflexes (spasticity) – often in the form of bending the child’s body to one side, asymmetric position of the limbs.
• Impaired coordination of movements (ataxia).
• Slow, flexible movements (athetosis).
• Tremors or uncontrolled erratic movements.
• Children express unreasonable anxiety or lethargy.
Secondary manifestations are:
• Disorders of sucking, swallowing, drooling.
• Delayed speech development.
• Convulsions (epilepsy).
• Impaired vision, hearing.
• Mental retardation.
How is cerebral palsy treated?
There are many methods of conservative and alternative medicine used to treat patients with cerebral palsy. Today it is impossible to cure these patients completely, however, there are already treatment regimens that are aimed at developing functions that are not enough to be able to lead the most fulfilling life possible:
– Kinesiotherapy (massage, physiotherapy exercises).
– Complex integral methods of rehabilitation.
• Professor Kozyavkin’s method (System of Intensive Neurophysiological Rehabilitation).
• Methodology of K.A. Semenova.
• Concept by K. and B. Bobat.
• V. Vojta’s method and others.
– Drug treatment (botulinum toxin A preparations, central muscle relaxants).
– Sensory integration, sensory room.
– Acupuncture therapy.
– Means of orthopedic correction stage plastering, orthotics, orthopedic shoes, splints according to indications.
– Surgical treatment (lengthening the tendons, reducing the tone of the affected muscles). – Hippotherapy, aqua therapy in specialized centers and swimming pools.
– Technical devices for medical rehabilitation.
Young children have a high potential for brain regeneration, and therefore treatment of cerebral palsy should be started as early as possible. Only the synergy of efforts of a multidisciplinary team of specialists in various fields of medicine, rehabilitation and psychology is able to maximize the effect of treatment and help to achieve its maximum results. Undoubtedly, this is hard, complex and, what is important, highly specialized work, but it should not be forgotten for a minute that the main goal of treating patients with cerebral palsy is not only improving their well-being or adapting to the requirements of our time, but also significantly improving their quality of life. Book your consultation with the best pediatric orthopedics in Gurgaon at the best hospital in Gurgaon today!