• What is Cerebral Palsy?
• Known Causes
• Characteristics
• Implications

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What is Cerebral Palsy?

Cerebral palsy is a condition caused by damage to the brain, usually occurring before, during or shortly following birth. "Cerebral" refers to the brain and "palsy" to a disorder of movement or posture. It is neither progressive nor communicable. It is also not "curable" in the accepted sense, although education, therapy and applied technology can help persons with cerebral palsy lead productive lives. It is not a disease and should never be referred to as such. It can range from mild to severe.

Known Causes

The causes of cerebral palsy include illness during pregnancy, premature delivery, or lack of oxygen supply to the baby; or it may occur early in life as a result of an accident, lead poisoning, viral infection, child abuse, or other factors. Chief among the causes is an insufficient amount of oxygen or poor flow of blood reaching the fetal or newborn brain. This can be caused by premature separation of the placenta, an awkward birth position, labor that goes on too long or is too abrupt, or interference with the umbilical cord. Other causes may be associated with premature birth, RH or A-B-O blood type incompatibility between parents, infection of the mother with German measles or other viral diseases in early pregnancy, and micro-organisms that attack the newborn's central nervous system. Lack of good prenatal care may also be a factor. A less common type is acquired cerebral palsy: head injury is the most frequent cause, usually the result of motor vehicle accidents, falls, or child abuse.

Characteristics

There are three main types of cerebral palsy: spastic -- stiff and difficult movement; athetoid -- involuntary and uncontrolled movement; and ataxic -- disturbed sense of balance and depth perception. There may be a combination of these types for any one individual. Other types do occur, although infrequently.

Cerebral palsy is characterised by an inability to fully control motor function. Depending on which part of the brain has been damaged and the degree of involvement of the central nervous system, one or more of the following may occur: spasms; tonal problems; involuntary movement; disturbance in gait and mobility; seizures; abnormal sensation and perception; impairment of sight, hearing or speech; and mental retardation.

Children with CP have damage to the area of their brain that controls muscle tone. Depending on where their brain injury is and how big it is, their muscle tone may be too tight, too loose, or a combination of too tight and loose. Muscle tone is what lets us keep our bodies in a certain position, like sitting with our heads up to look at the teacher in class. Changes in muscle tone let us move.

Spastic Cerebral Palsy: - If muscle tone is too high or too tight, the term spastic is used to describe the type of cerebral palsy. Children with spastic CP have stiff and jerky movements because their muscles are too tight. They often have a hard time moving from one position to another or letting go of something in their hand. This is the most common type of CP. About half of all people with CP have spastic CP.

Ataxic Cerebral Palsy: - Low muscle tone and poor coordination of movements is described as ataxic (a-tax-ick) CP. Kids with ataxic CP look very unsteady and shaky. They have alot of shakiness, like a tremor you might have seen in a very old person, especially when they are trying to do something like write or turn a page or cut with scissors. They also often have very poor balance and may be very unsteady when they walk. Because of the shaky movements and problems coordinating their muscles, kids with ataxic CP may take longer to finish writing or art projects.

Athetoid Cerebral Palsy: - The term athetoid is used to describe the type of cerebral palsy when muscle tone is mixed - sometimes too high and sometimes too low. Children with athetoid CP have trouble holding themselves in an upright, steady position for sitting or walking, and often show lots of movements of their face, arms and upper body that they don't mean to make (random, involuntary movements). These movements are usually big. For some kids with athetoid CP, it takes alot of work and concentration to get their hand to a certain spot (like to scratch their nose or reach for a cup). Because of their mixed tone and trouble keeping a position, they may not be able to hold onto things (like a toothbrush or fork or pencil). About one-fourth of all people with CP have athetoid CP.
Click here to see a short movie of a girl with athetoid CP.

Mixed Cerebral Palsy : - When muscle tone is too low in some muscles and too high in other muscles, the type of cerebral palsy is called mixed. About one-fourth of all people with CP have mixed CP.

Besides different kinds of muscle tone, kids with CP also show different parts of their bodies that are affected by the CP. This is also due to what part of their brain was hurt and how big the injury was.

Quadriplegia: - When a child shows CP in all four of their limbs--both arms and both legs, it is called quadriplegia. Quad means four. Usually kids with quadriplegia have trouble moving all the parts of their bodies, their face and trunk as well as their arms and legs, and may need a wheelchair to get around. Because of the problems controlling the muscles in their face and upper body, they also have trouble talking and eating.

Hemiplegia: - Hemiplegia means that the CP affect one side of the child's body. Hemi means half, so the right arm and leg or the left arm and leg are affected. The other side of the child's body works just fine. Many kids with hemiplegia are able to walk and run, although they may look a little awkward or have a limp.

Diplegia: - Some children have CP just in their legs or much more severe in their legs than in their arms. This is called diplegia. Di means two, so in diplegia only the two lower limbs are affected. As you probably can guess, the difficulty for children with diplegia is using their legs, so walking and running may be hard for them. Because their upper bodies are usually not affected they have good ability to hold themselves upright and good use of their arms and hands. You may wonder whether anyone ever has CP in their arms but not their legs. This happens sometimes, but it is very, very rare.

Implications

Early identification of cerebral palsy can lessen developmental problems and lead to appropriate intervention when it helps the most. Early intervention programs are family-centered in which professionals and families work together with the child in specific activities. Educators, physical and occupational therapists, social workers, speech- language pathologists, psychologists and physicians can assist families by providing information and education. Activities for children with cerebral palsy may include:

• speech and language therapy;
• occupational therapy;
• physical therapy;
• medical intervention;
• family support services;
• early education; and
• assistive technology.

Source: - The National Information Center for Children and Youth with Disabilities & Children's Medical Center.

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