About Cerebral Palsy

Living with cerebral palsy poses difficult physical challenges. One of these challenges is severe spasticity, which can get in the way of daily activities. Fortunately, there is a therapy from Medtronic that can minimise severe spasticity in some individuals.

Definition

Cerebral palsy can be defined as “persistent” (but not unchanging) disorder of movement and posture, as the result of one or more non-progressive abnormalities in the brain, before its growth and development are complete. Cerebral palsy is a movement and posture disorder resulting from an injury or defect to the developing brain (brain damage).

Causes

Cerebral palsy can be caused by brain injury during intrauterine life or at birth.  Several causal pathways of CP have been identified, such as kidney or urinary tract infections, metabolic disturbances, toxaemia, jaundice, rhesus incompatibility, rubella (German measles), direct trauma and hypoxia. It can also be acquired after birth.  In this case, cerebral palsy is usually caused by brain damage in the first few months or years of life.

Risk Factors

Several risk factors can increase the likelihood of cerebral palsy. However, it's important to know that these risk factors will not necessarily result in the disease.

These risk factors are usually present:

  • During foetal development before, during, or shortly after birth
  • During infancy

Risk factors for cerebral palsy include:1

  • Premature birth
  • Low birth weight
  • Poor intrauterine nutrition
  • Lack of growth factors during intrauterine life
  • RH or A-B-O blood type incompatibility between mother and infant
  • Infection of the mother with German measles or other viral diseases in early pregnancy
  • Bacterial infection of the mother, foetus or infant that directly or indirectly attacks the infant's central nervous system
  • Prolonged loss of oxygen during birth
  • Severe jaundice shortly after birth

Symptoms

Early signs of cerebral palsy usually appear before a child is 18 months old. Infants with cerebral palsy are frequently slow to reach developmental milestones, such as learning to roll over, sit, crawl, smile, or walk. Parents are often the first to suspect that their infant is not developing motor skills normally.1

Symptoms that can accompany cerebral palsy include:

  • Spasticity
  • Involuntary movement
  • Trouble walking or moving
  • Difficulty swallowing
  • Problems with speech

Cerebral palsy ranges from mild to severe. Physical signs of cerebral palsy include weakness and floppiness of muscles, or spasticity and rigidity. In some cases, neurological disorders (such as mental retardation or seizures) also occur in children with cerebral palsy.2

Diagnosis

Cerebral palsy is usually diagnosed early in life. Your doctor will review your child's medical and family history and perform a physical evaluation. In addition to checking for the typical symptoms, the doctor may perform specialised tests to help diagnose your child's condition. Your doctor can help distinguish normal variation in development resulting from a developmental disorder.

About Spasticity Due to Cerebral Palsy

Spasticity is caused by damage or injury to the part of the central nervous system (the brain or spinal cord) that controls voluntary movement. This damage disrupts important signals between the nervous system and muscles, creating an imbalance that increases muscle activity or spasms. Spasticity means stiff, and refers to the excess of tone in a muscle during the normal process of tightening and relaxing particular muscles in order to initiate, control and relax or release movement. It has also been described as a “velocity-dependent increase in resistance of a muscle to stretch”. This means that the faster a limb joint is moved, the greater the spasticity that results. 

Spasticity can make one's movement, posture, and balance difficult. It may affect your ability to move one or more of your limbs, or to move one side of your body. Sometimes spasticity is so severe that it gets in the way of daily activities, walking, dressing, sleeping, communication, feeding and personal care. In certain situations, this loss of control can be dangerous for the individual.

Uncontrolled, poorly managed spasticity is also recognised for the increased potential of additional medical problems such as muscle contractures, joint stiffness and pressure sores, requiring additional surgical and medical interventions.

Children with CP often have abnormal and asymmetrical tone, which often leads to contractures developing.  This is an underlying feature which most commonly leads to surgery and is of particular concern for growing children with CP.

Spasticity is also associated with decreased coordination, dexterity, endurance, and muscle weakness. It can very according to the child’s state of alertness, activity or posture and can be aggravated by many factors such as pain, stress, emotional state, tiredness, extremes of temperature, illness, constipation and diarrhoea.

Severe spasticity can also “burn off” a large portion of the calorific intake of a child’s diet and may result in an underweight child who may be more susceptible to illness and infection.

References

  1. UCP Research and Educational Foundation. Cerebral Palsy Facts and Figures. Available at: www.ucp.org. Accessed January 11, 2008.
  2. Mayo Clinic. Nervous System. Cerebral Palsy. Available at: www.mayoclinic.com. Accessed January 13, 2008.

 

Information on this site should not be used as a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information.

Last updated: 10 Nov 2010

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