Cerebral palsy

Overview

Cerebral palsy (CP) is a group of conditions that impact posture, muscle tone, and movement, and is caused by damage to the developing brain, usually occurring before birth when the brain is still immature.

The signs and symptoms of cerebral palsy typically emerge during infancy or preschool years. The condition generally causes movement difficulties, which can include increased reflexes, flaccidity or spasticity of the limbs and trunk, unusual posture, involuntary movements, unsteady walking, or a combination of these symptoms.

People who have cerebral palsy frequently experience eye muscle imbalance, which causes their eyes to not focus on the same thing, as well as swallowing issues. Due to muscle stiffness, they may also have less range of motion at different joints throughout their bodies.

Cerebral palsy can have a wide range of causes and functional implications. While some cerebral palsy sufferers can walk unaided, others cannot. Intellectual disability can affect some persons but not others. The presence of epilepsy, blindness, or deafness is also possible.

Cerebral palsy is a chronic condition. While a definitive cure for a certain condition may not exist, various treatments are available that can aid in enhancing one’s functionality.

Types of cerebral palsy

Cerebral palsy can be classified in two ways: by the parts of the body that are primarily affected, and by the most prominent movement issue observed.

Cerebral palsy movement abnormalities come in four different varieties. They are the outcome of injury to various brain regions.
Here are some examples of cerebral palsy:

• Spastic: Approximately 75% of CP patients have spastic cerebral palsy. Muscles in people with spastic CP are rigid, tight, and involuntarily contract. Their speech and walking may sound jerky as a result of their muscles’ spasticity.
• Dyskinetic: This kind of cerebral palsy, also called athetoid CP, results in abnormal motions of the tongue, face, and limbs. The movements could be smooth and slow or jerky and rapid. The person may appear to be twisting or writhing. When the person is moving around, the movements are more pronounced. Drooling is common in people with dyskinetic CP because they frequently have problems swallowing their saliva.
• Ataxic: Problems with balance, coordination, and depth perception result from this kind of CP. They can struggle to stand still or walk without stumbling or falling. Children with this kind of CP frequently walk with their feet apart. When they move, they might appear to be trembling.
• Mixed types: Multiple symptoms may appear at once when more than one area of the brain is damaged. A person with mixed cerebral palsy has signs of ataxic, dyskinetic, and spastic cerebral palsy.

Symptoms

Cerebral palsy signs and symptoms might differ widely from person to person, and they may affect the entire body, or may only affect one or two limbs or one side of the body. Typically, signs and symptoms include issues with development, speech and eating, movement and coordination, and other issues.

Movement and coordination

• Spasticity, the most prevalent movement disorder, is characterized by tight muscles and hyperactive reflexes.
• Walking difficulties, such as walking on your toes, a crouching gait, a scissors-like motion with knees crossed, a broad gait, or an asymmetrical gait
• Muscle tone differences, such as being either overly stiff or too floppy
• Problems with fine motor skills, such as difficulty picking up objects or buttoning clothing
• Rigid muscles that have normal reflexes
• Ataxia, a disorder of balance and motor coordination
• Jerky, uncontrollable movements or tremors
• Slow, twisting movements
• Preference for one side of the body, such as only using one hand to reach or dragging a leg when crawling

Speech and eating

• Problems in speaking or delays in speech growth
• Eating, sucking or chewing problems
• Abnormally high amount of drooling or swallowing issues

Development

• Problems with learning
• Disabilities in intellectual capability
• Delayed achievement of motor skill milestones, such as crawling or sitting up
• Slow growth, resulting in a lower size than anticipated

Other issues

Brain damage may be a factor in the development of several neurological issues, including:

• Vision issues and strange eye motions
• Hearing problems
• Unusual pain or touch sensations
• Mental illnesses, including emotional disorders and behavioral issues
• Issues with the bladder and bowels, such as constipation and urine incontinence
• Seizures

Because the underlying brain condition that causes cerebral palsy doesn’t alter with age, the symptoms typically don’t get worse. However, some symptoms may become more or less obvious as the child ages. And if not aggressively treated, muscle shortening and rigidity can worsen.

Getting a prompt diagnosis for your child’s mobility problems or developmental delays is essential. If you observe any signs of loss of awareness of the surroundings, unusual body movements or muscle tone, decreased coordination, swallowing difficulties, eye muscle imbalances, or any other developmental abnormalities, it’s crucial to consult your child’s doctor.

Causes

Damage to the growing brain or faulty brain development are the two main causes of cerebral palsy. This typically occurs prior to childbirth, although it can also happen during birth or the first few months of life. The cause is frequently unknown. There are numerous things that can affect brain growth. Several are:

• Gene mutations that resulting in genetic abnormalities or variations in the development of the brain
• Maternal infections that impact the growing fetus
• Fetal stroke, a reduction in blood flow to the growing brain
• A baby or fetus brain bleeds
• Infant infections that cause inflammation around or in the brain
• Traumatic head damage in a baby brought on by a car accident, a tumble, or physical abuse
• Lack of oxygen to the brain. Birth-related asphyxia is a considerably less prevalent cause than previously believed, yet it is nonetheless connected to difficult labor or delivery.

Risk factors

The risk of cerebral palsy is influenced by a number of variables.

Maternal health

The risk of cerebral palsy for the unborn child can be greatly increased by specific diseases or hazardous exposures during pregnancy. An infection or fever-induced inflammation can harm the developing brain of the unborn child.

• Herpes. This infection, which affects the womb and placenta, can be transferred from mother to child while she is pregnant.
• Syphilis. It is a bacterial infection that is spread through sexual activity.
• Cytomegalovirus. If a mother contracts this common virus for the first time when she is pregnant, it might cause birth abnormalities.
• German measles (rubella). A vaccine is available to protect against this viral illness.
• Toxoplasmosis. A parasite that can be found in contaminated food, soil, and cat excrement is what causes this ailment.
• Zika virus infection. This virus, which is caused by mosquito bites, may have an impact on a fetus’s brain development.
• Infections during pregnancy. The placenta and fetal membrane infections fall within this category.
• Exposure to toxins. Exposure to methyl mercury is one such example.
• Other health problems. Thyroid issues, preeclampsia, or seizures in the mother are additional disorders that can modestly raise the chance of cerebral palsy.

Infant disease

The following conditions in a newborn baby can significantly raise the chance of cerebral palsy:

• Bacterial meningitis. The membranes encircling the brain and spinal cord become inflamed as a result of this bacterial infection.
• Viral encephalitis. Similar inflammation is brought on by this viral infection in the membranes encircling the brain and spinal cord.
• Bleeding into the brain. This disorder is frequently brought on by a newborn having a stroke while still in the womb or in the first few months of life.
• Severe or untreated jaundice. Yellowing of the skin is a symptom of jaundice. When specific “used” blood cell byproducts aren’t removed from the bloodstream, the disease develops.

Pregnancy and birth risk factors

Additional pregnancy or birth factors linked to an increased risk of cerebral palsy include, though their potential contribution is limited:

• Low birth weight. Cerebral palsy is more likely to occur in infants under 5.5 pounds (2.5 kilograms). As the birth weight decreases, this risk rises.
• Multiple pregnancy. As more babies share the uterus, the risk of cerebral palsy rises. The likelihood of preterm birth and low birth weight may also be associated to the risk. The chance of cerebral palsy for the surviving rises if one or more of the infants pass away.
• Premature birth. Cerebral palsy risk is increased in prematurely born infants
• Delivery complications. Cerebral palsy risk may be increased by issues with labor and delivery.