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Cerebral Palsy

Cerebral palsy is a neurological disorder (a disorder that involves the brain, spinal cord, and nerves). It impairs a child’s ability to move, maintain posture, or keep her balance. In the U.S., 1 in 323 kids has it, making it the most common childhood motor disability, or disability that involves movement.

Although cerebral palsy is permanent, it is usually not life-threatening. It is not progressive, meaning it does not get worse over time.    

 

Types

There are four main types of cerebral palsy:

  • Spastic Cerebral Palsy: This is the most common type—about 80% of cases of cerebral palsy are spastic. A child with spastic cerebral palsy has “too much” muscle tone, meaning her muscles are stiff and movements can be “jerky” or awkward.
  • Dyskinetic Cerebral Palsy: This causes a child problems in controlling his arm, hand, leg, or feet. With this type of CP, a child’s muscle tone can change frequently, from too tight to too loose. His movements can become uncontrollable, and can be either slow and writhing or rapid and jerky.
  • Ataxic Cerebral Palsy: This causes difficulty with balance and coordination. A child with ataxic cerebral palsy may have trouble making movements that need control, like writing. She may also have difficulty with quick movements.
  • Mixed Cerebral Palsy: This is when a child has symptoms of different types of cerebral palsy. Spastic-dyskinetic is the most common mixed CP.  

 

Cerebral palsy can also be classified by the number of limbs affected:

  • Quadriplegia: All four limbs—both arms and both legs—are affected.
  • Diplegia: Two limbs are affected. It’s usually the legs, but the arms can be involved to a lesser degree.
  • Hemiplegia: Limbs one side of the body—left or right—are affected. Typically, the arm is more affected than the leg.      
  • Monoplegia: Only one limb is affected. Monoplegia is the least common form of cerebral palsy.
  • Total body involvement: This type affects all four limbs, and also impairs a child’s vision, speech, or cognitive function.

Symptoms

The symptoms vary from child to child, and may depend on the type or severity of the palsy. These symptoms may include:

  • Lack of muscle coordination
  • Weakness in the arms or legs
  • Stiff, tight muscles
  • Delays in reaching typical motor skill milestones
  • Difficulty speaking or swallowing
  • Excessive drooling

In more severe cases, a child may have learning disabilities, seizures, or problems with the spine or joints.

 

Causes

Cerebral palsy occurs when the part of the brain that controls movement does not develop normally or becomes damaged. While it is usually congenital—meaning a child is born with it—some children develop it later in life.

Many times, the exact cause of cerebral palsy is unknown. It may happen when the mother has an infection or fever, or if the brain doesn’t form correctly. Low birth weight or premature birth can also increase the risk of a child developing cerebral palsy.

If a child develops CP after birth, it may be due to a brain infection like bacterial meningitis, or a head injury.

Diagnosis

A child with cerebral palsy is usually diagnosed within the first two years of her life. But if her symptoms are mild, she might not be diagnosed until she’s 4 or 5. On the other end of the spectrum, if her symptoms are very severe, she may be diagnosed right at birth.

Currently, there is no single test to diagnose or confirm cerebral palsy. Instead, a physician will observe, screen, and test a child at well-child visits to make sure she’s hitting growth and development milestones.

If she’s falling behind, her physician may order imaging tests (e.g. ultrasounds) or a blood draw to look for signs of cerebral palsy and rule out other conditions.

Prevention

If cerebral palsy is due to a congenital abnormality, it’s not preventable. However, it is possible to reduce the risk.

Premature birth is one of the major causes of cerebral palsy. Taking steps to stay healthy during pregnancy (e.g., avoiding alcohol and cigarettes, managing stress, getting prenatal care) may lower your risk of giving birth too soon.

It’s also important to use basic safety techniques—like car seats or helmets—to prevent a child from getting injured and developing cerebral palsy.   

The OIC Cerebral Palsy Team

If your child or family member is referred to OIC’s for cerebral palsy, you can expect your team to consist of the following:


The Pediatric Orthopaedist specializes in the musculoskeletal system of children. They manage the problems associated with spasticity and provide surgical interventions when necessary such as tendon lengthening or correcting a bony deformity.


The Pediatric Neurologist specializes in disorders of the brain, spinal cord, peripheral nerves and muscles in children. They focus on establishing the underlying cause of neurological disorders, including cerebral palsy and also treat the associated medical problems such as seizures, movement disorders, etc.


The Pediatric Urologist is a physician who specializes in the diagnosis and treatment of congenital and acquired urological conditions and diseases in children. The pediatric urologist at Orthopaedic Hospital provides medical management and surgical intervention for bowel and bladder function, one of the most persistent problems this patient population experiences.
 

The Pediatrician reviews medical issues and coordinates the general healthcare of the patient, in addition to working with the orthopaedic surgeon for pre-operative assessments if surgery is indicated and overseeing medical issues for hospitalized patients.

The Physical Therapist is a health care professional trained to assess and treat movement and function. They examine muscle range of motion, spasticity, strength and posture and assess their impact on function and mobility. Our physical therapists communicate with community therapists to help design and implement treatment interventions and equipment such as wheelchairs and braces. Gait studies at the Kameron Gait and Motion Analysis Laboratory are conducted by physical therapists.

The Occupational Therapist assesses and makes recommendations for treatment of fine and gross motor skills, feeding and oral-motor development, computer use, dressing, bathing and other activities of daily living. 

The Social Worker provides psychosocial assessments, assists with locating community resources and assists in the coordination of schooling and social activities. 


The Nurse Specialist assists in making sure all medical orders are carried out, and provides case management and nursing assessment for the patient. 

Also part of the core team is a registered dietician and orthotist. The dietician provides assistance in meal plans so patients receive adequate caloric intake for healthy growth and development. The orthotist works with the team to prevent unequal or unbalanced muscle groups which can lead to deformities as the child grows.