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Cerebral Palsy

Cerebral Palsy in an extensive concept that represents a group of neurological disorders.

This is a state that continues throughout the patient's life and affects communications between the brain and the muscles. Impaired communications is denoted by a permanent lack of coordination between movement and balance.

What causes Cerebral Palsy:

In many cases the cause is unknown. The original disturbance is in abnormal brain development or in brain damage in the area that controls motor functioning.

The incidence of the phenomenon is 2 for every 1000 births. Cerebral palsy is more common among boys and in families with many children. Nevertheless, many risk factors in the development of cerebral palsy are indicated:

  • Premature birth.
  • Extremely low birth weight (this means, principally, babies whose birth weight is less than 1 kg.).
  • Viral infections.
  • Excessive use of chemical substances during pregnancy.
  • Infections
  • Cerebral bleeding
  • Injury
  • Birth complications

What is the clinical expression of Cerebral Palsy, what are the symptoms?

There are considerable differences between the different incidences. There may be a muscular weakness and reduced motor control or high muscular tension that is known also as "spasticity" of the limbs. Muscular rigidity may be expressed in stiffness of the legs and clenched fists. In medical literature it is customary to classify Cerebral Palsy according to sub-categories, on the basis of the child's motor functioning.

A. Spastic Diplegia – spastic movement of the arms or legs. (On occasion, this appears under the name Spastic Paraplegia.

B. Spastic Quadriplegia – spastic movement in all four limbs, arms and legs.

C. Spastic Hemiplegia – spasticity that affects half of the body (legs) or one side of the body (for example, the right arm and right leg).

D. Athetosis – rigid involuntary and unintentional movement.

Are there other or ancillary problems for children with Cerebral Palsy:

  • Convulsions
  • Sight, hearing and speech disorders
  • Learning difficulties and behavioral disorders
  • Mental retardation
  • Respiratory problems
  • Intestinal and bladder disorders.
  • Spinal curvature

In addition, it may be stated generally that babies with Cerebral Palsy undergo the customary stages of development very belatedly. Milestones such as turning from one side to another, sitting, crawling or walking are achieved much later. They also tend to maintain certain reflexes that are meant to disappear during early infancy. The symptoms of Cerebral Palsy often appear with illnesses or other disorders and therefore it is always worth consulting a pediatric specialist and obtaining his diagnosis rather than reaching conclusions alone.

How is Cerebral Palsy diagnosed.

The diagnosis is usually made on the basis of a physical examination, pre-birth history and the birth process. In order to diagnose Cerebral Palsy, the child should be at least 6 – 12 months old, the age at which most babies reach developmental milestones such as control of the hands and head and even walking.

Occasionally, the doctor will conduct some of the diagnostic tests that appear below:

A. Neurological test 0 (estimate of reflexes and cerebral – motor functions).

B. X –rays.

C. Electroencephalogram (EEG) - an examination of brain activity.

D. Various blood tests.

E. Occasionally in an ambulatory laboratory a test is conducted to assess the child's walking patterns.

F. MRI

G. CT

H. Genetic tests – diagnostic tests to assess the genetic tendency of the family.

I. Metabolism tests – diagnostic tests to ensure that there is no (total or partial) lack of specific enzymes (for example: amino- acids, vitamins, certain lacks ….) constituents that are essential for everyday bodily functioning.

Treating a child with Cerebral Palsy

Cerebral Palsy cannot be cured and it continues throughout life. Treatment focuses on increasing the child's ability at home and in the community, in preventing or reducing deformities. The doctor will prepare a program for therapy based on a number of considerations:

· The child's age, general health and medical history.

· The extent of the disease.

· The type of paralysis.

· The child's tolerance of medications, tests and treatment.

· The course of the disease.

· The opinion and preferences of the parents.

The most beneficial treatment will be achieved by a combination of a number of factors that provide treatment in the health services:

1. A pediatrician / family doctor.

2. An orthopedic surgeon: a surgeon who specializes in muscular, ligament, tendon and bone disorders.

3. A neurologist – a specialist in brain, spinal and nervous disorders.

4. A neuro – surgeon – a surgeon who specializes in brain and spinal surgical procedures.

5. An eye specialist.

6. A dentist.

7. A nurse.