What Is Cerebral Palsy?
Cerebral palsy is a term used to describe a group of chronic disorders impairing control of movement that appear in the first few years of life and generally do not worsen over time. The disorders are caused by faulty development of or damage to motor areas in the brain that disrupts the brain’s ability to control movement and posture. This damage can occur when there is trauma to the infant’s head during the birth process or severe asphyxia during the labor and delivery, but sometimes the cause of cerebral palsy is never known.
Symptoms of cerebral palsy include difficulty with fine motor tasks (such as writing or using scissors), difficulty maintaining balance or walking, and involuntary movements. The symptoms differ from person to person and may change over time. Some people with cerebral palsy are also affected by other medical disorders, including seizures or mental impairment, but cerebral palsy does not always cause profound handicap. Early signs of cerebral palsy usually appear before 3 years of age. Infants with cerebral palsy are frequently slow to reach developmental milestones such as learning to roll over, sit, crawl, smile, or walk. Cerebral palsy may be congenital or acquired after birth. Several of the causes of cerebral palsy that have been identified through research are preventable or treatable: head injury during labor or delivery, jaundice, Rh incompatibility, and rubella (German measles). Doctors diagnose cerebral palsy by testing motor skills and reflexes, looking into medical history, and employing a variety of specialized tests. Although its symptoms may change over time, cerebral palsy by definition is not progressive, so if a patient shows increased impairment, the problem may be something other than cerebral palsy.
Is there any treatment?
There is no standard therapy that works for all patients. Drugs can be used to control seizures and muscle spasms, special braces can compensate for muscle imbalance. Surgery, mechanical aids to help overcome impairments, counseling for emotional and psychological needs, and physical, occupational, speech, and behavioral therapy may be employed.
What is the outlook?
At this time, cerebral palsy cannot be cured, but due to medical research, many patients can enjoy near-normal lives if their neurological problems are properly managed.
What research is being done?
Research suggests that cerebral palsy results from incorrect cell development early in pregnancy. For example, a group of researchers has recently observed that more than one-third of children with cerebral palsy also have missing enamel on certain teeth. Scientists are also examining other eventsÑsuch as bleeding in the brain, seizures, and breathing and circulation problemsÑthat threaten the brain of a newborn baby. Some investigators are conducting studies to learn whether certain drugs can help prevent neonatal stroke, and other investigators are examining the causes of low birth-weight. Other scientists are exploring how brain insults (like brain damage from a shortage of oxygen or blood flow, bleeding in the brain, and seizures) can cause the abnormal release of brain chemicals and trigger brain disease.
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Newborns at Risk for Cerebral Palsy
Many children with cerebral palsy have a congenital malformation of the brain, meaning that the malformation existed at birth and was not caused by factors occurring during the birthing process. Prematurity and a low birth weight have been shown to be related to an increased incidence of specific disorders. Premature infants are at a much higher risk for developing cerebral palsy than full-term babies, and the risk increases as the birth weight decreases. Between 5 and 8 percent of infants weighing less than 1500 grams (3 pounds) at birth develop cerebral palsy, and infants weighing less than 1500 grams are 25 times more likely to develop cerebral palsy than infants who are born at full term weighing more than 2500 grams.
Many premature infants suffer bleeding within the brain, called intraventricular hemorrhages. This occurs most often in babies with the lowest weight: the problem is rare in babies who weigh more than 2000 grams (4 pounds). This bleeding may damage the part of the brain, called the white matter, that contains the “wires” that communicate signals between the different parts of the brain, so that a whole range of problems can develop in the child.
Some babies born after a full pregnancy can also develop bleeding inside the brain from overly rough handling of their heads during the birthing process.
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