CEREBRAL PALSY

Cerebral palsy is a non-progressive neuromuscular disorder that results in mild to severe disabilities throughout life. This disease manifests itself as a group of persistent qualitative motor disorders that appear in young children due to brain damage during delivery or pathological conditions during intrauterine life. Neurological problems are multiple but not progressive in nature. Approximately 2 in 100 live births have this problem. There is no hereditary tendency for this condition.

Causes of Cerebral Palsy:

1) Injury to the brain during childbirth.

2) Complication of forceps delivery.

3) Lack of oxygen to the baby during delivery.

4) Infections during delivery.

Signs and symptoms of cerebral palsy: --

Signs and symptoms are not necessarily the same in all affected babies, and brain damage can be mild or severe.

Mild cases: - 20% of children have a mild disability.

Moderate cases: 50% of children have a moderate disability and need personal assistance to get around.

Severe cases: approximately 30% of affected children are totally incapacitated and bedridden and always require assistance from others.

Abnormalities seen in cerebral palsy

1. Abnormal neonatal reflexes.

2, Stiffness of all muscles with awkward movements.

3. Extension of the extremities during vertical suspension of the infant.

4) Scissoring of the lower limbs due to spasm of the adductor muscles of the thigh.

5,In severe cases, the back bends backwards like a vault.

6,May have total or partial paralysis.

7) Neurological and behavioral developmental arrest.

8,Swallowing may be difficult in some cases.

9,Drooling of saliva.

10,Mild to severe mental retardation.

11) Abnormal movements are observed in some cases.

12) Trembling with typical movements.

13) If the cerebellum is affected, there is a loss of muscle tone and difficulty walking.

14) Total or partial loss of hearing.

15) Speech may be affected.

16. Strabismus and other visual problems may be associated.

17) Seizures may be observed in some children.

Cerebral palsy is diagnosed by a detailed clinical examination and by ruling out other similar diseases such as brain tumor, progressive atrophy, etc. All investigations such as CT scan, MRI and routine examinations are necessary to exclude other diseases.

Management of cerebral palsy

General management:

It includes proper nutrition and personal care.  Symptomatic medications are needed to reduce seizures and muscle rigidity.  Diazepam may reduce spasticity and athetosis.

Dantrolene sodium helps relax skeletal muscles.

Physical therapy:

Massage, exercise, hydrotherapy, and others are needed. Special training is given to train walking, swallowing and speaking. Affected children are also trained to hold items for routine activities.

Rehabilitation:

Moral and social support must be given to these children. They should be sent to special schools where special training can be provided by qualified personnel. Children with mental retardation need special training. Depending on their disability, special instruments and machines are used for locomotion and to help them in their daily activities.

Occupational therapy:

It is provided by occupational therapists who train disabled people to do appropriate work so that they can have their own income.