Cerebral palsy is a collective concept. The whole group of motor disorders, arising in the perinatal period, is included into it. Such disorders are the consequences of wrong activity of brain centers, responsible for movement. The disease does not have hereditary roots; therefore, absolutely healthy parents can have a child with cerebral palsy. The given term paper will discuss the cerebral palsy disorder, its causes, symptoms, diagnostics and treatment.
Cerebral palsy is the state, characterized by the insufficient control of muscles, muscular spasticity, paralyzes and other neurologic disorders, which compose the consequence of a brain injury arising during pregnancy, childbirth or at younger children age. Cerebral palsy is not a disease and it does not progress. Brain sites, which control the movements of muscles, are especially vulnerable to the damage in premature born children and the children of the first year of life.
Cerebral palsy is met in 1-2 of 1000 children of the first year of life but is registered in prematurely born children. Also, the symptomatology of cerebral palsy can change in connection with age dynamics and complication by other diseases. Thus, there can be a false impression of the disease progress. Prevention of the secondary disorders is a recovery therapy (rehabilitation, drug or expeditious treatment, etc.) (Sankar Mundkur 866).
Seventy to 80 percent of cerebral palsy cases are acquired prenatally and from largely unknown causes. Birth complications, including asphyxia, are currently estimated to account for about 6 percent of patients with congenital cerebral palsy. Neonatal risk factors for cerebral palsy include birth after fewer than 32 weeks’ gestation, birth weight of less than 5 lb, 8 oz (2,500 g), intrauterine growth retardation, intracranial hemorrhage, and trauma (Krigger 91).
Etiology of Cerebral Palsy
Various injuries can cause cerebral palsy; however, the reason of the disease remains unclear. Around 10 – 15% of cases are connected with patrimonial injuries and insufficient supply of a brain with oxygen before, during and immediately after the birth. Prematurely born children are especially vulnerable to it partly because they have badly developed blood vessels of a brain, which cannot provide a brain with enough oxygen. A high content of bilirubin in the blood of newborn children can lead to kernicterus and a brain injury. However, jaundice of newborns can be easily recovered by modern means, which sufficiently decreases the quantity of kernicterus cases. In the first years of life, serious illnesses like meningitis, sepsis, a trauma and heavy dehydration can cause a brain injury. Such diseases are the possible reasons of a cerebral palsy (McLaughlin Walker 7). Thus, the main causes of cerebral palsy include:
- Prematurity. It is the most considerable risk factor, which causes a significant amount of cases;
- Fetus hypoxia. A chronic oxygen starvation in the pre-natal period breaks the formation of the nervous system structures;
- Viral pre-natal infections;
- Rhesus factor conflict of a mother and a child;
- Impact of exogenous toxic substances on fetus;
- Infections in the post-natal period. A number of infections affect nervous system and can provoke cerebral palsy;
- Brain injuries;
- Consequences of the wrong medical manipulations during childbirth (Sankar Mundkur 867).
The main signs of cerebral palsy include the disorders of the motor functions and muscular activity, coordination of movements, violations and a delay of psychomotor and speech development. It is impossible to recover from the cerebral palsy, but it is possible to rehabilitate and reach the greatest possible improvement of the health state.
Symptoms of Cerebral Palsy
Depending on the primary nature of a motive frustration, there are five forms of cerebral palsy:
- Double hemiplegia – motor disorders are presented by tetra paresis (restrictions of movements both in hands and legs). By its clinical manifestations, it is the most severe form of disease, characterized by the damage of big hemispheres;
- Spastic diplegia – motor disorders are presented by tetra paresis, but the tone of muscles is changed not by the rigidity type, but by spasticity. Hands are afflicted less than feet;
- Hyperkinetic form is characterized by the involuntary movements, which disturb performance of purposeful movements (walking, actions of hands, etc.);
- Atonic-astatic form is characterized by minimal palsies. The tone of muscles is qualified as hypotonia;
- Hemiparitic form is characterized by the damage of the same extremities. Hands are usually affected more than legs.
Diagnostics of Cerebral Palsy
The diagnostics of cerebral palsy is performed on the basis of the family anamnesis and the data of clinical examination. In the first months of life, cerebral palsy can be suspected at the absence or delay of the main unconditioned reflexes. Later, it can be revealed at the emergence of the mesencephalic postural reflexes, asymmetries of a muscular tone, its deviations from the physiological norm (muscular hypotonia or moderate hypertension), restriction of the volume of spontaneous movements, asymmetry of movements, a tremor of fingers, etc. Such signs and the burdened anamnesis of pregnancy (infection, intoxication, a Rhesus factor conflict of a mother and a fetus) are the risk factors of cerebral palsy development (McLaughlin Walker 8).
Cerebral palsy cannot be diagnosed in infancy. When such disorders as bad development of muscles, weakness, a muscular spasticity or lack of coordination of movements are noticed, a doctor checks a child for cerebral palsy or any other progressing diseases, which require urgent treatment. The definite kind of cerebral palsy cannot be diagnosed to 18 months. The laboratory researches do not diagnose cerebral palsy. However, in order to exclude the other diseases, doctors can prescribe blood tests, electric research of muscles, a biopsy of muscles and a computer tomography or magnetic and resonant brain tomography. Cerebral palsy is usually diagnosed after the first year of a child’s life, when motor, speech and psychological disorders become more distinct (Sankar Mundkur 866).
Moreover, it is necessary to differentiate cerebral palsy from hereditary diseases, chromosomal syndromes, tumors of a nervous system and neurological infections. At differential diagnostics, such factors as data of genealogical anamnesis, the course of pregnancy, age of patients, clinical symptomatology (nature of motive frustration and changes of a muscular tone), efficiency of therapy and the feature of its course should be taken into consideration.
Treatment of Cerebral Palsy
Treatment of the pathology is a lifelong multidimensional process directed at the maintenance and restoration of the disabled functions. In fact, there is no treatment for the disorder and the forecast of the disease development depends on its form. Disabled people suffering from cerebral palsy in many cases are capable of living a normal life in society, if parents take the necessary measures to rehabilitate a child at early stages, especially until 8 years. At this age, a brain actively develops and healthy departments can assume the performance of some lost or disabled functions. The earlier treatment and rehabilitation of cerebral palsy starts, the more successful the process will be.
The treatment of cerebral palsy has mainly symptomatic character and is focused at the development of motor skills, maximally available to a specific child. Therapy should be based on the following principles:
- Early beginning. The diagnosis and an initiation of treatment should be started in a maternity hospital;
- Staging. The stages of the specialized medical aid include maternity hospitals, sanatoriums, children’s homes, kindergartens, schools, boarding schools, medical centers, etc;
- Complexity and continuity. The common efforts of parents and doctors should provide the maximum recovery and correctional effect, which means the development of not only motor, but also speech, communicative and intellectual skills of a sick child. (McLaughlin Walker 10).
Complex treatment includes orthopedic actions, physical therapy, massage, logopedic therapy, medicamentous therapy and surgical interventions if necessary. A medicamentous therapy is prescribed for a brain stimulation and improvement of its metabolism, correction of disorders of a muscular tone, exchange processes in muscular tissues, decrease in intra cranial pressure and neuroreflex excitability (McLaughlin Walker 10).
To sum up, the given term paper discussed the causes, symptoms, diagnostics and treatment of cerebral palsy. If there are no severe intellectual and physical disorders, many children with cerebral palsy grow normally and regularly attend school. The other children need an active physical therapy and special training. Thus, their opportunities are strongly limited, as they demand a lifelong care and help. However, even in severe cases children need education and training.
Parents should understand a condition of their child and learn how to solve the arising problems. A child with cerebral palsy can reach maximum of the opportunities if parental care is combined with the help of public and private organizations, such as health care organizations and rehabilitation centers. The forecast depends on a kind of a cerebral palsy and its severity. More than 90% of children with cerebral palsy reach maturity. Only at the heaviest forms, when a child is not capable to self-service at all, life expectancy is significantly reduced.