What Is Cerebral Palsy?  
Cerebral Palsy (CP) is a term used to describe a group of disorders affecting 
 body movement and muscle co-ordination. The medical definition of cerebral 
palsy  is a "non-progressive" but not unchanging disorder of movement and/or 
posture,  due to an insult to or anomaly of the developing brain. Development of 
the brain  starts in early pregnancy and continues until about age three. 
Damage to the  brain during this time may result in cerebral palsy.    
This damage interferes with messages from the brain to the body, and from the 
 body to the brain. The effects of cerebral palsy vary widely from individual 
to  individual. At its mildest, cerebral palsy may result in a slight 
awkwardness of  movement or hand control. At its most severe, CP may result in 
virtually no  muscle control, profoundly affecting movement and speech. Depending on 
which  areas of the brain have been damaged, one or more of the following may 
 occur:   
(1) muscle tightness or spasms  
(2) involuntary movement   
(3) difficulty with "gross motor skills" such as walking or running   
(4) difficulty with "fine motor skills" such as writing or doing up  buttons  
(5) difficulty in perception and sensation  

These effects may cause associated problems such as difficulties in feeding,  
poor bladder and bowel control, breathing problems, and pressure sores. The  
brain damage which caused cerebral palsy may also lead to other conditions 
such  as: seizures, learning disabilities or developmental delay. It is important 
to  remember that limbs affected by cerebral palsy are not paralysed and can 
feel  pain, heat, cold and pressure. It is also important to remember that the 
degree  of physical disability experienced by a person with cerebral palsy is 
not an  indication of his/her level of intelligence.    
Cerebral palsy is not a progressive condition - damage to the brain is a  
one-time event so it will not get worse - and people with cerebral palsy have a  
normal life-span. Although the condition is not progressive, the effects of CP 
 may change over time. Some may improve: for example, a child whose hands are 
 affected may be able to gain enough hand control to write and to dress  
him/herself. Others may get worse: tight muscles can cause problems in the hips  
and spine of growing children which require orthopaedic surgery; the aging  
process can be harder on bodies with abnormal posture or which have had little  
exercise.  
Medically it is important to remember that Cerebral Palsy: 
(1) is NOT contagious
(2) is NOT hereditary  
(3) is NOT  life-threatening

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Types of Cerebral Palsy 

(A) Classification By Number of Limbs Involved   
(1) Quadriplegia - all 4 limbs are involved.   
(2)  Diplegia - all four limbs are involved. Both legs are more severely  
affected than the arms.   
(3) Hemiplegia - one side of the  body is affected. The arm is usually more 
involved than the leg.    
(4) Triplegia - three limbs are involved, usually both arms and a  leg.   
(5) Monoplegia - only one limb is affected, usually  an arm.    
(B) Classification By Movement Disorder   
(1) Spastic CP- Spastic muscles are tight and stiff, and have  increased 
resistance to being stretched. They become overactive when used and  produce 
clumsy movements. Normal muscles work in pairs: when one group  contracts, the 
other group relaxes to allow free movement in the desired  direction. Spastic 
muscles become active together and block effective movement.  This muscular 
"tug-of-war" is called co-contraction.   
Spasticity may be mild and affect only a few movements, or severe and affect  
the whole body. The amount of spasticity usually changes over time. Therapy,  
surgery, drugs and adaptive equipment may help to control spasticity. Damage 
to  the brain's cerebral cortex is generally the cause of spastic cerebral  
palsy. 
(2) Athetoid CP- Athetosis leads to difficulty in controlling and  
co-ordinating movement. People with athetoid cerebral palsy have many  involuntary 
writhing movements and are constantly in motion. They often have  speech 
difficulties. Athetoid cerebral palsy results from damage to the basal  ganglia in the 
midbrain. It was once common as a result of blood type  incompatibility, but is 
now rarely seen.   
(3) Ataxic CP- Ataxic CP is the least common form of cerebral palsy.  People 
with ataxic CP have a disturbed sense of balance and depth perception.  They 
usually have poor muscle tone (hypotonic), a staggering walk and unsteady  
hands. Ataxia results from damage to the cerebellum, the brain's major centre  for 
balance and co-ordination.   
(C) Combined Classifications  
The classifications of movement disorder and number of limbs involved are  
usually combined (e.g. spastic diplegia). These technical words can be useful in 
 describing the type and extent of cerebral palsy, but they are only labels. 
A  label does not describe an individual.  
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Causes of Cerebral Palsy 
Any damage to the developing brain, whether caused by genetic or  
developmental disorders, injury or disease, may produce cerebral palsy.   
During pregnancy, anything which tends to produce a premature or low birth  
weight baby who is not developed enough to cope with the stresses of 
independent  life will increase the likelihood of cerebral palsy. Factors which may 
cause  cerebral palsy include:  
(1) multiple births (e.g. twins, triplets) 
<L1>(2) a damaged placenta  which may interfere with fetal gr   
<L1>(3) sexually  transmitted infectious diseases, e.g. AIDS, herpes, 
syphilis,  gonor 
<L1>(4) poor nutri 
<L1>(5) exposure to toxic  substances, including nicotine, alcohol and d   
<L1>(6) Rh  or A-B-O blood type incompatibility between mother and in    
<L1>(7) chromosome abnormali   
<L1>(8) biochemical  genetic disor   
<L1>(9) chance malformations of the baby's  b  
<L1>(10) a labour which is too long or too abrupt can cause  damage. Poor 
oxygen supply may destroy brain tis   
<L1>(11)  German measles during pregn
<L1>(12) small pelvic structure 
<L1>(13) premature deli
<L1>(14) caesarian or breech  deli
<L1>(15) effects of anesthetics, analges
In early childhood, cerebral palsy can occur if a young child's brain is  
damaged by:  
(1) infections such as meningitis
(2) brain haemorrhages 
<L1>(3)  head injury following falls, car accidents or ab
<L1>(4) drowning  accid
<L1>(5) poison
Some measures of prevention are possible today. Pregnant women are tested for 
 the Rh factor and, if Rh negative, they can be immunized within 72 hours of  
giving birth. This prevents any adverse consequences of blood incompatibility 
in  a subsequent pregnancy. Newborns with jaundice can be treated effectively 
with  phototherapy.   
Education programs stress the importance of optimal well-being prior to  
conception and adequate prenatal care. Safety campaigns give advice on  protecting 
children from accidents and injury. These measures have undoubtedly  
prevented many children from developing cerebral palsy.  
Diagnosis  
CAT scans (Computerized Axial Tonography) and MRI (Magnetic Resonance  
Imaging), can help identify lesions in the brain. This technology may enable  some 
children who are considered at risk of having cerebral palsy to be  diagnosed 
very early. However, for the majority of people with CP it will be  months, and 
sometimes years, before a diagnosis is confirmed. Many parents  report that 
this waiting period, when they know their child is not developing at  the same 
speed as her peers, but they do not yet know why, is particularly  stressful.  
 
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