Greetings All,
May's Informational Topic is Cerebral Palsy - I still don't have my new
computer and this e-mail program is driving me buggy!!
Brightest Blessings
Trisha
Definition
A group of disorders characterized by loss of movement
</health/Diseases_and_Conditions/Disease_Feed_Data/Muscle_function_loss/inde
x.html> or loss of other nerve functions. These disorders are caused by
injuries to the brain that occur during fetal development or near the time
of birth.
Causes, incidence, and risk factors
The incidence
</health/Diseases_and_Conditions/Disease_Feed_Data/Incidence/index.html> of
cerebral palsy is approximately 2 to 4 individuals for every 1000 births.
Cerebral palsy results from injury to the cerebrum (the largest portion of
the brain, involved with higher mental faculties, sensations, and voluntary
muscle
</health/Diseases_and_Conditions/Disease_Feed_Data/Muscle_spasms__cramps_/in
dex.html> activities).
Initially cerebral palsy was thought to be related to birth asphyxia and
trauma but in a study of 45,000 births it was shown that birth asphyxia is
an uncommon cause of cerebral palsy. The cause of hypoxia
</health/Diseases_and_Conditions/Disease_Feed_Data/Skin_discoloration__bluis
h/index.html> (low oxygen) to the damaged areas of the brain has not been
adequately made clear, but it is believed that there are predisposing
factors occurring during the development of the fetus that makes it more
susceptible to hypoxia. Premature infants have a slightly higher incidence
of cerebral palsy. Cerebral palsy may also occur during early infancy as a
result of cerebral injury caused by illnesses (encephalitis
</health/Diseases_and_Conditions/Disease_Feed_Data/Encephalitis/index.html>,
meningitis
</health/Diseases_and_Conditions/Disease_Feed_Data/Meningitis/index.html>,
herpes simplex
</health/Diseases_and_Conditions/Disease_Feed_Data/Herpes_simplex/index.html
> infections, and so on), head injury
</health/Diseases_and_Conditions/Disease_Feed_Data/Head_injury/index.html>
that results in subdural hematoma
</health/Diseases_and_Conditions/Disease_Feed_Data/Acute__subacute__subdural
_hematoma/index.html>, blood vessel injuries, and many others.
Injury to the cerebrum can result in the loss of nerve functions in widely
different areas. The classical finding of CP is spasticity
</health/Diseases_and_Conditions/Disease_Feed_Data/Spasticity/index.html>
(increased muscle tone) which may affect a single limb, one side of the body
(spastic hemiplegia), both legs (spastic diplegia) or both arms and legs
(spastic quadriplegia). In addition there may be partial or full loss of
movement
</health/Diseases_and_Conditions/Disease_Feed_Data/Muscle_function_loss/inde
x.html> (paralysis
</health/Diseases_and_Conditions/Disease_Feed_Data/Muscle_function_loss/inde
x.html>), sensory abnormalities, and defects of hearing and vision. Speech
abnormalities are common and seizures
</health/Diseases_and_Conditions/Disease_Feed_Data/Seizures/index.html> may
occur. Intellectual function may range from extremely bright normal to
severe mental retardation
</health/Diseases_and_Conditions/Disease_Feed_Data/Mental_retardation/index.
html>. Symptoms are usually evident before age 2 and in severe cases may
appear as early as three months. Cerebral palsy is a non-progressive type of
encephalopathy (injury to the brain) and symptoms directly resulting from
the disease do not worsen.
Classifications of cerebral palsy include spastic, dyskinetic, ataxic, and
mixed cerebral palsy. Spastic cerebral palsy includes about 50% of cases.
Dyskinetic (athetoid) cerebral palsy affects about 20%. It involves
development of abnormal movements (twisting, jerking, or other movements).
Ataxic cerebral palsy involves tremors
</health/Diseases_and_Conditions/Disease_Feed_Data/Tremor/index.html>,
unsteady gait
</health/Diseases_and_Conditions/Disease_Feed_Data/Walking_gait_abnormalitie
s/index.html>, loss of coordination
</health/Diseases_and_Conditions/Disease_Feed_Data/Movement__uncoordinated/i
ndex.html>, and abnormal movements. It affects about 10%. The remaining 20%
are classified as mixed, with any combination of symptoms.
Prevention
Adequate prenatal care may reduce the risk of some rare causes of cerebral
palsy, however, dramatic improvements over the last 15 years in obstetrical
care at delivery has not reduced the incidence
</health/Diseases_and_Conditions/Disease_Feed_Data/Incidence/index.html> of
cerebral palsy. In most cases, the injury causing the disorder may not be
preventable.
Symptoms
* seizures
</health/Diseases_and_Conditions/Disease_Feed_Data/Seizures/index.html>
* muscle contractions
</health/Diseases_and_Conditions/Disease_Feed_Data/Muscle_spasms__cramps_/in
dex.html>
* difficulty sucking or feeding
* irregular breathing
</health/Diseases_and_Conditions/Disease_Feed_Data/Breathing_difficulties___
first_aid/index.html>
* delayed development of motor skills, such as reaching, sitting,
rolling, crawling, walking, and so on
* motormental retardation
* mental retardation
</health/Diseases_and_Conditions/Disease_Feed_Data/Mental_retardation/index.
html>
* speech abnormalities (dysarthria
</health/Diseases_and_Conditions/Disease_Feed_Data/Speech_impairment/index.h
tml>)
* visual abnormalities
* hearing abnormalities
* spasticity
</health/Diseases_and_Conditions/Disease_Feed_Data/Spasticity/index.html>
* progressive joint contractures
</health/Diseases_and_Conditions/Disease_Feed_Data/Contracture_deformity/ind
ex.html>
* limited range of motion
</health/Diseases_and_Conditions/Disease_Feed_Data/Limited_range_of_motion/i
ndex.html>
* peg teeth
Signs and Tests
Examination indicates delayed development of motor skills in many cases.
Infantile reflexes (such as sucking and startle) may persist past the age
where they usually disappear. Muscle
</health/Diseases_and_Conditions/Disease_Feed_Data/Muscle_spasms__cramps_/in
dex.html> tremor
</health/Diseases_and_Conditions/Disease_Feed_Data/Tremor/index.html> or
spasticity
</health/Diseases_and_Conditions/Disease_Feed_Data/Spasticity/index.html>
may be evident, with a tendency of infants to tuck their arms in toward
their sides, scissors movements of the legs, or other abnormal movements.
Various laboratory tests may be performed to eliminate nutritional or other
causes of the symptoms.
* MRI of the head
</health/Diseases_and_Conditions/Disease_Feed_Data/Cranial_MRI/index.html>
demonstrates structural or congenital abnormalities
* CT scan of the head
</health/Diseases_and_Conditions/Disease_Feed_Data/Cranial_CT_scan/index.htm
l> demonstrates structural or congenital abnormalities
* hearing screen (to determine auditory status)
* visual testing (to determine visual status)
* EEG
</health/Diseases_and_Conditions/Disease_Feed_Data/EEG/index.html>
Treatment
There is no specific cure for cerebral palsy. The goal of treatment is to
maximize independence. Treatment is guided by the symptoms exhibited and may
include physical therapy, braces, appropriate glasses and hearing aids,
medications, special education or appropriate schooling, and, in severe
cases, institutionalization.
Mainstreaming in regular schools is advised unless physical disabilities or
mental development makes this impossible. Glasses, hearing aids, or other
equipment must be designed specifically for the particular disabilities and
may assist with communication and learning. Physical therapy, occupational
therapy, orthopedic intervention, or other treatments may be appropriate.
Medications may include muscle
</health/Diseases_and_Conditions/Disease_Feed_Data/Muscle_spasms__cramps_/in
dex.html> relaxants to reduce tremors
</health/Diseases_and_Conditions/Disease_Feed_Data/Tremor/index.html> and
spasticity
</health/Diseases_and_Conditions/Disease_Feed_Data/Spasticity/index.html>,
and anticonvulsants to prevent or reduce the frequency of seizures
</health/Diseases_and_Conditions/Disease_Feed_Data/Seizures/index.html>.
Surgery may be needed in some cases to release joint contractures
</health/Diseases_and_Conditions/Disease_Feed_Data/Contracture_deformity/ind
ex.html> which are a progressive problem associated with spasticity. Surgery
may also be necessary for placement of feeding tubes and to control
gastroesophageal reflux
</health/Diseases_and_Conditions/Disease_Feed_Data/Gastroesophageal_reflux_d
isease/index.html>.
The stress
</health/Diseases_and_Conditions/Disease_Feed_Data/Anxiety__stress__and_tens
ion/index.html> of coping with this disorder can often be helped by joining
a support group
</health/Diseases_and_Conditions/Disease_Feed_Data/Resources/index.html>
where members share common experiences and problems. See cerebral palsy -
support group
</health/Diseases_and_Conditions/Disease_Feed_Data/Cerebral_palsy___resource
s/index.html>.
Expectations (prognosis)
Cerebral palsy is a lifelong disorder. Long-term care may be required. The
disorder does not affect expected length of life. The extent of disability
varies.
Complications
* seizures
</health/Diseases_and_Conditions/Disease_Feed_Data/Seizures/index.html>
* injuries from falls
* reduced mobility
* reduced communication skills (sometimes)
* reduced intellect (sometimes)
Calling your health care provider
Call your health care provider if symptoms of cerebral palsy develop,
especially if you know that an injury occurred during birth or early
infancy.
Sites address and other sites
http://health.yahoo.com/health/Diseases_and_Conditions/Disease_Feed_Data/Cer
ebral_Palsy/
Cerebral Palsy and Spasticity -
http://www.miller-dwan.com/content/md.cerebalpal.html
The Godmother - http://www.the-godmother.com/
Cerebral Palsy - A multimedia tutorial for Children and Parents -
http://www.med.virginia.edu/cmc/tutorials/cp/cp.htm
Cerebral Palsy -- Hope Through Research -
http://www.ninds.nih.gov/patients/disorder/cp/cphtr.htm
The American Cerebral Palsy Information Center -
http://www.cerebralpalsy.org/
North American Growth In Cerebral Palsy Center -
http://www.people.virginia.edu/~mon-grow/
United States Cerebral Palsy Athletic Association (USCPAA)
<http://www.uscpaa.org/>
United Cerebral Palsy Employment and Training
<http://chicago.i-challenge.com/ucpa/>
American Academy for Cerebral Palsy and Developmental Medicine
<http://www.aacpdm.org>
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