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What is cerebral palsy?
Cerebral Palsy is considered a neurological disorder caused by a non-progressive brain injury or malformation that occurs while the child’s brain is under development. Cerebral Palsy primarily affects body movement and muscle coordination.
What Causes CP
In each child with cerebral palsy, the parts of the brain that are damaged are different. The causes are often difficult to find
Causes Before birth:
- Infections of the mother while she is pregnant. These include German measles and shingles (herpes zoster).
- Differences between the blood of mother and child (rh incompatibility)
- Problems of the mother, such as diabetes or toxemia of pregnancy.
- No cause can be found in about 30% of the children.
- Inherited. This is rare, but there is a ‘familial spastic paraplegia’.
Causes around the time of birth
- Lack of oxygen (air) at birth. The baby does not breathe soon enough and becomes blue and limp. In some areas, misuse of hormones (oxytocics) to speed up birth narrows the blood vessels in the womb so much that the baby does not get enough oxygen. In other cases, the baby may have the cord wrapped around her neck. The baby is born blue and limp—with brain damage.
- Birth injuries from difficult births. These are mostly large babies of mothers who are small or very young. The baby’s head may be pushed out of shape, blood vessels torn, and the brain damaged.
- Prematurity. Babies born before 9 months and who weigh under 2 kilos (5 pounds) are much more likely to have cerebral palsy. In rich countries, over half the cases of cerebral palsy happen in babies that are born early.
Causes after birth
- Very high fever due to infection or dehydration (water loss from diarrhea). It is more common in bottle-fed babies
- Brain infections (meningitis, encephalitis). There are many causes, including malaria and tuberculosis.
- Head injuries
- Lack of oxygen from drowning, gas poisoning, or other causes
- Poisoning from lead glazes on pottery, pesticides sprayed on crops, and other poisons.
- Bleeding or blood clots in the brain, often from unknown cause.
- Brain tumors. These cause progressive brain damage in which the signs are similar to cerebral palsy but steadily get worse
Is Cerebral Palsy Contagious?
No! It cannot be passed from one child to another.
Can persons with cerebral palsy marry and have children?
Yes. And the children will not have the condition (except maybe in a very rare type of cerebral palsy).
What medical or surgical treatment is there?
Except for drugs to control seizures, medicines usually do not help. (Although medicines to reduce spasticity are often prescribed, they usually do no good, and may cause problems.) Surgery is sometimes useful for correcting severe, stubborn contractures. However, surgery to weaken or release spastic muscles is less often effective and sometimes makes things worse. Careful evaluation is needed. Surgery usually should be considered only if the child is already walking and has increasing difficulty because of contractures. In a child who cannot balance well enough to stand, surgery usually will not help. Sometimes surgery to separate the legs can help make cleaning and bathing easier.
What can be done?
The damaged parts of the brain cannot be repaired, but often the child can learn to use the undamaged parts to do what she wants to do. It is important for parents to know more or less what to expect:
what can be done
Will my child ever be able to walk?
This is often one of the biggest concerns of parents. Walking is important both functionally and socially. But in terms of the child’s needs, other skills may be more important. For the child to lead as happy, independent a life as possible, necessary skills and accomplishments (in order of importance) are:
- Having confidence in yourself and liking yourself
- Communication and relationship with others
- Self-care activities such as eating, dressing, toileting
- Getting from place to place
- (And if possible) walking
We all need to realize that walking is not the most important skill a child needs and it is certainly not the first. Before a child can walk he needs reasonable head control, needs to be able to sit without help, and to be able to keep his balance while standing.
How can the health workers help?
Health workers look at:
- What the child can do
- What the child looks like when he moves and when he is in different positions
- what he cannot do, and what prevents him from doing it. what the child can do
What can the child do?
Can the child:
- Lift her head? hold it up? sit? roll over?
- Pull herself along the floor in any way possible? crawl? walk?
How does the child use her hands?
How much can the child do for herself?
- Can she grasp things and hold on; let go; use both hands together (or only one at a time)?
- Can she use her fingers to pick up small stones or pieces of food
- Can she feed herself; wash herself; dress herself? Is she ‘toilet trained’?
- After observing and discussing what the child can do, we must expect him to do these things. If the parents are used to doing almost everything for the child, at first this may be difficult (for both parents and child). But soon it will help the child have more confidence. The parents, also, will be encouraged by seeing what he can do for himself, and they will think less about what he cannot do.