Cerebral Palsy

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A cerebral palsy is a group of disorders that vary in severity and affect normal movement in different parts of the body. This condition can cause problems with posture, gait, muscle tone, and coordination of movement. The word “cerebral” refers to the brain’s cerebrum, which is the part of the brain that regulates motor function.

Palsy” describes the paralysis of voluntary movement in certain parts of the body. Depending on how the condition is managed, motor skills can improve or worsen over time. While symptoms and severity vary from case to case, there are many medical and support options to help patients diagnosed with this condition lead fulfilling lives.

Types of Cerebral Palsy

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Overall, there are four main types of cerebral palsy reflecting abnormalities in different parts of the brain and resulting in various kinds of symptoms:

 

Spastic cerebral palsy

Spastic cerebral palsy causes children to have exaggerated reflexes and stiff, sometimes painful muscles. The majority of children will experience some degree of difficulty walking, depending on the type and extent of spasticity they have. Spastic cerebral palsy is categorized into three different subtypes, including spastic diplegia, spastic hemiplegia, and spastic quadriplegia.

 

Dyskinetic cerebral palsy

Dyskinetic cerebral palsy is the second most common type of cerebral palsy after spastic forms. It is marked by abnormal movements in the arms, hands, and legs, making it difficult to control body movements and coordination. Children with this form of cerebral palsy can exhibit slow, writhing-type movements or quick, jerking movements. In turn, walking and sitting down can be difficult. Muscle tone can be variable and change from tight to loose from day to day. Many patients have trouble controlling their face and tongue movements, resulting in difficulties with speech. There are various types of movement disorders seen in dyskinetic palsy, such as dystonia, athetosis, and chorea. These movement disorders can exist together in different combinations, presenting issues with fine motor skills, including grasping small objects, as well as gross mother dysfunction.

 

Ataxic cerebral palsy

Children with ataxic cerebral palsy exhibit uncoordinated, jerky movements. This is the least common type of cerebral palsy. The movements are initiated by a voluntary effort, which then becomes interrupted and uncontrolled, causing a lack of balance or coordination. There can be difficulties in walking and writing due to instability, effects on speech, and swallowing, as well as eye movements.

 

Mixed cerebral palsy

Sometimes children develop a mix of the types of cerebral palsy. A combination of dyskinetic and spastic cerebral palsy is the most common, but children can create a blend of any cerebral palsy. Symptoms will depend on which types of cerebral palsy the child has. Mixed cerebral palsy can also result in additional associated medical problems and disorders. Some common symptoms and problems experienced by children diagnosed with mixed cerebral palsy include stiff muscles, cognitive issues, seizures, drooling, and vision problems.

Causes & Symptoms

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The cause of cerebral palsy is a brain injury or brain malformation that occurs while the brain is developing (before, during, or after birth). As a result of brain damage during brain development, a child’s muscle control, muscle coordination, muscle tone, reflex, posture, and balance can all be affected. It can also impact a child’s fine motor skills, gross motor skills, and oral motor functioning.

Who gets Cerebral Palsy?

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There are several amounts of risk factors that are associated with an increased risk of developing cerebral palsy. Certain infections or toxic exposures during pregnancy can increase cerebral palsy risk to the newborn child.

Inflammation triggered by infection or fever can damage the unborn child’s brain. Some of these infections include herpes, syphilis, zika virus, German measles, and toxoplasmosis. Illness is another factor that can increase the risk of having cerebral palsy, including:

 

  • Viral encephalitis – This viral infection similarly causes inflammation in the membranes surrounding the brain and spinal cord.

 

  • Bacterial meningitis – This bacterial infection causes inflammation in the membranes surrounding the brain and spinal cord.

 

  • Severe/untreated jaundice – This infection appears as a yellowing of the skin. The condition occurs when certain byproducts of used blood cells are not filtered from the bloodstream.

 

  • Bleeding in the brain – This condition is commonly caused by the baby having a stroke in the womb or in early infancy.

 

Additional pregnancy and birth risk factors accompanied by cerebral palsy risks include the following below:

 

  • Low birth weight – Babies who weigh less than 5.5lbs are at a higher risk of developing cerebral palsy. This risk increases as birth weight suddenly drop.

 

  • Multiple babies – Cerebral palsy risk increases with the number of babies sharing the uterus. The risk also can be related to the likelihood of premature birth and low birth weight. If one or more of the babies die, the survivor’s risk of cerebral palsy increases.

 

  • Premature birth – Babies born prematurely are at higher risk of cerebral palsy. The earlier a newborn child is delivered, the larger the cerebral palsy risk.

How Does it Affect You? How Serious is it?

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Muscle weakness, muscle spasticity, and coordination problems can contribute to a number of complications either during childhood or in adulthood, including:

 

  • Contracture – Contracture is muscle tissue shortening due to severe muscle tightening that can be the result of spasticity. Contracture can inhibit bone growth, cause bones to bend, and result in joint deformities, dislocation, or partial dislocation. These can include hip dislocation, curvature of the spine (scoliosis), and other orthopedic deformities.

 

  • Mental health conditions – Patients with cerebral palsy might have mental health conditions, such as depression. Social isolation and the challenges of coping with disabilities can contribute to depression. Behavioral problems can also occur.

 

  • Malnutrition – Swallowing or feeding problems can make it difficult for someone who has cerebral palsy, particularly an infant, to get enough nutrition. This can impair growth and weaken bones. In severe cases, some children or adults need a feeding tube to get enough nutrition.

 

  • Osteoporosis – Fractures due to low bone density can result from several risk factors such as lack of mobility, inadequate nutrition, and anti-epileptic drug use.

 

  • Osteoarthritis – Pressure on joints or abnormal alignment of joints from muscle spasticity may lead to the early onset of this painful degenerative bone disease.

 

  • Other types of complications – These include sleep disorders, chronic pain, skin breakdown, intestinal problems, and issues with oral health.

 

Recommended Treatment & Rehabilitation

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During a diagnosis of cerebral palsy, doctors will first test reflexes, muscle tone, posture, coordination, and other factors, all of which can develop over months or even years. Primary care physicians may also want to order tests such as MRIs, cranial ultrasounds, or CT scans in order to obtain an image of the brain. Even once a diagnosis of cerebral palsy is made, parents may wish to seek a second opinion to rule out a misdiagnosis.

Medication may be used to treat some symptoms of cerebral palsy, including involuntary movement, seizures, and spasticity. Some common classes of medications for children living with cerebral palsy include:

 

  • Antidepressants (relieves symptoms of depression)

 

  • Anticonvulsants (suppresses neurons that cause seizures)

 

  • Muscle relaxants

 

  • Nerve blocks

 

  • Botox (treats spasticity)

 

  • Non-steroidal anti-inflammatory drugs (NSAIDs)

 

Medication may also be used to help treat secondary disorders caused by cerebral palsy such as incontinence, acid reflux, behavioral disorders, and more.

Generally, there are several different therapy options to help treat cerebral palsy symptoms, which include the following:

 

Occupational therapy

This helps children with cerebral palsy learn how to complete everyday tasks and activities by improving fine motor skills and cognitive ability.

 

Speech therapy

Speech therapy can help children to improve their communication and language skills. This type of therapy can give children the confidence to learn and socialize. Speech therapy can also help children who have difficulty eating and swallowing.

 

Alternative therapy

This helps children focus on themselves as an individual and lets them overcome physical and mental obstacles. Alternative therapy includes hippotherapy, muscle therapy, aquatic therapy, acupuncture, and more.

 

Physiotherapy

Muscle training and exercises can help your child’s strength, flexibility, balance, motor development, and mobility. You’ll also learn how to safely care for your child’s everyday needs at home, such as bathing and feeding your child. Your physiotherapist can provide guidance on how you can continue muscle training and exercise at home between therapy visits.

For the first 1-2 years after birth, both physical and occupational therapists work on issues such as head and trunk control, rolling, and grasping. Later, both types of therapists are involved in wheelchair assessments. Braces, splints, or other supportive devices might be recommended for your child to help with function, such as improved walking, and stretching stiff muscles.

 

Stretching

Stretching is one of the most important exercises for individuals with cerebral palsy. A muscle must stretch before it can strengthen. Stretching expands range of motion, reduces stiffness, lengthens tight muscles, and relieves pain. Therefore, here are some exercise examples, including:

 

Calf stretch

Many patients with cerebral palsy experience spasticity in their calves. This can pull the heels up and result in abnormal gait patterns like toe-walking. To lengthen tight calves, stand facing a wall and take a big step back with one leg. Adjust your legs so that the front leg is bent, and the heel of the back leg is raised. Lean your arms against the wall for stability and gently lower the hell. Hold for 20-30 seconds and then switch legs, repeating with 2 sets a day.

 

Hamstring stretch

Your hamstrings are muscles at the back of the thighs. These muscles oppose the quads, so they also need to be lengthened to allow for regular hip and knee movements. To stretch the hamstrings, sit on the floor with both legs straightened in front of you and lean your body forward in a pain-free range. Finally, hold for 30 seconds and repeat 2-3 times a day.

 

Quadricep stretch

Your quads are the muscles at the front of the thighs. When they get tight, your knees may start to turn inwards and contribute to abnormal gait patterns. To stretch your quads, sit on the floor with one leg bent back and the other out in front of you. Gently lean back until you feel the strain, but not enough pain. Lastly, hold for 20-30 seconds and then switch legs 2-3 times a day.

Alternative & Homeopathic Treatment

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Most home remedies can help relieve symptoms of cerebral palsy like pain, spasticity, and stress. Some of these homeopathic treatments are:

 

Essential oils

Essential oils are concentrated oils extracted from plants. They can be massaged into the skin or inhaled for therapeutic benefits. Aromatherapy helps stimulate the hypothalamus, which regulates hormones. Essential oils are definitely worth trying because they’re relatively affordable and have a very low risk of side effects. Some popular options include lavender oil and peppermint oil. Lavender oil is widely used for its calming, antidepressant, and pain-relieving properties. As for peppermint oil, this can help stimulate the brain to improve memory and concentration.

 

Diet

What you feed into your body plays a giant role in the way you feel and how your body functions. Many patients with cerebral palsy experience cognitive impairments and digestive problems. Therefore, foods high in omega-3 fatty acids like salmon and walnuts help promote healthy brain functionality.

 

Yoga

Yoga is an ideal exercise for individuals with cerebral palsy because it incorporates deep breathing, meditation, and body positioning into a single activity. Deep breathing helps ensure that ample amounts of oxygen are being delivered throughout the body, which helps promote healthy cellular functioning.

 

Cold and heat application

Cold inhibits spastic muscles, while heat relaxes them. Although the effects are short-lived, both cold therapy and heat therapy can help individuals with cerebral palsy manage their high muscle tone. Cold therapy is ideal for reducing swelling and inflammation. It causes the blood vessels to constrict, which reduces blood flow to the site of pain and helps numb the pain. In contrast, heat therapy is better for promoting circulation and soothing spastic muscles.

 

Epsom salts

Bathing in Epsom salts may help relieve the pain and inflammation caused by cerebral palsy. Epsom salt is also known as magnesium sulfate. Some studies show that pregnant women who were at risk of premature delivery that were given magnesium sulfate had significantly lower rates of giving birth to children with cerebral palsy than the group given the placebo.