Cerebral palsy is a term used to describe a group of chronic conditions affecting body movement and muscle coordination. It is caused by damage to one or more specific areas of the brain, usually occurring during fetal development; before, during or shortly following birth; or during infancy. "Cerebral" refers to the brain and "palsy" to muscle weakness/poor control. Cerebral palsy itself is not progressive (i.e., it does not get worse); however, secondary conditions can develop which may get better over time, get worse, or remain the same. Cerebral palsy is not communicable. It is not a disease and should never be referred to as such. Although cerebral palsy is not "curable" in the accepted sense, training and therapy can help improve function. WHAT ARE THE EFFECTS?
Cerebral palsy is characterized by an inability to fully control motor function, particularly muscle control and coordination. Depending on which areas of the brain have been damaged, one or more of the following may occur: muscle tightness or spasm; involuntary movement; disturbance in gait and mobility. In addition, the following may also occur: abnormal sensation and perception; impairment of sight, hearing or speech; seizures; and mental retardation. Other problems that may arise are difficulties in feeding, bladder and bowel control, problems with breathing because of postural difficulties, skin disorders because of pressure sores, and learning disabilities.
WHAT ARE THE CAUSES?
A large number of factors which can injure the developing brain may produce cerebral palsy. One important cause is an insufficient amount of oxygen reaching the fetal or newborn brain. Oxygen supply can be interrupted by premature separation of the placenta from the wall of the uterus, awkward birth position of the baby, labor that is too long or too abrupt, or interference with circulation in the umbilical cord. Premature birth, low birth weight, RH or A-B-O blood type incompatibility between mother and infant, infection of the mother with German measles or other virus diseases in early pregnancy, and microorganisms that attack the infant's central nervous system also are risk factors for cerebral palsy. Most causes of cerebral palsy are related to the developmental and childbearing processes and, since the condition is not inherited, the condition is often called congenital cerebral palsy. A less common type is acquired cerebral palsy, usually occurring before two years of age. Head injury is the most frequent cause, usually the result of motor vehicle accidents, falls, or child abuse; another cause is brain infection.
ARE THERE DIFFERENT TYPES OF CEREBRAL PALSY?
spastic, dystonic, athetoid, choreiform, ataxic, and mixed
There are three main types: spastic -- stiff and difficult movement; athetoid -- involuntary and uncontrolled movement; ataxic -- disturbed sense of balance and depth perception. There may be a mixture of these types for any individual. Other types do occur, although infrequently.
HOW MANY PEOPLE HAVE CEREBRAL PALSY?
It is estimated that some 500,000 children and adults in the United States manifest one or more of the symptoms of cerebral palsy. Currently about 5,000 babies and infants are diagnosed with the condition each year. In addition, some 1,200 - 1,500 preschool age children annually are recognized to have cerebral palsy.
CAN CP BE PREVENTED?
No. The risk can be decreased by some of the things listed
below, but we still do not know what causes most CP, the problems with
blood supply to the fetal brain in the last trimester. Measures of prevention are increasingly possible today. Pregnant women are tested routinely for the Rh factor and, if Rh negative, they can be immunized within 72 hours after the birth (or after the pregnancy terminates) and thereby prevent adverse consequences of blood incompatibility in a subsequent pregnancy. If the woman has not been immunized, the consequences of blood incompatibility in the newborn can be prevented by exchange transfusion in the baby. If a newborn baby has jaundice, this can be treated by phototherapy in the hospital nursery. Other preventive programs are directed toward the prevention of
prematurely; reducing exposure of pregnant women to virus and other infections; unnecessary exposure to X-rays, drugs and medications; and the control of diabetes, anemia and other nutritional deficiencies. Of great importance are optimal well being prior to conception, adequate prenatal care, and protecting infants from accidents or injury.
CAN CEREBRAL PALSY BE TREATED?
"Management" is a better word than "treatment." Management consists of helping the child achieve maximum potential in growth and development. This should be started as early as possible with identification of the very young child who may have a developmental disorder. A management program can then be started promptly to include attention to the child's movement, learning, speech, hearing, and social and emotional development. In these programs, physicians, therapists, educators, nurses, social workers, and other professionals assist the family as well as the child. Certain medications, surgery, and braces may be used to improve nerve and muscle coordination and prevent dysfunction.
As individuals mature, they may require support services such as personal assistance services, continuing therapy, educational and vocational training, independent living services, counseling, transportation, recreation/leisure programs, and employment opportunities, all essential to the developing adult. People with cerebral palsy can go to school, have jobs, get married, raise families, and live in homes of their own. Most of all, people with cerebral palsy need the opportunity for independence and full inclusion in our society.
IS RESEARCH BEING DONE?
Yes. Active national programs of research are being vigorously pursued to prevent cerebral palsy and to improve the quality of life for persons with cerebral palsy. The two organizations with major research programs are the United Cerebral Palsy Research and Educational Foundation in the private sector and the National Institutes of Health in the government sector. The research questions being addressed include:
These questions
