CEREBRAL PALSY

This article comes here because I read an article which had been forwarded by my friend; it shows the some photos of a man attacked by Cerebral Palsy. So let us know the thing.

What is CEREBRAL PALSY

Cerebral Palsy is often referred to as CP. Damage to the muscles or nerves does not cause cerebral palsy, but damage to the motor area or improper development in the brain does. Development of the brain starts during pregnancy and continues till the age of three. When the brain is damaged or hurt during pregnancy, during birth or after birth of the baby, then cerebral palsy may result. We all know that the brain controls all our actions and hence the movements of the muscles. If the brain is injured or not properly developed, the messages which allow the child to walk, talk, stand, and sit are not properly conveyed and the child experiences difficulty in movement. Hence, the conditions could range from very slight awkwardness in movement or muscle control to total loss of muscle control. The muscles that are affected could be confined to one side of the body or the entire body. Muscles become stiff (spasticity) and reflex movements are absolutely uncontrolled. Unfortunately, the damage is permanent. There is no cure as such for cerebral palsy but Therapy and training can help the child to lead a better life. It is not a disease in the strict sense of the word and hence is not contagious or hereditary in nature. Although C.P. is a non-progressive condition ---that is the damage to the brain does not worsen with the passage of time, the effects of cerebral palsy may change. Body movement and muscle coordination may deteriorate with the aging process or in some cases the condition may actually improve. Cerebral Palsy need not necessarily incapacitate the child entirely. Since the learning and thinking centers are controlled by a different part of the brain, loss of motor control is not necessarily accompanied by a loss in thinking or the ability to learn. In fact many children with cerebral palsy have average intelligence. Depending on which areas of the brain have been damaged, the child will encounter muscle spasms, involuntary movement, difficulty with walking and running (gross motor skills), difficulty with writing (fine motor skills) or experience difficulty in perception and sensation and may have difficulty even in swallowing. Unfortunately the effects of cerebral palsy may bring along with it other associated problems which may lead to difficulties in feeding, developmental delay and seizures which are more difficult to handle. Spastic hemiplegia is said to occur when one side is affected---either the right or left side. In spastic quadriplegia all four limbs are affected and in paraplegia only the legs are affected. Children with cerebral palsy need special education from special schools, which focus on speech therapy, improvement of motor skills, and more importantly cater to their individual needs because no two children suffering from CP are alike. Symptoms of cerebral palsy Indications of cerebral palsy are often noticed first by the parents. These symptoms manifest usually before the child is 18 months old, but if it is a severe case of cerebral palsy, indications are visible even before three months. Motor skills may be affected to the extent that the common "developmental milestones" like sitting, crawling, rolling over, smiling and walking are all delayed. Some children are impassive; others do not react to noises while some children experience difficulty in following the movement of objects. Irregular breathing, difficulty in sucking and feeding and limited range of motion is also evident. A few children are mentally retarded while some have superior intellect. Because there is no control of the muscles in the throat and mouth, there could be an abnormality in speech. As the motor areas are most likely to be affected, even swallowing saliva could be very difficult. When swallowing is affected, eating is a problem and the risk of inhaling liquids into the lungs is great. Behavioral, learning and reading problems are also triggered off by cerebral palsy and the situation could become really difficult. Children tend to throw more tantrums than usual and could become violent and difficult to control. While motor movements are affected there could also be a loss in muscle tone. Hypotonia refers to loose and flaccid muscles while hypertonia refers to muscles that tend to become stiff and rigid. In both conditions, the muscles cannot be used optimally. Sometimes it is very hard to detect CP. The muscles on one side only may function so well that the defect on the other side goes unnoticed for a very long time. Walking on the toes could also be indicative of CP. Uncoordinated and uncontrolled jerky motions of limbs, clenched fists; unusual postures may also be seen. Changing from one position to another is also difficult for the child. In some cases, muscle tone is affected to such an extent that the feet are turned inwards while walking. Since the limbs cross at the knees, the gait is often referred to as "scissors gait". It is often found that the limbs are shorter on one side and non-intervention could lead to curvature of the spine itself. Difference in muscle tone on both sides could lead to unequal pressures on joints, which could later stiffen. Most children with cerebral palsy experience seizures, but these seizures are not evident because of so many other abnormalities. Defects in tooth enamel and an inability to brush their teeth properly make the children with cerebral palsy prone to dental cavities. Thus children suffering from cerebral palsy could have different symptoms. On an average it is seen that no two children experience the same symptoms. There is no cure for cerebral palsy, but with early detection of CP, it can be made more manageable. Causes of cerebral palsy As cerebral palsy is a consequence of damage to a developing brain, it can occur anytime during pregnancy, during labor, just before birth, during birth, in a newborn child or in early childhood. If the pregnant woman contracts rubella, herpes simplex, or other types of infection, it could affect the development of the fetal brain and cause cerebral palsy. Placental abnormalities could deprive the brain tissue of the much-needed oxygen for proper growth. Malnutrition deprives the fetus of the essential nutrients and the use of drugs, alcohol or tobacco could pose hazards to the fetal brain. Untreated high blood pressure and high blood sugar levels and blood type incompatibly are risk factors. Multiple births (twins or triplets) would mean that the weight of each infant is less and is more vulnerable. . During birth: Positioning of the baby in a breech or transverse manner which makes delivery difficult, small pelvic structure of the woman or the use of anesthetics and analgesics during birth, rupture of the amniotic membranes leading to infection, compression of the umbilical cord, untreated seizures, problems with the heart are all contributory factors. Children who do not cry within the first five minutes of birth or have to be kept on a ventilator for a few weeks are also prone to CP. In early childhood: CP may occur if the brain is damaged by meningitis, hemorrhages, head injuries resulting from accidents or falls, and asphyxia (lack of oxygen during drowning) or poisoning. These however are not the only causes of cerebral palsy. There are a number of cases where it is actually very difficult to determine the actual cause. Some children have congenital defects in the heart, kidney or spine and they are very vulnerable to Cerebral Palsy. Although we do know much about CP than we did a decade ago, it is not possible to identify a particular pattern of symptoms, which could result in CP. Cerebral palsy treatment There is no cure for cerebral palsy, as the damage to the brain cannot be reversed. What can be done however is that it can be managed. There are limitations to the amount of improvement that can be brought about, so the best thing that can be done is to teach children to achieve their maximum potential. This is easier said than done, for it requires patience on the part of the parents and children and the cooperation of doctors, nurses and therapists. Motivation is a key factor and this has got to stem from within. To make that happen there has to be external motivation. Play, outdoor games are an important factor which children enjoy. The dual benefit of learning and having fun at the same time can be achieved. Almost all cases of cerebral palsy require physiotherapy in some form or the other. The parts of the body that are not affected need to be exercised regularly to increase their function and the parts which are affected have to be exercised to optimize their functioning capacity. Vocation and occupational therapy have got to be an integrated part of any management program, for it caters to the daily needs of the individual. Brushing, dressing, practicing to hold objects, listening to music and nursery rhymes and doing daily chores help the children to have a sense of independence. Speech Language Therapy is essential for constructive communication. Where the muscles of the tongue, mouth and throat are affected, swallowing is a problem. Speech is also difficult. Speech therapy can help to make it less difficult. Educational Therapies In order to fit in with the real world, education in some form is a must. Conductive education focuses on all aspects of learning--- Developing motor skills, and acquiring social and emotional skills. The BOBATH therapy is aimed at optimizing co-coordinated movements. The FELDENKARAIS therapy is a form of somatic education that focuses on improving coordination between the muscles. Drugs are an inevitable part of managing cerebral palsy. They could be in the form of anticonvulsant drugs, muscle relaxants or anticholinergic drugs are used to control bladder movements. Acupressure, acupuncture and massage, help in controlling muscle spasms. When the child experiences difficulties because of muscle contractions, surgery may be resorted to. The nature of surgery would be to lengthen the tendons or to transfer tendons from one area to another. The elbows, backs of the heel or the shoulders are areas of the body where this procedure is done. In cases where the child cannot eat, liquid feeding tubes are inserted. As a prerequisite to treatment, prevention and early diagnosis are key factors that reduce the incidence of cerebral palsy. Nullifying Blood incompatibility in pregnant women, adequate prenatal care, treating jaundice in newborns with photo therapy and educating parents on protecting children from brain injury. CAT scans and MRI help to identify lesions in the brain of children and this helps to diagnose cerebral palsy early. In spite of doing all this, it takes months or years sometimes to diagnose a case of cerebral palsy.