It is a non-progressive a neuromuscular disorder causing mild to severe disabilities throughout life. This
condition is manifested as a group of persisting qualitative motor disorders that
appear in young children due to damage to the brain during delivery or due to
some pathological conditions in the intrauterine life. The neurological
problems are multiple but non-progressive. Approximately 2 per 100 live birth
is having this problem. This disease is having no hereditary tendency.
Causes of cerebral
palsy:
1) Injury to the brain
during delivery.
2) As a complication of
forceps delivery.
3) Lack of oxygen supply
to the baby during delivery.
4) Infections during
delivery.
Signs and symptoms of
cerebral palsy:--
The signs and symptoms
may not be similar in all babies affected. Depending upon the damage to the
brain there may be mild to severe lesions.
Mild cases:- 20% of children
will have mild disabilities.
Moderate cases:-50%
cases are having a moderate disability. The affected children require self-help
for assisting their impaired ambulation capacity.
Severe cases:-About 30%
of the affected children are incapacitated and bedridden and they always need
care from others.
Abnormal findings in
cerebral palsy:-
1. Abnormal neonatal reflexes.
2. Stiffness of all muscles with awkward motion.
3. Extention of extremities on the vertical suspension of the infant.
4. Scissoring of the lower limbs due to spasm of the adductor muscles
of the thigh.
5. In severe cases, the backbend backwards like and arch.
6. May have total or partial paralysis.
7. The arrest of neurological and behavioural development.
8. Swallowing may be difficult in some cases.
9. Drooling of saliva.
10.Mild
to severe mental retardations.
11.Abnormal
movements are seen in some cases.
12.Tremors
with typical movements.
13.If
the cerebellum is affected there will be loss of muscle tone with difficulty in
walking.
14.Complete
or partial loss of hearing.
15.Speech
may be affected.
16.Squint
and other visual problems may be associated.
. 17.Convulsions
may be seen in some children.
Cerebral palsy is
diagnosed by detailed clinical examination and by eliminating other similar
diseases like brain tumor, progressive atrophy, etc.All investigations like CT
scan, MRI and routine investigations are needed to rule out other diseases.
Management of cerebral
palsy:--
General management:
This includes proper
nutrition and personal care. Symptomatic
medicines are needed to reduce convulsions and muscle stiffness. Diazepam can
reduce spasticity and athetosis. Dantrolene sodium helps to relax skeletal muscles.
Physiotherapy:
Here massage, exercise,
hydrotherapy, etc are needed. Special training is given to train walking, swallowing
and talking. The affected children are also trained to hold articles for
routine activities.
Rehabilitation:
Moral and social support
should be given to these children. They should be sent to special schools where
special training can be given by trained staff. Mentally retarded children need
special training. Depending upon the disability special instruments and
machines are given for locomotion and to assist their day-to-day activities.
Occupational therapy:
This is given by
occupational therapists. They train disabled people to do some suitable works
so that these people can have their income.