Cerebral Palsy: An Overview and New Information about Cause

Cerebral palsy is an umbrella term that describes a group of disorders affecting the body’s ability to move. Cerebral palsy becomes apparent in the first few years of life and generally does not get worse over time. While cerebral palsy is characterized by an inability to move muscles, it’s not the muscles themselves that are damaged. It’s actually that motor areas of the brain are damaged, and this affects other areas of the body.

Symptoms of cerebral palsy can range from very mild to very severe. Mild symptoms could include having difficulty writing, using scissors or performing similar types of fine motor skills. Severe symptoms would include an inability to walk and a need for lifelong care.

Some people who have cerebral palsy also have other disorders, such as seizures, mental impairment and difficulty with speech and/or hearing. But these are not part of the cerebral palsy.

Often, when you use the term cerebral palsy, many people envision someone who is severely disabled, who perhaps is in a wheelchair and whose hands are constantly writhing. While this is true of the severe cases, many people who have cerebral palsy are simply slightly awkward. They generally do quite well with physical therapy, and are able to lead completely independent, normal lives.

When is cerebral usually detected?
Cerebral palsy begins to be noticeable when a baby or toddler doesn’t reach certain developmental milestones, such as rolling over, sitting up, crawling or walking. To make a diagnosis, doctors evaluate the baby’s muscle tone, which may be floppy or stiff, and the baby’s reflexes. They also take a thorough medical history to determine whether there could be another reason for the developmental problems. They also often perform brain imaging tests.

Treatment
Treatment for cerebral palsy usually begins right after diagnosis. A team of professionals designs an individualized treatment plan that helps children to reach their own potential. This includes occupational therapy, physical therapy, drug therapy when beneficial, surgery when necessary, speech therapy and other types of therapies. People with cerebral palsy also have a variety of mechanical aids available to them, such as walkers, positioning devices, special wheelchairs and scooters. Additionally, many people with cerebral palsy benefit from the use of computers to help them in a wide range of ways.

What are the causes?
For many years, doctors have believed that oxygen deprivation (called “hypoxia”) was the main cause of cerebral palsy in premature infants. But a new study indicates that infection is probably the cause of many more cases of cerebral palsy than previously thought.

In the study, researchers compared premature infants who had a specific type of damage to the white matter of their brains (the damage is called PVL) and compared them to premature babies who did not have brain damage. Results showed that oxygen deprivation was no more common in the babies with PVL than it was in the babies who did not have brain damage. The main difference between the two groups of preemies was that the ones with PVL had suffered many different types of infections.

Can you prevent these infections?
In some cases, there’s nothing a pregnant woman can do to prevent cerebral palsy in her child. But women should talk to their doctors about ways they can do their best to prevent infections during pregnancy. For example, if you’ve never had German measles and you’ve never had a vaccine for it, it’s a good idea to get vaccinated before getting pregnant. If you have a cat, especially one that goes outdoors a lot, get someone else to clean the litter box. You can contract an infection called toxoplasmosis from the feces of cats.

In general, you should work with your doctor to have a pregnancy that’s as healthy as possible. Eat well, avoid alcohol and drug abuse and have regular prenatal visits. That’s actually the best way to avoid many complications of pregnancy, not just cerebral palsy.

Source:
The American Journal of Obstetrics and Gynecology, October 2204; The March of Dimes; National Institute of Neurological Disorders and Stroke; United Cerebral Palsy