Cerebral palsy is a term used to describe a group of chronic disorders impairing control of movement. The disorders appear in the first few years of life and generally do not worsen over time.
These disorders are not caused by problems in the muscles or nerves outside the brain. Instead, faulty development or damage to motor areas in the brain disrupts the brain’s ability to adequately control movement and posture.
Cerebral palsy is classified into four broad categories - spastic, athetoid, ataxic, and mixed forms - according to the type of movement disturbance.
1. Spastic cerebral palsy affects 70 to 80 percent of patients. In this form, the muscles are stiffly and permanently contracted. Doctors will often describe which type of spastic cerebral palsy a patient has based on which limbs are affected.
2. Athetoid or dyskinetic cerebral palsy is the form characterized by uncontrolled, slow, and writhing movements. These abnormal movements usually affect the hands, feet, arms, or legs and, in some cases, the muscles of the face and tongue, causing grimacing or drooling.
3. Ataxic cerebral palsy is a rare form that affects balance and coordination. Affected persons may walk unsteadily with a wide-based gait, placing their feet unusually far apart. It also can produce intention tremor.
4. Mixed forms of cerebral palsy exist in that it is common for patients to have more than one form of cerebral palsy. The most common combination includes spasticity and athetoid movements but other combinations are possible.
Cerebral palsy is not contagious, nor is it usually inherited from one generation to the next. At this time it cannot be cured, although there is research directed towards improving treatments and methods of prevention.
Cerebral palsy is caused by injuries, infections or other trauma to the brain when an infant is in utero, or at the time of birth.
Symptoms of cerebral palsy lie along a spectrum of varying severity. An individual with cerebral palsy may have difficulty with fine motor tasks, such as writing or cutting with scissors; experience trouble with maintaining balance and walking; or be affected by involuntary movements such as uncontrollable writhing motion of the hands or drooling.
The symptoms differ from one person to the next, and may even change over time in the individual. Some people with cerebral palsy are also affected by other medical disorders, including seizures or mental impairment.
Contrary to common belief, however, cerebral palsy does not always cause profound handicap. While a child with severe cerebral palsy might be unable to walk and need extensive, lifelong care, a child with mild cerebral palsy might be only slightly awkward and require no special assistance.
Although cerebral palsy cannot be cured, treatment can often improve a child’s capabilities. In fact, progress due to medical research now means that many patients can enjoy near-normal lives if their neurological symptoms are properly managed.
There is no standard therapy that works for all patients. Some approaches that can be included in a treatment plan are drugs to control seizures and muscle spasms, special braces to compensate for muscle imbalance, surgery, mechanical aids to help overcome impairments, counseling for emotional and psychological needs, and physical, occupational, speech, and behavioral therapy.
In general, the earlier treatment begins, the better chance a child has of overcoming developmental disabilities or learning new ways to accomplish difficult tasks.
What type of cerebral palsy does the child have?
To what extent can movement be improved?
What treatment approaches are there?
Will you prescribe drugs?
Do you recommend physical therapy?
What is the long-term outlook?