Cerebral palsy

Cerebral palsy (CP) is a group of disorders that affect a person's ability to move and maintain balance and posture. CP is the most common motor disability in childhood. Cerebral means pertaining to the brain. Palsy refers to weakness or problems using the muscles. CP is caused by abnormal brain development or damage to the developing brain that affects a person's ability to control their muscles.

CP symptoms vary from person to person. A person with severe CP may need to use special equipment to walk, or may not be able to walk at all and may need lifelong care. A person with mild CP may walk a little awkwardly, but may not need any special assistance. CP does not worsen over time, but the exact symptoms can change throughout a person's life.

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All people with CP have problems with movement and posture. Many also have related conditions such as intellectual disability; seizures; problems with vision, hearing or speech; changes in the spine (scoliosis); or joint problems (contractures).

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Types of Cerebral Palsy

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Doctors classify CP according to the main type of movement disorder involved. Depending on which areas of the brain are affected, one or more of the following movement disorders may occur:

• stiff muscles (spasticity)

• Uncontrollable movements (dyskinesia)

• Poor balance and coordination (ataxia)

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There are four main types of CP:

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Spastic Cerebral Palsy

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The most common type of CP is spastic CP. Spastic CP affects about 80% of people with CP.

Muscle tone is increased in people with spastic CP. This means their muscles are stiff and their movements may be awkward as a result. Spastic CP is usually defined by which parts of the body are affected:

• Spastic diplegia/dyparesis―In this type of CP, the muscle stiffness is mainly in the legs and the arms are less or not affected. People with spastic diplegia may have difficulty walking because tight hip and leg muscles cause their legs to pull together, turn inward, and cross the knees (also known as scissoring).

• Spastic hemiplegia/hemiparesis―This type of CP affects only one side of a person's body; usually the arm is more affected than the leg.

• Spastic quadriplegia/quadriparesis―Spastic quadriplegia is the most severe form of spastic CP and affects all four extremities, trunk, and face. People with spastic quadriparesis are often unable to walk and often have other developmental disabilities such as intellectual disability; seizures; or problems with vision, hearing, or speech.

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Dyskinetic Cerebral Palsy (includes athetoid, choreoathetoid, and dystonic cerebral palsy)

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People with dyskinetic CP have trouble controlling the movements of their hands, arms, feet, and legs, making it difficult to sit and walk. Movements are uncontrollable and can be slow and jerky or fast and jerky. Sometimes the face and tongue are affected and the person has difficulty in sucking, swallowing and speaking. The muscle tone of a person with dyskinetic CP may vary (ranging from very tight to very loose) not only from day to day, but even within a single day.

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Ataxic Cerebral Palsy

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People with ataxic CP have balance and coordination problems. They may be unstable while walking. They may have difficulty with fast movements or movements that require a lot of control, such as typing. They may have trouble controlling their hands or arms when they reach for something.

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Mixed Cerebral Palsy

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Some people have symptoms of more than one type of CP. The most common type of mixed CP is spastic-dyskinetic CP.

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Early Symptoms

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The symptoms of CP vary greatly because there are many different types and levels of disability. The main sign that a child may have CP is a delay in reaching motor or movement milestones (such as rolling over, sitting, standing, or walking). Below are some other signs of possible CP. It is important to note that some children without CP may also have some of these symptoms.

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In a Baby Under 6 Months

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• His head tenses when you lift him while lying on his back

• if hardness is felt

• When held supported in your arms, he seems to overextend his back and neck, acts as if he is constantly pulling away from you

• If you lift him, his legs stiffen and cross or shear

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In a Baby Over 6 Months

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• If it doesn't turn both ways

• If he can't get his hands together

• If he has trouble getting his hands to his mouth

• Reaching out with only one hand while holding the other fisted

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In a Baby Over 10 Months

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• Craws unsteadily by pushing with one hand and foot and dragging the opposite hand and leg.

• Crawls on hips or jumps on knees but cannot crawl on all fours.

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Scanning and Diagnosis

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Diagnosing CP at an early age is important for the well-being of children and their families. Diagnosing CP can take several steps:

Developmental Monitoring

Developmental monitoring (also called supervision) means monitoring a child's growth and development over time. If concerns are raised about the child's development during monitoring, developmental screening testing should be performed as soon as possible.

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Developmental Screening

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During developmental screening, a short test is done to see if the child has certain developmental delays, such as motor or movement delays. If the results of the screening test are alarming, the doctor will refer you for developmental and medical evaluations.

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Causes and Risk Factors

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CP is caused by abnormal development of the brain or damage to the developing brain that affects a child's ability to control their muscles. There are several possible causes of abnormal development or damage. People used to think that CP was mainly caused by a lack of oxygen during the birth process. Now he thinks it only causes a small number of CP cases.

The abnormal development of the brain, or the damage that leads to CP, can happen before, during, or within a month of birth, or during the first years of a child's life, while the brain is developing. SP due to abnormal development of the brain or damage that occurs before or during birth is called  congenital  SP. The majority of CP (85-90%) is congenital. In most cases, the specific cause is unknown. A small percentage of CP is due to abnormal development of the brain or damage that occurs 28 days after birth. This is called acquired CP and is usually associated with an infection (such as meningitis) or a head injury.

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