Cerebral Palsy

Cerebral Palsy

Introduction

CP or Cerebral palsy is a non-progressive group, with non-contagious state of motor causing physical disability in the process of human development, especially diversified areas in body movement. Cerebral is for cerebrum that gets affected of brain, and palsy on the other hand refers movement disorder. It is basically the damage of centre for motor control in the process of developing brain and is liable to happen during the phase of pregnancy, childbirth or the stage after birth till three years of age. According to the research led by Rosenbaum, et.al. (2007) cerebral palsy is liable to limit in terms of movement as well as cause for posture, added by sensation disturbances, depth perception and some other sight-based perceptual hurdle, mode of communication, impairments as in cognition as well as epilepsy as in some cases. All kinds of CP get accompanied by problems related to secondary musculoskeletal led through underlying disorder.

Various researches in the field of neonatology actually assist in reduce cerebral palsy among the newborn babies and increased survival of babies with least birth weights (Groch, 2007).

Cerebral Palsy and Nervous system

Very typical kinds of causes related to problems within intrauterine development (as for instance, radiation exposure, infection), asphyxia prior to birth, brain’s hypoxia and condition of birth trauma in the time of labor as well as delivery, added by perinatal complicacies in the time of childhood. It can also cause in case of multiple births. 40 to 50 percent of children with cerebral palsy, born prematurely. These infants are vulnerable as all their parts are not fully structured or developed, and so are with increased risk for hypoxic injury towards brain, manifesting CP. Interpreting problems are there to differentiate among cerebral palsy led by brain damage from inadequate oxygenation and cerebral palsy led by prenatal damage of brain leading to premature delivery (Hirsh, et.al., 2010).

After the phase of birth, there are some other causes that can lead towards the inclusion of toxins, poisoning, severe jaundice, physical injury of the brain, shaken mode of baby syndrome, instances of brain hypoxia (near drowning), and condition of encephalitis ormeningitis. Three very common causes related to asphyxia among young children can be noted as: choking over foreign objects like toys and food pieces, near drowning and poisoning. There still some structural anomalies of the brain like lissencephaly under clinical CP features (can be caused by damage of brain or for not having normal brain). Thus CP is not hereditary or genetic but is the result of chromosome disorders.

Cerebral Palsy: Diagnosis

CP can get diagnosed from physical examination or history of the respective patient. As it gets diagnosed, more diagnostic tests turn optional. American Academy of Neurology, 2004 researched over CT and imaging of MRI. According to them CT/MRI with neuroimaging gets warranted as the etiology in the cerebral palsy of the patient does not get established. MRI is more considered over CT, because of diagnostic yield and necessary safety as accompanied. Neuroimaging study considers abnormal timing in initial damage. MRI/CT can reveal treatable status like porencephaly, hydrocephalus, arteriovenous malformation, vermian tumor and hygromas, added by subdural hematomas (Kolawole, et. al., 1989). Moreover, study related to abnormal neuroimaging shows higher likelihood towards noted and co-orelated conditions, like mental retardation and epilepsy (Ashwal, et. al., 2004). The process of diagnosis of CP can be performed just after the birth of the child, yet in general get postponed till the child gets into the age line of 18 to 24 months, to evaluate determined functional status as well as symptoms of progression/regression.

Cerebral Palsy: Treatment

Any mode of treatment related to CP gets noted as a multi-dimensional process for the entire life. It concentrates over the maintenance of related conditions. To get diagnosed for CP, brain damage must remain as non-progressive and free of diseases. Manifestation of such damages change with the development of the body and brain. However, real damage of brain never increases. Treatment is for preventing brain damage from prohibiting all the healthy developments. Brain till the age of 8, is not in a concrete state of development and thus gets the capability to identify as well as reroute various signal paths that might get affected through initial trauma. Thus earlier treatments are more effective and successful (Reliability of the Diagnosis of Cerebral Palsy, 2003).

There are diversified therapies implemented under diversified manners at every stage of disability and remain vital for CP people. Earliest proven intervention takes place at the time of recovery of the infant in neonatal intensive care unit (or the NICU). Treatment can remain inclusive of therapies related to physical; occupational; speech; alleviate pain; drugs towards control of seizures or relax muscle spasms (as the baclofen, benzodiazepines and intrathecal phenol or the baclofen); whereby hyperbaric oxygen; implication of Botox towards the mode of relaxing contracting muscles; professional surgery for the correction of anatomical abnormalities or some sort of release of tight muscles; rolling walkers; inclusion of braces and some other orthotic devices; and aids for communication like computers with voice synthesizers. As for example, by using standing frame, there is the possibility to reduce spasticity added by the improvement of motion among those people who are at the state of CP and are dependent over wheelchairs (Taub, et. al., 2001). Still, the therapies are partially beneficial and cannot assure full recovery of the CP patient. Developments can be assured and a better life can be offered to the CP patient without dependence, but absolutely nomal conditions are yet to achieve.

Conclusion

Cerebral Palsy is not genetic and early treatments are very effective. However, it is ne3cessary to note that treatment gets symptomatic in general; and lay emphasis over the act of people in developing various motor skills and learn the way to compensate determined lack in them. CP people who cannot speak can be developed to remain augmentative as well as can be trained with alternative modes of communication systems like Blissymbols. CP thus needs primitive attention and exclusive assistance to offer the patient with a better life.

Sources

Ashwal S, Russman BS, Blasco PA et al. (2004). "Practice parameter: diagnostic assessment of the child with cerebral palsy: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society". Neurology 62 (6): 851–63.PMID 15037681.

Groch, J. (2007). "Medical news: Cerebral palsy rates decline in very low birthweight children". MedPage Today. MedPage Today. Retrieved 2013-04-01.

Hirsh, Adam T., Juan C. Gallegos, Kevin J. Gertz, Joyce M. Engel, and Mark P. Jensen. (2010) "Symptom Burden in Individuals with Cerebral Palsy." Journal of Rehabilitation Research & Development 47.9: 863-67. Academic Search Premier. Web. 13 Mar. 2013

Kolawole TM, Patel PJ, Mahdi AH (1989). "Computed tomographic (CT) scans in cerebral palsy (CP)". Pediatr Radiol 20 (1–2): 23–27. doi:10.1007/BF02010628. PMID 2602010.

Reliability of the Diagnosis of Cerebral Palsy, at Cerebral Palsy Research Foundation. Posted on 01 October 2003. http://www.cpirf.org/stories/1065 Retrieved 2013-04-01.

Rosenbaum, P; Paneth, N; Leviton, A; Goldstein, M; Bax, M; Damiano, D; Dan, B; Jacobsson, B (2007). "A report: The definition and classification of cerebral palsy April 2006". Developmental medicine and child neurology. Supplement 109: 8–14. doi:10.1111/j.1469-8749.2007.tb12610.x. PMID 17370477.

Taub, Edward; Ramey, S., De Luca, S., Echols, K. (2001). "Efficacy of Constraint-Induced Movement Therapy for Children With Cerebral Palsy With Asymmetric Motor Impairment".Pediatrics 113 (2): 305–312. doi:10.1542/peds.113.2.305. PMID 14754942.