Cerebral palsy is a term used to describe a group of chronic conditions affecting body movement and muscle coordination. It is caused by damage to one or more specific areas of the brain, usually occurring during fetal development; before, during, or shortly after birth; or during infancy.
Thus, these disorders are not caused by problems in the muscles or nerves.
Instead, faulty development or damage to motor areas in the brain disrupt the brain's ability
to adequately control movement and posture.

Although cerebral palsy is not "curable" in the accepted sense, training and therapy
can help improve function.

Cerebral palsy (CP) is latin and it means paralyzation through brain damage.
It is the most common reason for child-disability.
Out of the 100 000 children born in Sweden every year, 200 have CP.

"Cerebral" refers to the brain and "palsy" to muscle weakness/poor control.
Cerebral palsy itself is not progressive (i.e. brain damage does not get worse);
however, secondary conditions, such as muscle spasticity,
can develop which may get better over time, get worse, or remain the same.
Cerebral palsy is not communicable.

It is not a disease and should not be referred to as such.

 Symptoms

Cerebral palsy is caused by faulty development of, or damage to, motor areas in the brain that disrupts the brain's ability to control movement and posture. Symptoms of cerebral palsy include difficulty with fine motor tasks (such as writing or using scissors), difficulty maintaining balance
or walking, involuntary movements.

The symptoms differ from person to person and may change over time. Some people with cerebral palsy are also affected by other medical disorders, but cerebral palsy does not always cause
profound problems. Early signs of cerebral palsy usually appear before 3 years of age. Infants with cerebral palsy are frequently slow to reach developmental milestones such as learning to roll over, sit, crawl, smile, or walk. Cerebral palsy may be congenital or acquired after birth.

Many different reasons for the damage

It can be because the mother has been ill during pregnancy. She may have had a virus of some kind,
an interrupion in her metabolism or a heart condition.

More than half of all CP injuries arise during labour. the most common reasons are haemorrhage, asphyxia or premature birth. Since the 70's CP has increased because more premature children
can be saved.

Congenital cerebral palsy, results from brain injury during intra-uterine life. It is present at birth, although it may not be detected for months. It is responsible for about 70% of children who have cerebral palsy. An additional 20 % are diagnosed with congenital cerebral palsy due to a brain injury during the birthing process. In most cases, the cause of congenital cerebral palsy is unknown.

On the other hand, in the United States, about 10 percent of children who have cerebral palsy
acquire the disorder after birth. (The figures are higher in underdeveloped countries.) Acquired cerebral palsy results from brain damage in the first few months or years of life and can follow brain infections, such as bacterial meningitis or viral encephalitis, or the results of head injury
-- most often from a motor vehicle accident, a fall, or child abuse.

Are there different types of cerebral palsy?

Yes. Spastic diplegia, is only one of several disorders called cerebral palsy. Today doctors classify cerebral palsy into three principal categories—spastic, athetoid, and ataxic,—according to the type
of movement disturbance. A fourth category can be a mixture of these types for any individual.

Spastic cerebral palsy. In this form of cerebral palsy, which affects 70 to 80 percent of patients,
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, i.e spastic diplegia (both legs) or left hemi-paresis (the left side of the body). The names given to these types combine a Latin description of affected limbs with the term plegia or paresis, meaning paralyzed or weak. In some cases, spastic cerebral palsy follows a period of poor muscle tone (hypotonia) in the young infant.

Athetoid, or dyskinetic cerebral palsy. This form of cerebral palsy is characterized by uncontrolled, slow, 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. The
movements often increase during periods of emotional stress and disappear during sleep. Patients may also have problems coordinating the muscle movements needed for speech, a condition
known as dysarthria. Athetoid cerebral palsy affects about 10 to 20 percent of patients.

Ataxic cerebral palsy. This rare form affects the sense of balance and depth perception. Affected persons often have poor coordination; walk unsteadily with a wide-based gait, placing their feet unusually far apart; and experience difficulty when attempting quick or precise movements,
such as writing or buttoning a shirt. They may also have intention tremor. In this form of tremor, beginning a voluntary movement, such as reaching for a book, causes a trembling that affects the body part being used and that worsens as the individual gets nearer to the desired object.
The ataxic form affects an estimated 5 to 10 percent of cerebral palsy patients.

Mixed forms. It is not unusual for patients to have symptoms of more than one of the previous
three forms. The most common mixed form includes spasticity and athetoid movements
but other combinations are also possible.

What are the early signs?

Early signs of cerebral palsy usually appear before 18 months of age, and parents are often the first
to suspect that their infant is not developing motor skills normally. Infants with cerebral palsy are frequently slow to reach developmental milestones, such as learning to roll over, sit, crawl, smile,
or walk. This is sometimes called developmental delay.

Some affected children have abnormal muscle tone. Decreased muscle tone is called hypotonia;
the baby may seem flaccid and relaxed, even floppy. Increased muscle tone is called hypertonia,
and the baby may seem stiff or rigid. In some cases, the baby has an early period of hypotonia that progresses to hypertonia after the first 2 to 3 months of life. Affected children may also have
unusual posture or favor one side of their body.

Parents who are concerned about their baby's development for any reason should contact their physician, who can help distinguish normal variation in development from a developmental disorder.

How is cerebral palsy diagnosed?

Doctors diagnose cerebral palsy by testing an infant's motor skills and looking carefully at the mother’s and infant's medical history. In addition to checking for those symptoms described above
-- slow development, abnormal muscle tone, and unusual posture --
a physician also tests the infant's reflexes and looks for early development of hand preference,
hearing and sight is also checked.

Can cerebral palsy be treated?

"Management" is a better word than "treatment." Management consists of helping the child achieve maximum potential in growth and development. This should be started as early as possible with identification of the very young child who may have a developmental brain disorder.
A management program can then be started promptly wherein programs, physicians, therapists, educators, nurses, social workers, and other professionals assist the family as well as the child.
Certain medications, surgery, and braces may be used to improve nerve and muscle coordination
and prevent or minimize dysfunction.

As individuals mature, they may require support services such as personal assistance services, continuing therapy, educational and vocational training, independent living services, counseling, transportation, recreation/leisure programs, and employment opportunities, all essential to the developing adult. People with cerebral palsy can go to school, have jobs, get married, raise families, and live in homes of their own. Most of all people with cerebral palsy need the opportunity for independence and full inclusion in our society.

Facts and info from UCP

Useful links if you want to learn more
Cerebral Palsy - A guide for care
NINDS - National Institute for Neurological Disorders and Stroke
4MYCHILD
 
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