One in two thousand people have cerebral palsy. No two cases are usually the same, and their consequences can range from mobility problems to mental retardation. Know how to approach it.
Cerebral palsy (CP) is a disorder in engine development, chronic and character not progressive, secondary brain injury, usually produced during the intrauterine growth. But it can also occur at the time of delivery (from lack of oxygen during the period of expulsion, for example) or during the first two years of the baby’s life while his brain is still developing (trauma, infection).
It is not a specific disease but a group of disorders with variable causes, presenting very mild or severe symptoms. The injuries typical of cerebral palsy translate into difficulty in controlling the motor system’s functions. The affected person may give spasms or muscle stiffness, involuntary movements, lack of coordination, or disorders in the body’s posture or mobility. Depending on the injury’s extent and location, there may be other problems such as mental retardation, speech or learning difficulties, or visual or hearing impairments.
It is estimated that two out of every thousand people have cerebral palsy, a percentage that rises to ten out of every thousand when it comes to premature babies or those with low birth weight. This prevalence remains stable in developed countries, but thanks to advances in treatment and care, those affected’ life expectancies have increased in recent years, thus increasing patients’ number.
Causes of cerebral palsy
In most cases, cerebral palsy injury occurs during pregnancy due to intrauterine infections, vascular processes, brain malformations, genetic causes, etc.
It has been shown that more than a third of affected children weighed less than 2.5 kg at birth. Hence, the probable cause in these cases is cerebral anoxia (lack of oxygen), usually complicated with internal bleeding, associated with prematurity and low weight. Trauma in childbirth is also a possible cause.
Less than 10% of cases are due to problems arising after the birth of the full-term baby, and possible causes include meningitis, encephalitis, severe infections, trauma, vascular accidents.
In some cases, the cause of cerebral palsy cannot be determined.
Symptoms of cerebral palsy
The symptoms of cerebral palsy vary significantly from one patient to another, so no two equal – cases are usually observed before two years of age. Affected children show delays in their ability to sit, turn, reach for an object, crawl, stand up. The clinical classification of patients with cerebral palsy is based on characteristics observed in affected children. Which are related to the type of predominant motor disorder and its extent and severity, the presence of other associated diseases (sensory, cognitive, behavioral disorders and epilepsy, mental retardation also be observed frequently), the causes of the injury, etc. Among the most common presentations:
Spastic cerebral palsy
As quadriplegia, diplegia, paraplegia, hemiplegia, and monoplegia, it is the most common form of paralysis, and the usual clinical manifestations are hyperexcitability and abnormal persistence of neonatal reflexes. These manifestations cause the fists to remain tightly closed. There are tonic neck reflexes, often maintained constantly, and extension postures when the child is held vertically (arched back, rigid extension, and internal rotation of the legs). Spasticity and stiffness become apparent as the patient grows older, often leading to abnormal limb posture and contractures.
In spastic quadriplegia, the most severe form, all four limbs are affected. The child has associated mental retardation (in more than 90% of cases) and frequent seizures.
N spastic diplegia, all four limbs are affected, although it is much more intense in the lower extremities. Intelligence is often average, but apraxia (inability to perform purposefully, learned, and familiar movements) makes learning difficult.
In spastic paraplegia, only the lower extremities are affected.
The spastic hemiplegia is manifested in the third of children diagnosed and affects one side of the body. Often there is homonymous hemianopia (partial or complete loss of vision of one half of the visual field in both eyes) and chemosensory deficit (lack of sensation in the affected half of the body). A limp is characteristic, and the arm’s posture is sustained flexion when the forearm is prone (showing the back of the hand) and the wrist is flexed.
The monoplejía is limited to one limb weakness. It is rare.