Cerebral Palsy: Types, Causes, Signs, and Symptoms

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Cerebral Palsy is an umbrella term for a set of neurological disorders which generally motor functions and coordination. Cerebral Palsy literally means weakness in body movement due to issues in the brain. Globally, nearly 1-4 children in every 1000 children suffer from cerebral palsy (CP). In this content piece, we will look at the signs and symptoms of cerebral palsy, causes of cerebral palsy, and types of CP in an attempt to get a more wholesome answer to the question, what is cerebral palsy?

What is Cerebral Palsy

In 2012, Pediatrics published a study report by Novak I et al. the study at some point stated that as of 2012, 17 million people across the globe were living with cerebral palsy. The report further confirmed that nearly 350 million people in the world are associated with or related to persons living with CP. The report further suggested that a significant number of people living with CP also lived with some of the kind of comorbidity pertaining but not restricted to the ability to walk, talk, and so on. Cerebral Palsy is also known as a lifelong disability and so far it has no definite cure.

Different Types of Cerebral Palsy (CP):

Cerebral Palsy can affect several parts of the body in different ways. Thus, cerebral palsy is largely divided into two categories, the first is defined by the number of body parts CP affects, and the other describes the kind of disability CP causes.

  • Based on Number of Body Parts Affected:

Although people generally focus on the disability rather than the body part affected, it is necessary to understand this distinction if one wishes to get a wholesome picture of cerebral palsy related nomenclature:

1. Quadriplegia:

Under this kind of CP, a person’s limbs are affected and weakened, rendering them unable to move. Along with affecting all the limbs, the cerebral palsy also affects the face muscles, mouth and trunk. Such individuals are completely dependent on their caretakers for their daily chores.

2. Diplegia:

Diplegia is the kind of CP, where a person left immobile as his/her legs are weakened and unable to support them. Such individuals are generally confined to a wheelchair for a movement, however, diplegia may also affect the arms, although the degree of impact would be significantly lesser than quadriplegia.

3. Hemiplegia:

Hemiplegia is the condition where one side (leg, and arm) of a person’s body is rendered weakened, which means, a side of a person’s body suffers from movement disorders.

  • Based on the Type of Disability Caused:

CP affects different parts of the brain, which in turn can cause different kinds of movement disorders in an individual:

1. Ataxic Cerebral Palsy:

This is a rather uncommon form of Cerebral Palsy (CP). Persons suffering from Ataxic CP are unable to effectively regulate their voluntary movements, which often makes it look like their movements are off-beat or jerky. Such individuals have difficulty displaying regular motor functions like walking in a straight line or grasping things. They often seem clumsy to the people around them.

2. Dyskinetic Cerebral Palsy:

Also known as Athetoid Cerebral Palsy, this type of CP is known to cause involuntary, and abnormal body movements in the hands, arms, and legs. In some cases of dyskinetic cerebral palsy, the tongue and face are also affected, making the face spasm involuntary or making functions like swallowing and speaking difficult for a patient.

3. Spastic Cerebral Palsy:

With nearly 80% of cases of cerebral palsy being diagnosed as spastic cerebral palsy, one has to admit that this is the most common form of CP in the world. This kind affects the legs, making movement difficult, as it affects the muscles of the legs and sometimes arms, making the muscles stiff, leading to amplified reflexes.

4. Hypotonic Cerebral Palsy:

Hypotonic CP generally causes overly relaxed muscled, with poor muscle tone, giving limbs the limbs a kind of lose look, something akin to the limb not having a proper structure or bone support as the limb movement looks flappy. Babies with hypotonic CP, are not able to control their neck movements and may face problems in developing other motor skills.

5. Mixed Cerebral Palsy:

Some people with cerebral palsy show symptoms of suffering from more than one type of CP. Most commonly, some people show symptoms of both spastic and dyskinetic CP at the same time, such a type of CP is known as Mixed Cerebral Palsy.

Cerebral Palsy in Children:

Cerebral Palsy in Children

Cerebral Palsy in children is either present since birth or caused due to external factors within the first 5 years of the child. CP in children poses a challenge to their cognitive development. It also hampers their physical development and movement. CP in children can be caused because of several causes like:

  • Premature childbirth
  • Stroke in the mother’s womb
  • Brain injury
  • Lead poisoning
  • Meningitis
  • Genetic disorders
  • Shaken Baby Syndrome

Cerebral Palsy in children poses several challenges as it might be accompanied by other diseases which could negatively impact a developing brain. However, some children with brain damage induced cerebral palsy, face very little problems with cognitive and physical development, while others show delayed or extremely slow development, and this variation largely depends on the extent of brain damage a child has suffered. Brain damage induced CP can cause disabilities such as:

  • Problem with speech
  • Weakening of bones
  • Learning disabilities
  • Blindness or visual impairment
  • Deafness or hearing impairment

Children with cerebral palsy generally also suffer from seizures, as well as find communication challenging. Some children with CP end up needing constant support either through devices like wheelchairs or through therapy.

  • Teaching Children With Cerebral Palsy:

Teaching children with cerebral palsy may require an educator to make some extra arrangements, depending on the need of the child. However, some things like ease of access, the presence of well-placed ramps, accessible toilets, movement space in classrooms and so on should be a prerogative of every educational institution. Here is what you as an educator could do to help your ward:

  • Plan for extra time to allow students to finish their tasks
  • Encourage your student to be more independent.
  • Use more sensory forms of learning especially audio and video
  • Take pointers from the student’s therapist
  • Applaud all attempts at communication
  • Keep minimal sources of distraction in the classroom.

Cerebral Palsy In Adults:

People often forget that children with CP at some become adults with CP and while there is a wealth of literature and coping mechanisms for children suffering from Cerebral Palsy, there has traditionally been very little focus on adults with CP. In fact, the American Medical Association published the results of a study which conducted that by volume there are more adult persons with CP than children with CP. However, nearly every research ever conducted on CP confirms that very little data is available on adults suffering from the same ailment. Here a few things that we need to remember that as an individual ages the neurological damage becomes more pronounced, leading to ultimately confining the patient to a wheelchair, causing constant fatigue, leading to the rarely reported, unusual pain felt by them. CP also leads adults to age faster, along with other more damaging chronic diseases.

Signs & Symptoms of Cerebral Palsy (CP):

How do you identify if someone you care about has started showing early symptoms of cerebral palsy? In this section we will discuss the signs and symptoms of CP in children and adults:

  • Cerebral Palsy Symptoms In Babies:

How do you that a child is suffering from cerebral palsy? What are the key symptoms to look for in cases of CP? Here are a few tell tale signs of CP:

  • Low muscle build, the baby’s hands and legs would be floppy when you pick him/her up.
  • The baby finds it difficult to swallow or feed
  • Delayed development
  • If the baby has not started speaking by 24 months of age it may be a sign of CP
  • Bad posture or poor muscle control
  • Cerebral Palsy Symptoms In Adults:

Cerebral Palsy is a disease which is mostly unique to the individual, thus every individual shows a different set of signs and symptoms. Some common symptoms are:

  • Floppy or stiff muscles.
  • Spasticity i.e. stiff muscles and abnormal reflexes
  • Ataxia: A visible lack of or difficulty in muscle coordination.
  • Rigidity: Normal reflexes but stiff muscles.
  • Athetosis: abnormal contraction of muscles causing unintended and slow writhing movement.
  • Delayed motor skills development in babies, especially, if one looks at reaching developmental milestones.
  • Delayed development of speech.
  • Suffering from seizures.
  • Some individuals may indicate an increased preference for using one side of the body.

CP causing brain disorder doesn’t worsen with time, but muscle rigidity and shortness may worsen if not treated. This also means that the symptoms of CP may not worsen with age, however, with time, some brain abnormalities may crop up along with CP:

  • Vision impairment or hearing loss
  • Abnormal perceptions of pain or touch
  • Urinary Incontinence.

Cerebral Palsy Causes:

Cerebral Palsy is generally caused due to some disruptions in the development of the brain, either before or after a child is born. In most cases, no one knows what exactly triggers CP. However, here are a few probable causes and risks:

  • Genetic Mutation
  • Stroke suffered by the baby while inside the womb of the mother due to disruption in the supply of blood to the still developing brain
  • Infections among infants which cause inflammation of the brain like meningitis, brain fever and so on.
  • Asphyxiation during birth
  • Infections suffered by the mother which may hamper the health of the baby
  • Head injury to the infant
  • Aggressive shaking
  • Mother and fetus’ Rh factors are not compatible leading to complications
  • Premature delivery

Cerebral Palsy Treatment:

As we have stated before, CP is largely an individual disease. Thus, treatment is largely dependent on the individual and the type of CP he/she is facing along with the body parts that are affected. Since CP is also irreversible, doctors create individual treatment plans, the following are some general aims and processes of the treatment.

Medications:

Some medicines help certain patients with controlling symptoms like seizures, muscle spasms, and uncontrolled movements. It should be remembered that while medicines may help some patients, they may not be suitable for others who would have to opt for other treatment methods.

Surgery:

Most patients generally opt for surgery only pertaining to the upper parts of their body like arms or shoulders. Undergoing surgery may help some children gain more muscle and limb control, flexibility as well as reduce spasms. However, it should be remembered that surgery may not suit every child who suffers from CP. It is also important to remember that children can also opt for surgery for other parts of their bodies like hips, wrists, muscles, tendons, nerves, legs, or shoulders. Patients undergoing surgery also have to undergo post surgery physical therapy. Sometimes, patients undergoing surgery are unable to continue with physical therapy, the approach depends on the healthcare provider as well as the patient.

Parents or caregivers should remember that a doctor would suggest surgery only if its benefits are much more than all potential and real setbacks. They should also remember that surgery is not a one-stop solution, and the patient will need further support.

Complementary and Alternative Medicine:

Complementary and Alternative medicine is a more holistic approach to treating CP. It is not invasive as medicines or surgeries. There are several therapies under alternative medicines that one could opt for, here are some popular examples:

Water Therapy: To help increase more muscle control, improve muscle health and tone as well as physical function.

Movement Therapy: The movement therapy focuses on helping with body movement and physical balance.

Mind and Body Therapy: The focus is on acupuncture, massage, yoga and more for physical control and better muscle health.

Stem Cell Therapy For Cerebral Palsy:

There are several researchers who are currently looking into understanding how stem cell therapy can help patients with CP. Researchers believe that brain stem cell therapy or treatment may help reverse some brain abnormality. This treatment can be carried out either via transplanting some brain cells or by medicines which could repair and activate brains cells to function normally. However, very little research has been conducted to successfully prove these theories. One of the biggest hurdles is that CP is a disease which is unique to each patient, which means a standard neural cell transplant or medicines to activate only certain types of brain cells may not be much helpful. The other drawback being that the brain is a highly specialised and specific organ, which means that every nerve cell which is being touched needs to be connected and worked upon in a precise manner.

Cerebral Palsy Life Expectancy:

There have been no studies to ascertain the average life expectancy of persons suffering from CP. However, depending on the severity of CP, a person can be expected to live anywhere between the age of 30- 70 years. Life expectancy is also dependent on the quality of treatment a patient receives. Generally, people with severe symptoms have lesser life expectancy.

Effects of Cerebral Palsy:

Cerebral Palsy can have severe effects on the normal functioning of a person’s life. Here are some ways in which CP affects development of a person:

  • Effects Of Cerebral Palsy on Learning:

Cerebral Palsy can affect learning, depending on its severity. Children who suffer from mild symptoms of CP are able to learn and reach milestones either in time or within an acceptable limit of delay. However, children who suffer from extreme symptoms may struggle with learning and reaching milestones.

  • Effects Of Cerebral Palsy On The Body:

Cerebral Palsy mostly affects muscle movement and health as well as motor skills. This means, that in extreme cases a person is not only unable to move, they are also unable to breathe and swallow or even speak. This makes them perpetually dependant on their caretakers. However, others may only suffer from the inability to move or speak or may even show milder symptoms which are manageable.

  • Co-Occurring Disorders:

Cerebral Palsy is not an aggressive disease, it does not escalate with time, however, there could be a host of disease which can occur along with it or is inevitably caused by it. These co-occurring disease may, in turn, be fatal or aggressive.  Here are some examples of Co-occurring diseases:

    • Immobilization
    • Bones Weakness
    • Behavioral Issues
    • Abdominal Pain
    • Yeast Infection
    • Deformities
    • Constipation
    • Undernourishment

Celebrities With Cerebral Palsy (CP):

There have been several celebrities who also live with CP. Here are a few famous people who are open about their condition and thriving:

1. RJ Mitte:

RJ Mitte is famous for his work in the TV series Breaking Bad where he plays the role of Walter “Flynn” White Jr., who also suffers from CP. RJ Mitte was diagnosed with CP at the age of 3 and even had to depend on leg braces and crutches till his teens, however, regular exercise and physical therapy have helped the actor extremely well, as today, he is also a model. Mitte has been very vocal about fighting for the rights of persons with disability, including asking fashion brands to create clothes which accommodate disabilities. He is also very vocal about creating awareness about CP.

2. Jhamak Ghimire:

Jhamak Ghimire is the voiceless woman with a voice which stands for children and women. Jhamak Ghimere can only use her left foot to type and type she does, she is columnist in a Nepali newspaper, as well as, the author of a novel Jiwan Kada Ki Phool, which is her autobiography. She also won the Madan Puraskar for this book. Interestingly, Jhamak Ghimere cannot speak and is completely self taught.

 

News on Cerebral Palsy:

Cerebral Palsy Patients May Be Troubled By Heart Diseases:

– 10th Oct 2018

According to a study published in Developmental Medicine and Child Neurology, Cerebral Palsy may cause Cardiovascular diseases in adults. Although CP mostly starts in childhood and affects muscle movement and motor skills, however, this recent study has revealed that CP can also lead to CVD in adults. Researchers from McMaster University, Ontario, who conducted this research project, conducted a very thorough research with participants aging above the age of 18 years. 19 studies were reviewed under the criteria set by the team of researchers. One study stated, that there were more instances of adults suffering from CVD who were also suffering from CP. In fact, 12 out of 19 studies proved that adults with Cerebral Palsy suffered from heart diseases because of obesity and lack of exercise. The researchers also concluded that health care providers need to be careful of these causalities and make plans for treatment accordingly.

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