What is Cerebral Palsy (CP)?
“Cerebral” refers to the brain, and “palsy” means muscle paralysis. In combination, they refer to a group of conditions where an individual’s ability to move is affected. A person with cerebral palsy may have muscle rigidity or muscle weakness, either of which could cause difficulty with walking, speaking, and fine motor skills such as writing. Individuals with CP often require a walker or wheelchair to get around. Sometimes mental retardation accompanies Cerebral Palsy. Approximately 2 to 3 children out of 1,000 have this condition.
It is important to note that CP is not progressive. Although certain symptoms may become more or less difficult to manage as the child grows, the condition itself is not going to worsen. This information can be comforting to parents who are fearful for their child’s future. (A child whose muscle control is diminishing with time almost certainly has another disease and not CP.)
There are three different types of Cerebral Palsy:
- Spastic. This refers to muscle rigidity, where the affected person has stiffness in either both legs, both arms, one side of the body, or all four limbs and neck. This type accounts for 70 to 80 percent of cases.
- Athetoid or dyskinetic. About 10 to 20 percent of cases affect the entire body, and muscle tone varies from too tight to too loose. This form of CP is known for its uncontrolled and jerky movements. Speech and swallowing are also involved.
- Ataxic. About 5 to 10 percent of cases involve loss of balance and unsteady gait, and difficulty with precise movements like eating with silverware or writing with a pen.
What causes Cerebral Palsy?
Although we know that Cerebral Palsy is caused by brain damage to areas of the brain which control movement, in many cases we don’t know what specifically caused the brain damage. Although we often hear about babies being deprived of oxygen during or shortly after birth, this accounts for less than ten percent of CP cases. In 70% of the documented cases, CP is caused prior to birth as the fetus is developing in the womb. An event occurs which disrupts the normal development of the unborn child’s brain.
- Disruption in Fetal Brain Development
Some possible causes for fetal brain development disruption include: Infection in the mother during pregnancy, insufficient oxygen reaching the fetus inside the womb, and blood diseases, including RH disease, where there is a blood incompatibility between mother and fetus. - Brain Damage Caused After Birth
Some infants develop CP when they are born prematurely, when they are deprived of oxygen at birth, or if they are born severely jaundiced. Some babies suffer brain damage in the early months of life due to trauma, injury, or abuse. A child who falls into a swimming pool and is rescued prior to drowning may suffer brain damage causing CP. A child whose head is injured due to improper use of a car seat could develop the condition. Seizures, or brain diseases such as Meningitis, can also result in Cerebral Palsy.
I’m worried about my baby. Is there a way to tell if she has CP?
Cerebral Palsy is very difficult to diagnose prior to the age of two. If you are concerned, schedule an appointment with the pediatrician immediately, and discuss your fears. A doctor who is suspicious of CP will be looking primarily at whether your baby is reaching her normal developmental milestones, such as turning over, sitting up, crawling, standing, and walking. (See my blog: Your Child’s Developmental Milestones: A Guide for Parents.) There are no x-rays or blood tests used in diagnosing Cerebral Palsy. It’s a process of elimination, after it has become obvious that the child’s development is delayed. The pediatrician will rule out every other disease which has similar symptoms.
I’m pregnant. Is there anything I can do to make sure my baby doesn’t get CP?
No, and yes. No— because we don’t really understand all the causes for Cerebral Palsy, it’s nearly impossible to prevent. And despite state-of-the-art obstetrical and neonatal care, the number of CP cases is rising. This may be due to a higher survival rate for premature infants, who, in spite of beating death, suffer brain bleeds and other complications that cause CP.
However, Yes–RH disease and congenital rubella, which used to be major causes, are now preventable. Also, better child safety seats, vaccinations for meningitis, and phototherapy for jaundice are all available and aid in prevention. During pregnancy if you avoid smoking, alchohol, and drugs, wear a seatbelt, have a healthy diet, and follow your doctors advice during regular prenatal care, you are giving your baby the best odds at health.
For more information about Cerebral Palsy, visit the United Cerebral Palsy website, at: http://www.ucp.org/
I will write more about CP treatments in a future blog.