Cerebral palsy caused by birth
Causes and Risk Factors of Cerebral Palsy
Cerebral palsy (CP) is caused by abnormal development of the brain or damage to the developing brain that affects a child’s ability to control his or her muscles. There are several possible causes of the abnormal development or damage. People used to think that CP was mainly caused by lack of oxygen during the birth process. Now, scientists think that this causes only a small number of CP cases.
The abnormal development of the brain or damage that leads to CP can happen before birth, during birth, within a month after birth, or during the first years of a child’s life, while the brain is still developing.
Congenital CP
CP related to abnormal development of the brain or damage that happened before or during birth is called congenital CP. The majority of CP (85%–90%) is congenital. In many cases, the specific cause is not known.
Risk Factors for Congenital CP
Some things increase the chance that a child will have CP. These are called risk factors. It is important to remember that having a risk factor does not mean that a child will have CP. Some of the risk factors for congenital CP are:
- Low birthweight―Children who weigh less than 5 1/2 pounds (2,500 grams) at birth, and especially those who weigh less than 3 pounds, 5 ounces (1,500 grams) have a greater chance of having CP. Read articleexternal icon
- Premature birth―Children who were born before the 37th week of pregnancy, especially if they were born before the 32nd week of pregnancy, have a greater chance of having CP. Intensive care for premature infants has improved a lot over the past several decades. Babies born very early are more likely to live now, but many have medical problems that can put them at risk for CP. Read articleexternal icon
- Multiple births―Twins, triplets, and other multiple births have a higher risk for CP, especially if a baby’s twin or triplet dies before birth or shortly after birth. Some, but not all of this increased risk is due to the fact that children born from multiple pregnancies often are born early or with low birthweight, or both. Read summaryexternal icon
- Assisted reproductive technology (ART) infertility treatments―Children born from pregnancies resulting from the use of some infertility treatments have a greater chance of having CP. Most of the increased risk is explained by preterm delivery or multiple births, or both; both preterm delivery and multiple births are increased among children conceived with ART infertility treatments. Read articleexternal icon, Read summaryexternal icon
- Infections during pregnancy―Infections can lead to increases in certain proteins called cytokines that circulate in the brain and blood of the baby during pregnancy. Cytokines cause inflammation, which can lead to brain damage in the baby. Fever in the mother during pregnancy or delivery also can cause this problem. Some types of infection that have been linked with CP include viruses such as chickenpox, rubella (german measles), and cytomegalovirus (CMV), and bacterial infections such as infections of the placenta or fetal membranes, or maternal pelvic infections. Read summaryexternal icon, Read articleexternal icon
- Jaundice and kernicterus― Jaundice is the yellow color seen in the skin of many newborns. Jaundice happens when a chemical called bilirubin builds up in the baby’s blood. When too much bilirubin builds up in a new baby’s body, the skin and whites of the eyes might look yellow. This yellow coloring is called jaundice. When severe jaundice goes untreated for too long, it can cause a condition called kernicterus. This can cause CP and other conditions. Sometimes, kernicterus results from ABO or Rh blood type difference between the mother and baby. This causes the red blood cells in the baby to break down too fast, resulting in severe jaundice.
- Medical conditions of the mother―Mothers with thyroid problems, intellectual disability, or seizures have a slightly higher risk of having a child with CP. Read summaryexternal icon
- Birth complications―Detachment of the placenta, uterine rupture, or problems with the umbilical cord during birth can disrupt oxygen supply to the baby and result in CP. Read summaryexternal icon
Preventing CP
In many cases, the cause or causes of congenital CP aren’t fully known, which means that currently little can be done to prevent it. CP related to genetics is not preventable. However, there are actions people can take before and during pregnancy, as well as after birth that might help reduce the risk of developmental problems, including CP.
Taking steps to help ensure a healthy pregnancy can help prevent developmental problems, including CP. Acquired CP often is related to an infection or injury, and some of these cases can be prevented.
Before Pregnancy
- Be as healthy as possible before pregnancy. Make sure that any infections in the mother are treated and health conditions are in control, ideally before pregnancy occurs.
- Get vaccinated for certain diseases (such as chickenpox and rubella) that could harm a developing baby. It is important to have many of these vaccinations before becoming pregnant.
- If assistive reproductive technology (ART) infertility treatments are used to get pregnant, consider ways to reduce the chance of a multiple pregnancy (twins, triplets, or more), such as transferring only one embryo at a time.
During Pregnancy
- Learn how to have a healthy pregnancy.
- Get early and regular prenatal care, both for your health and for that of your developing baby.
- Wash your hands often with soap and water to help reduce the risk of infections that might harm your developing baby.
- Contact your health care provider if you get sick, have a fever, or have other signs of infection during pregnancy.
- A flu shot is your best protection against serious illness from the flu. A flu shot can protect pregnant women and their unborn babies, both before and after birth. Flu shots have not been shown to cause harm to pregnant women or their babies.
- If there is a difference in the blood type or Rh incompatibility between mother and baby it can cause Jaundice and kernicterus. Women should know their blood type and talk to their doctor about ways to prevent problems. Doctors can treat the mother with Rh immune globulin (“Rhogam”) when she is 28 weeks pregnant and again shortly after giving birth to prevent kernicterus from occurring.
- Talk to your doctor about ways to prevent problems if you are at risk for preterm delivery. Research has shown that taking magnesium sulfate before anticipated early preterm birth reduces the risk of CP among surviving infants. (1,2,3,4)
After the Baby is Born
- Learn how to help keep your baby healthy and safe after birth.
- Any baby can get jaundice. Severe jaundice that is not treated can cause brain damage, called kernicterus. Kernicterus is a cause of CP that potentially can be prevented. Your baby should be checked for jaundice in the hospital and again within 48 hours after leaving the hospital. Ask your doctor or nurse about a jaundice bilirubin test. In addition, steps can be taken to prevent kernicterus that is caused by Rh blood type incompatibility between the mother and baby.
- Make sure your child is vaccinated against infections that can cause meningitis and encephalitis, including Haemophilus influenzae type B (HiB vaccine) and Streptococcus pneumoniae (pneumococcal vaccine).
- Take steps to prevent injuries:
- Buckle your child in the car using an infant or child car seat, booster seat, or seat belt (according to the child’s height, weight, and age).
- Make living areas safer for children by using window guards to keep young children from falling out of open windows and using safety gates at the top and bottom of stairs.
- Make sure the surface on your child’s playground is made of a shock-absorbing material, such as hardwood mulch or sand.
- Carefully watch young children at all times around bathtubs, swimming or wading pools, and natural bodies of water. Adults watching kids near water should avoid distracting activities like using a computer or handheld device, reading, or talking on the phone.
- Make sure your child wears a helmet for activities like riding a bike.
- Never hit, throw, shake, or hurt a child.
For More Information
- American Academy of Pediatrics Healthy Children / Cerebral Palsyexternal icon
- National Institute of Neurological Disorders and Stroke (NINDS) Cerebral Palsy Informationexternal icon
References
- Doyle LW, Crowther CA, Middleton P, Marret S. Antenatal magnesium sulfate and neurologic outcome in preterm infants: a systematic review. Obstet Gynecol. 2009 Jun;113(6):1327-33.
- Magnesium sulfate before anticipated preterm birth for neuroprotection. Committee Opinion No. 455. American College of Obstetricians and Gynecologists. Obstet Gynecol 2010;115:669–71.
- Crowther CA, Middleton PF, Voysey M, et al (2017). Assessing the neuroprotective benefits for babies of antenatal magnesium sulphate: An individual participant meta-analysis. PLoS Med, 14(10):e1002398.
- Magnesium sulfate use in obstetrics. Committee Opinion No. 652. American College of Obstetricians and Gynecologists. Obstet Gynecol 2016;127(1):e52-3.
Cerebral palsy - Symptoms and causes
Overview
Cerebral palsy is a group of disorders that affect movement and muscle tone or posture. It's caused by damage that occurs to the immature, developing brain, most often before birth.
Signs and symptoms appear during infancy or preschool years. In general, cerebral palsy causes impaired movement associated with exaggerated reflexes, floppiness or spasticity of the limbs and trunk, unusual posture, involuntary movements, unsteady walking, or some combination of these.
People with cerebral palsy can have problems swallowing and commonly have eye muscle imbalance, in which the eyes don't focus on the same object. They also might have reduced range of motion at various joints of their bodies due to muscle stiffness.
The cause of cerebral palsy and its effect on function vary greatly. Some people with cerebral palsy can walk; others need assistance. Some people have intellectual disabilities, but others do not. Epilepsy, blindness or deafness also might be present. Cerebral palsy is a lifelong disorder. There is no cure, but treatments can help improve function.
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Symptoms
Signs and symptoms of cerebral palsy can vary greatly from person to person. Cerebral palsy can affect the whole body, or it might be limited primarily to one or two limbs, or one side of the body. Generally, signs and symptoms include problems with movement and coordination, speech and eating, development, and other problems.
Movement and coordination
- Stiff muscles and exaggerated reflexes (spasticity), the most common movement disorder
- Variations in muscle tone, such as being either too stiff or too floppy
- Stiff muscles with normal reflexes (rigidity)
- Lack of balance and muscle coordination (ataxia)
- Tremors or jerky involuntary movements
- Slow, writhing movements
- Favoring one side of the body, such as only reaching with one hand or dragging a leg while crawling
- Difficulty walking, such as walking on toes, a crouched gait, a scissors-like gait with knees crossing, a wide gait or an asymmetrical gait
- Difficulty with fine motor skills, such as buttoning clothes or picking up utensils
Speech and eating
- Delays in speech development
- Difficulty speaking
- Difficulty with sucking, chewing or eating
- Excessive drooling or problems with swallowing
Development
- Delays in reaching motor skills milestones, such as sitting up or crawling
- Learning difficulties
- Intellectual disabilities
- Delayed growth, resulting in smaller size than would be expected
Other problems
Damage to the brain can contribute to other neurological problems, such as:
- Seizures (epilepsy)
- Difficulty hearing
- Problems with vision and abnormal eye movements
- Abnormal touch or pain sensations
- Bladder and bowel problems, including constipation and urinary incontinence
- Mental health conditions, such as emotional disorders and behavioral problems
The brain disorder causing cerebral palsy doesn't change with time, so the symptoms usually don't worsen with age. However, as the child gets older, some symptoms might become more or less apparent. And muscle shortening and muscle rigidity can worsen if not treated aggressively.
When to see a doctor
It's important to get a prompt diagnosis for a movement disorder or delays in your child's development. See your child's doctor if you have concerns about episodes of loss of awareness of surroundings or of unusual bodily movements or muscle tone, impaired coordination, swallowing difficulties, eye muscle imbalance, or other developmental issues.
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Causes
Cerebral palsy is caused by abnormal brain development or damage to the developing brain. This usually happens before a child is born, but it can occur at birth or in early infancy. In many cases, the cause isn't known. Many factors can lead to problems with brain development. Some include:
- Gene mutations that result in genetic disorders or differences in brain development
- Maternal infections that affect the developing fetus
- Fetal stroke, a disruption of blood supply to the developing brain
- Bleeding into the brain in the womb or as a newborn
- Infant infections that cause inflammation in or around the brain
- Traumatic head injury to an infant, such as from a motor vehicle accident, fall or physical abuse
- Lack of oxygen to the brain related to difficult labor or delivery, although birth-related asphyxia is much less commonly a cause than historically thought
Risk factors
A number of factors are associated with an increased risk of cerebral palsy.
Maternal health
Certain infections or toxic exposures during pregnancy can significantly increase cerebral palsy risk to the baby. Inflammation triggered by infection or fever can damage the unborn baby's developing brain.
- Cytomegalovirus. This common virus causes flu-like symptoms and can lead to birth defects if a mother has her first active infection during pregnancy.
- German measles (rubella). This viral infection can be prevented with a vaccine.
- Herpes. This infection can be passed from mother to child during pregnancy, affecting the womb and placenta.
- Syphilis. This is a sexually transmitted bacterial infection.
- Toxoplasmosis. This infection is caused by a parasite found in contaminated food, soil and the feces of infected cats.
- Zika virus infection. This infection is spread through mosquito bites and can affect fetal brain development.
- Intrauterine infections. This includes infections of the placenta or fetal membranes.
- Exposure to toxins. One example is exposure to methyl mercury.
- Other conditions. Other conditions affecting the mother that can slightly increase the risk of cerebral palsy include thyroid problems, preeclampsia or seizures.
Infant illness
Illnesses in a newborn baby that can greatly increase the risk of cerebral palsy include:
- Bacterial meningitis. This bacterial infection causes inflammation in the membranes surrounding the brain and spinal cord.
- Viral encephalitis. This viral infection similarly causes inflammation in the membranes surrounding the brain and spinal cord.
- Severe or untreated jaundice. Jaundice appears as a yellowing of the skin. The condition occurs when certain byproducts of "used" blood cells aren't filtered from the bloodstream.
- Bleeding into the brain. This condition is commonly caused by the baby having a stroke in the womb or in early infancy.
Factors of pregnancy and birth
While the potential contribution from each is limited, additional pregnancy or birth factors associated with increased cerebral palsy risk include:
- Low birth weight. Babies who weigh less than 5.5 pounds (2.5 kilograms) are at higher risk of developing cerebral palsy. This risk increases as birth weight drops.
- Multiple babies. Cerebral palsy risk increases with the number of babies sharing the uterus. The risk also can be related to the likelihood of premature birth and low birth weight. If one or more of the babies die, the survivors' risk of cerebral palsy increases.
- Premature birth. Babies born prematurely are at higher risk of cerebral palsy. The earlier a baby is born, the greater the cerebral palsy risk.
- Delivery complications. Problems during labor and delivery may increase the risk of cerebral palsy.
Complications
Muscle weakness, muscle spasticity and coordination problems can contribute to a number of complications either during childhood or in adulthood, including:
- Contracture. Contracture is muscle tissue shortening due to severe muscle tightening that can be the result of spasticity. Contracture can inhibit bone growth, cause bones to bend, and result in joint deformities, dislocation or partial dislocation. These can include hip dislocation, curvature of the spine (scoliosis) and other orthopedic deformities.
- Malnutrition. Swallowing or feeding problems can make it difficult for someone who has cerebral palsy, particularly an infant, to get enough nutrition. This can impair growth and weaken bones. Some children or adults need a feeding tube to get enough nutrition.
- Mental health conditions. People with cerebral palsy might have mental health conditions, such as depression. Social isolation and the challenges of coping with disabilities can contribute to depression. Behavioral problems can also occur.
- Heart and lung disease. People with cerebral palsy may develop heart disease, lung disease and breathing disorders. Problems with swallowing can result in respiratory problems, such as aspiration pneumonia.
- Osteoarthritis. Pressure on joints or abnormal alignment of joints from muscle spasticity may lead to the early onset of this painful degenerative bone disease.
- Osteoporosis. Fractures due to low bone density can result from several factors such as lack of mobility, inadequate nutrition and anti-epileptic drug use.
- Other complications. These can include sleep disorders, chronic pain, skin breakdown, intestinal problems and issues with oral health.
Prevention
Most cases of cerebral palsy can't be prevented, but you can reduce risks. If you're pregnant or planning to become pregnant, you can take these steps to keep healthy and minimize pregnancy complications:
- Make sure you're vaccinated. Getting vaccinated against diseases such as rubella, preferably before getting pregnant, might prevent an infection that could cause fetal brain damage.
- Take care of yourself. The healthier you are heading into a pregnancy, the less likely you'll be to develop an infection that results in cerebral palsy.
- Seek early and continuous prenatal care. Regular visits to your doctor during your pregnancy are a good way to reduce health risks to you and your unborn baby. Seeing your doctor regularly can help prevent premature birth, low birth weight and infections.
- Avoid alcohol, tobacco and illegal drugs. These have been linked to cerebral palsy risk.
Rarely, cerebral palsy can be caused by brain damage that occurs in childhood. Practice good general safety. Prevent head injuries by providing your child with a car seat, bicycle helmet, safety rails on the bed and appropriate supervision.
By Mayo Clinic Staff
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Infantile cerebral palsy (ICP) - treatment, symptoms, causes, diagnosis
Cerebral palsy is a group of diseases in which there is a violation of motor functions and posture. This is due to a brain injury or a violation of the formation of the brain. This disease is one of the most common causes of permanent disability in children. Cerebral palsy occurs in about 2 cases for every thousand people.
Cerebral palsy causes reflex movements that the person cannot control and hardening of a muscle that can affect part or all of the body. These impairments can range from moderate to severe. There may also be intellectual disability, convulsive seizures, impaired vision and hearing.
It is sometimes difficult for parents to accept a diagnosis of cerebral palsy.
Causes
Cerebral palsy (CP) is the result of an injury or abnormal development of the brain. In many cases, the exact cause of cerebral palsy is not known. Damage or impaired brain development can occur during pregnancy, birth, and even during the first 2 to 3 years after birth.
- A possible cause of cerebral palsy during pregnancy or birth may be genetic problems, infections or health problems in the mother or fetus during pregnancy, or complications associated with childbirth and delivery. Any of these problems can affect the development of the fetus, blood supply, providing the fetus with the necessary nutrients that it receives through the blood. For example, systematic hypoglycemia can lead to the development of cerebral palsy.
- One of the possible causes of cerebral palsy may be prematurity associated with early birth (preterm birth), and, accordingly, with underdevelopment of the brain. Babies born too early are at high risk of bleeding in the brain (intraventricular bleeding). A condition called periventricular leukomalacia (leukomalacia), in which damage to the white matter of the brain occurs, is also more likely in premature babies than in full-term babies. Both conditions increase the risk of cerebral palsy. • Possible causes of cerebral palsy during the first 2 or 3 years after birth are usually related to brain damage from a serious illness such as meningitis; brain injury due to an accident or brain hypoxia.
Prevention
The cause of cerebral palsy (CP) is sometimes unknown. But certain risk factors have been identified and proven to be associated with the incidence of cerebral palsy. Some of these risk factors can be avoided. Fulfilling certain conditions during pregnancy helps reduce the risk of brain damage in the fetus. These recommendations include:
- Good nutrition.
- Do not smoke.
- Do not come into contact with toxic substances
- See your doctor regularly.
Recommendations after childbirth:
- Minimize injury from accidents
- Determine neonatal jaundice
- Do not use substances containing heavy metals (lead)
- Isolate the child from patients with infectious diseases (especially meningitis)
- Immunize the child in a timely manner.
Symptoms
Even when the disease is present at birth, symptoms of cerebral palsy (CP) may not be noticed until the child is 1 to 3 years old. This is due to the growth of the child. Neither doctors nor parents may not pay attention to violations of the child's motor sphere until these violations become apparent. Children may retain the reflex movements of newborns without age-appropriate development of movement skills. And sometimes the first to pay attention to the underdevelopment of the child are nannies. If cerebral palsy has a severe form, then the symptoms of this disease are already found in the newborn. But the appearance of symptoms depends on the type of cerebral palsy.
The most common symptoms of severe cerebral palsy are
- Swallowing and sucking disorders
- Weak cry
- Convulsions.
- Unusual postures of a child. The body can be very relaxed or very strong hyperextension with spread of the arms and legs. These postures are significantly different from those that occur with colic in newborns.
Some problems associated with cerebral palsy become more apparent over time or develop as the child grows. They may include:
- Muscle wasting in injured arms or legs. Problems in the nervous system impair movement in the affected arms and legs, and muscle stiffness affects muscle growth.
- Pathological sensations and perception. Some patients with cerebral palsy are very sensitive to pain. Even normal daily activities, such as brushing your teeth, can be painful. Pathological sensations can also affect the ability to identify objects by touch (for example, to distinguish between a soft ball and a hard one).
- Skin irritation. Drooling, which is common, can irritate the skin around the mouth, chin, and chest.
- Problems with teeth. Children who have difficulty brushing their teeth are at risk for gum disease and tooth decay. Anti-seizure medications can also contribute to gum disease.
- Accidents. Falls and other accidents are risks associated with impaired coordination of movements, as well as in the presence of convulsive attacks.
- Infections and somatic diseases. Adults with cerebral palsy are at high risk for heart and lung diseases. For example, in severe cerebral palsy, swallowing problems occur and when choking, part of the food enters the trachea, which contributes to lung diseases. (pneumonia)
All patients with cerebral palsy have certain problems with body movement and posture, but many babies do not show signs of cerebral palsy at birth and sometimes only nannies or nurses are the first to pay attention to deviations in the child's movements that contradict age criteria. The signs of cerebral palsy may become more apparent as the child grows. Some developing disorders may not become apparent until after the child's first year. The brain injury that causes cerebral palsy does not show up for a long time, but the effects may appear, change, or become more severe as the child gets older.
Certain effects of cerebral palsy depend on its type and severity, level of mental development and the presence of other complications and diseases.
- The type of cerebral palsy determines the movement disorders in a child.
Most patients with cerebral palsy have spastic cerebral palsy. Its presence can affect both in all parts of the body, and in individual parts. For example, a child with spastic cerebral palsy may develop symptoms mainly in one leg or one half of the body. Most children usually try to adjust to motor impairments. Some patients can even live independently and work, needing only occasional assistance. In cases where there are disorders in both legs, patients require a wheelchair or other devices to compensate for motor functions.
Complete cerebral palsy causes the most severe problems. Severe spastic cerebral palsy and choreoathetoid cerebral palsy are types of complete paralysis. Many of these patients are unable to care for themselves due to both motor and intellectual impairments and require constant care. Complications such as seizures and other long-term physical effects of cerebral palsy are difficult to predict until a child is 1 to 3 years old. But sometimes such predictions are not possible until the child reaches school age, and in the process of learning, communicative intellectual and other abilities can be analyzed
- The severity of mental impairment, if any, is a strong indicator of daily functioning. Slightly more than half of patients who have cerebral palsy have some degree of intellectual disability. Children with spastic quadriplegia usually have severe mental impairments.
- Other conditions, such as hearing loss or problems, often occur with cerebral palsy. Sometimes these disorders are noted immediately; in other cases, they are not detected until the child is older.
In addition, just like people with normal physical development, people with cerebral palsy experience social and emotional problems during their lives. Since their physical defects exacerbate problems, patients with cerebral palsy need the attention and understanding of other people.
Most patients with cerebral palsy survive to adulthood, but their life expectancy is somewhat shorter. Much depends on how severe the form of cerebral palsy is and the presence of complications. Some patients with cerebral palsy even have the opportunity to work, especially with the development of computer technology, such opportunities have increased significantly.
Cerebral palsy is classified according to the type of body movement and postural problems.
Spastic (pyramidal) cerebral palsy
Spastic cerebral palsy is the most common type. A patient with spastic cerebral palsy develops muscle stiffness in some parts of the body that are unable to relax. In damaged joints, contractures occur, and the range of motion in them is sharply limited. In addition, patients with spastic cerebral palsy have problems with coordination of movements, speech disorders and swallowing disorders.
There are four types of spastic cerebral palsy, grouped according to how many limbs are involved. Hemiplegia - one arm and one leg on one side of the body, or both legs (diplegia or paraplegia). They are the most common types of spastic cerebral palsy.
- Monoplegia: Only one arm or leg is impaired.
- Quadriplegia: Both arms and both legs involved. Usually in such cases it happens, and damage to the brain stem and, accordingly, this is manifested by swallowing disorders. Newborns with quadriplegia may have problems with sucking, swallowing, weak crying, the body may be cottony or vice versa tense. Often, when in contact with a child, hypertonicity of the body appears. The child may sleep a lot and not show interest in the environment.
- Triplegia: Either both arms and one leg or both legs and one arm are called.
Non-spastic (extrapyramidal) cerebral palsy
Non-spastic forms of cerebral palsy include dyskinetic cerebral palsy (subdivided into athetoid and dystonic forms) and ataxic cerebral palsy.
- Dyskinetic cerebral palsy is associated with moderate to severe muscle tone. In some cases, there are uncontrollable jerky twitches or involuntary slow movements. These movements most often involve the muscles of the face and neck, arms, legs, and sometimes the lower back. The athetoid type (hyperkinetic) type of cerebral palsy is characterized by relaxed muscles during sleep with slight twitches and grimaces. When the muscles of the face and mouth are involved, there may be disturbances in the process of eating, salivation, choking on food (water) and the appearance of inadequate facial expressions.
- Ataxic cerebral palsy is the rarest type of cerebral palsy and affects the entire body. Pathological movements occur in the torso, arms, legs.
Ataxic cerebral palsy is manifested by the following problems:
- Body imbalance
- Violation of precise movements. For example, the patient is unable to place their hand on the desired object or perform even simple movements (for example, bring the cup exactly to the mouth). Often only one hand is able to reach the object; the other hand may tremble from trying to move that object. The patient is often unable to fasten clothing, write, or use scissors.
- Movement coordination. A person with ataxic cerebral palsy may walk with too large steps or legs wide apart.
- Mixed cerebral palsy
- Some children have symptoms of more than one type of cerebral palsy. For example, spastic legs (symptoms of spastic cerebral palsy related to diplegia) and problems with facial muscle control (symptoms of dyskinetic CP).
- Total (complete) cerebral palsy of the body affects the entire body to one degree or another. Complications of cerebral palsy and other health problems are most likely to develop when the whole body is involved rather than isolated parts.
Diagnosis
Symptoms of cerebral palsy may not be present or not detected at birth. Therefore, the attending physician observing the newborn needs to carefully monitor the child so as not to miss the symptoms. Nevertheless, it is not worth overdiagnosing cerebral palsy, since many motor disorders in children of this age are transient. Often the diagnosis can be made only a few years after the birth of the child, when it is possible to notice movement disorders. Diagnosis of cerebral palsy is based on monitoring the physical development of the child with the presence of various deviations in physical and intellectual development, analysis data and instrumental research methods such as MRI. Diagnosis of cerebral palsy includes:
- Collection of information about the child's medical history, including pregnancy details. Quite often, the presence of a developmental delay is reported by the parents themselves or it is detected during professional examinations in children's institutions.
- A physical examination is required to look for signs of cerebral palsy. During a physical examination, the doctor evaluates how long the reflexes of newborns in a child last compared to normal periods. In addition, an assessment of muscle function, posture, hearing function, vision is performed.
- Samples for the detection of a latent form of the disease. Developmental questionnaires and other tests help determine the extent of developmental delays.
- Magnetic resonance imaging (MRI) of the head, which may be done to identify abnormalities in the brain.
The complex of these diagnostic approaches allows making a diagnosis.
If the diagnosis is not clear, additional tests may be ordered to assess the state of the brain and to rule out possible other diseases. Analyzes may include:
- Additional questionnaires.
- Computed tomography (CT) of the head.
- Ultrasound examination of the brain.
Evaluation and control of cerebral palsy
After cerebral palsy is diagnosed, the child must be further examined and other diseases that may be simultaneously with cerebral palsy should be identified.
- Other developmental delays in addition to those already identified. Developing abilities should be assessed periodically to see if new symptoms appear, such as speech delay, as the child's nervous system is in continuous development.
- Intelligent delay can be detected using certain tests.
- Convulsive episodes. Electroencephalography (EEG) is used to detect abnormal activity in the brain if the child has a history of seizures.
- Feeding and swallowing problems.
- Vision or hearing problems.
- Problems of behavior.
Most often, a doctor can predict many of the long-term physical aspects of cerebral palsy when a child is 1 to 3 years old. But sometimes such predictions are not possible until the child reaches school age, when deviations can be detected in the course of learning and development of communication capabilities.
Some children need repeat testing, which may include:
- X-rays to look for hip dislocations (subluxations). Children with cerebral palsy usually have several X-rays between the ages of 2 and 5 years. In addition, x-rays may be ordered if there is pain in the hips or if there are signs of hip dislocation. It is also possible to prescribe an x-ray of the spine to detect deformities in the spine.
- Gait analysis, which helps to identify disorders and correct treatment tactics.
Additional examination methods are prescribed if necessary and if indicated.
Treatment
Cerebral palsy is an incurable disease. But a variety of treatments help patients with cerebral palsy minimize motor and other impairments and thus improve their quality of life. Brain injury or other factors leading to cerebral palsy do not progress, but new symptoms may appear or progress as the child grows and develops.
Initial treatment
Exercise therapy is an important part of treatment that begins shortly after a child is diagnosed and often continues throughout the child's life. This type of treatment may also be given before a diagnosis is made, depending on the child's symptoms.
Medications can help manage some of the symptoms of cerebral palsy and prevent complications. For example, antispasmodics and muscle relaxants help relax spasmodic (spastic) muscles and increase range of motion. Anticholinergics help improve limb movement or reduce salivation. Other drugs may be used as symptomatic treatment (eg, anticonvulsants, if seizures are present)
Permanent treatment
Permanent treatment for cerebral palsy (CP) focuses on continuing and adjusting existing treatments and adding new treatments as needed. as mobile as possible. It may also help prevent the need for surgery. If the child underwent surgical treatment, then intensive exercise therapy may be necessary for 6 or more months. Drug treatment should be constantly monitored in order to avoid possible side effects of drugs.
Rehabilitation of cerebral palsy in Moscow - Prices for rehabilitation of cerebral palsy in the center "Overcoming" - Treatment of cerebral palsy in children and adults ) 128-77-43
Cerebral palsy ( cerebral palsy ) is a congenital pathology of the central nervous system, as a result of which brain function is disrupted. This disease and its consequences cannot be completely eliminated, therefore, the treatment of cerebral palsy in children and adults consists in regular rehabilitation courses, in constant work at home and in specially equipped conditions at the “Overcoming” center in Moscow. Orthopedic surgeries may be prescribed for special indications.
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Neurological disorders associated with cerebral palsy limit mobility and prevent a person from fully interacting with the outside world. The disease is characterized by:
- Violation of movements and muscle tone
Movements seem clumsy, unnatural, jerky. Muscle tone can be increased or weakened, which is why gestures and facial expressions are either sharp or sluggish, slow. - mental retardation
Mental retardation is not diagnosed in all cases. The higher the intellectual level of the patient, the lower the degree of established disability. - Incorrect, slurred speech
Due to a decrease in muscle tone, patients are not able to accurately control the position of the lips, tongue, throat, therefore, the reproduction of individual sounds, coherent speech is difficult or impossible. - Convulsions
As a rule, it manifests itself already in the first months of life. Difficult to distinguish because they often coincide with pathological movements caused by the disease. - Skeletal deformity
Cerebral palsy is characterized by shortening of the limbs. Without proper orthopedic rehabilitation, scoliosis and curvature of the pelvic bones are added to the existing disorders of the musculoskeletal system. - Contractures of the joints
The movement of the joint is limited and cannot be performed with full amplitude. - The development of strabismus or myopia
Many patients are diagnosed with visual impairment.
Cerebral palsy does not progress, but if physical and medical rehabilitation is not carried out for patients with cerebral palsy, the condition of patients as they grow older may become more complicated. This is due to the appearance of new disorders caused by already existing congenital pathologies. Early interventions for the recovery of children with cerebral palsy help prevent complications. The “Overcoming” center conducts rehabilitation programs for cerebral palsy for adolescents from 14 years of age and adult patients with this disease.
Comprehensive rehabilitation program for cerebral palsy in children and adults
The course is based on tools that will help correct disorders caused by cerebral palsy and strengthen the patient's socialization skills, his ability to learn and self-care. An important role in this is played by therapeutic exercises, hydrocolonotherapy, kinesiotherapy, as well as staying in the sensory room.
Our rehabilitation center has extensive experience in dealing with cerebral palsy. This helps to develop effective recovery programs tailored to the individual characteristics of each patient.
The course includes:
- Individual kinesiotherapy – 20 procedures;
- Individual mechanotherapy – 20 procedures;
- Individual hydrokinesitherapy – 8 procedures;
- Classical massage – 10 procedures;
- Physiotherapy - 20 procedures;
- Balance training - 10 procedures;
- Speech therapist - 8 lessons;
- Neuropsychologist - 4 lessons;
- Ergotherapy – 6 procedures;
- Social adaptation - 14 procedures.
In order to create an optimal course of recovery, each patient undergoes diagnostics, which helps to determine the degree of development of the disease, the specifics and complexity of disorders.
Examination by medical specialists:
- neurologist;
- therapist;
- physiotherapist;
- exercise therapy doctor;
- urologist;
- psychologist.
In the process of diagnostics, the following are carried out:
- clinical blood tests;
- general blood and urine analysis;
- testing for infections;
- ECG;
- chest x-ray;
- x-ray of joints and bones;
- Ultrasound of the kidneys, ureters, bladder,
abdominal and pelvic organs.
After undergoing a course of rehabilitation and adaptation, patients with cerebral palsy use in real life the practical skills of self-care, work and household activities obtained in our center. They cope with physical and mental tasks more confidently, become more socially active, and more easily endure the difficulties caused by a neurological disease. In reviews of the treatment and rehabilitation of cerebral palsy, our patients and their relatives regularly thank the “Overcoming” center for their professional work.
Terms of recovery of children and adults with cerebral palsy
The sooner the stages of social and physical rehabilitation of disabled people with cerebral palsy begin, the faster and more effective the process of recovery and adaptation of the patient in real life, taking into account the limitations caused by the existing disease. It is important to introduce rehabilitation measures into the life of a child with cerebral palsy from the first day of birth. With insufficient attention to disorders caused by cerebral palsy, the first complications may appear already in adolescence. Adult patients with cerebral palsy who have not previously received appropriate treatment are more difficult to rehabilitate and require additional attention from rehabilitators.
The basic recovery course for patients with cerebral palsy, compiled by the specialists of the "Overcoming" center in Moscow, is designed for 30 days. The proposed program can be adjusted, depending on individual indications.
Conditions for the treatment of patients with cerebral palsy in Moscow
The number of disabled people diagnosed with cerebral palsy is growing every year, which is largely due to the improvement in the quality of diagnosis and the system for tracking patients with pathologies of the central nervous system. Timely detection of this kind of violations significantly increases the patient's chances of successfully combating the limitations that this disease dictates. Today, relatives and representatives of such patients often seek help abroad, but modern rehabilitation centers in Russia are not inferior in the quality of treatment for children's cerebral palsy.
In the Moscow center "Overcoming" for the purposes of sanatorium treatment and rehabilitation of patients with cerebral palsy, both time-tested mechanical systems and innovative robotic complexes for restoring movement functions are used. In addition, each year, as a rule, brings new technical discoveries, including those related to the global Internet, which can significantly expand the capabilities of patients with a high degree of disability.
Staying in a rehabilitation sanatorium under the cerebral palsy treatment program includes observing the correct regimen of physical activity and rest, nutrition, rehabilitation classes and procedures, as well as social and cultural adaptation (creative events, visiting exhibitions, theaters, etc.).
Medical rehabilitation of patients with cerebral palsy
In addition to clinical, laboratory, functional diagnostics and physiotherapy methods of recovery, treatment includes the selection of medications. In the case of cerebral palsy, the main task of drug therapy is to control seizures, relieve muscle spasm and pain.
For each patient undergoing rehabilitation after a stroke, traumatic brain injury or cerebral palsy, an individual drug therapy plan is selected based on the clinical recommendations of the specialized doctors of our center.
The cost of rehabilitation of patients with cerebral palsy in Moscow
The best rehabilitation of cerebral palsy is a combination of professional methods of treatment, recovery and thoughtful consistent work of rehabilitation center "Overcoming". The sooner you seek medical help, the faster and more effectively the patient will be able to get used to independent living and learn important self-care skills. Prices for the rehabilitation of cerebral palsy are calculated based on the duration of the course, the physical, technical and medical means used.
Video: Neurochat helps patients who cannot speak!
The innovative NeuroChat program has become a great help for patients who do not have the ability to clearly express their thoughts. Already today, the new system is being actively introduced into the processes of rehabilitation after traumatic brain injuries, stroke, cerebral palsy and multiple sclerosis. The first clinical trials of the Neurochat system took place at the Overcoming rehabilitation center on October 10, 2017.