Dedicated to Neurological Discoveries
1. What is Cerebral Palsy?
Cerebral Palsy is the second most common neurological discoder in children.
It occurs in approximately 3-5 out of every 1,000 children.
A child afflicted with Cerebral Palsy has abnormal movement or posture caused by damage to a developing brain either before birth, during delivery or in the first few years of life.
2. What are the early signs of Cerebral Palsy?
Each child with Cerebral Palsy is affected differently, depending on the part of the brain that has been damaged and the degree of the damage.
Although movement and posture are affected, some children may have additional problems with eye sight or hearing, and may also have epilepsy, learning or feeding problems.
Some of the early signs are :-- Delay in developing movement ie. rolling over, sitting or crawling.
- Inability to sit unaided.
- Both legs cress over ('scissor') when held up, standing or walking.
- Tendency to walk on toes.
- Walk with hips and knees bent. ("Crouching" posture)
- Having tight, stiff or floppy arms and legs.
- Using one hand more than the other (hand preference) before the age of 18 months. (Normally children use both hands equilly and are only clearly right or left handed at around 18 months.)
- Inability or having difficulty in reaching out to pick toys.
Over time, muscles may shorten and the child may develop permanent bone and joint deformities resulting in an inability to move the affected joints.
3. What causes Cerebral Palsy?
In many cases, it is difficult to determine the cause of the brain damage. Some of the known caused of Cerebral Palsy are :
| Before Birth | During Delivery | After Delivery |
| Maternal expose to certain infection during pregnancy (i.e. Rubella Cytomegalovirus or Toxoplasma) | Prematurity | Brain Infection |
| Genetic or chromosomal abnormalities | Lack of Oxgyen to the brain | Head injury (from falls, accident or child abuse) |
| Bleeding in the brain | Brain infection | Bleeding in the brain |
| Lack of Oxygen to the brain | ||
| Metabolic disorders |
In most of the cases, parents are not to be blamed for their child's condition. Therefore, they should not feel guilty as it is not only unjustified but also damaging to the parent-child relationship.
4. Can Cerebral Palsy be treated?
The damaged part of the brain cannot be improved, neither can it regress. However other parts of the brain may be trained to take over some of the functions that have been lost.
Much can be done to maximize the potential of the child and to prevent the development of bone and joint deformities that may cause further loss body functions.
5. What are the treatment options?
- Intensive Physio and Occupational Therapy
- Seating and Positioning
- Orthoses (Braces) Orthoses are devices that we used to:
- reduce abnormal skeletal changes and support joints.
- control and reduce abnormal muscle activity which can lead to muscle shortening and joint deformities.
- Surgery
- Medications
- Botulinum toxin injection
This therapies involve stretching and strengthening exercises to relax the muscles, improve balance,muscle growth and achieve better function.
A correct seating arrangement and positioning is a MUST to develop normal posture, thus preventing abnormal curvature of the spine or muscle contracture.
This therapies involve stretching and strengthening exercises to relax the muscles, improve balance, muscle growth and achieve better function.
Surgery may be required when the child has fixed contractures and if bone deformities are present.
Ideally, this is best done only after the child has achieved his mature gait. Common procedures are tendon lengthening or release, tendon transfer, osteotomy and neurectomy.
Some medications are useful in reducing muscle spasm. Some are taken orally and some are injected.
Before Injection
Both legs cross over ('scissor')when she is held up, she need support to stand.
After Injection
She is able to stand with minimal support and without scissoring. She is also able to sit cross-legged.
Before Injection
He had marked crouch gait and walked only 5 steps. He also fell easily. After Injection
He is able to walk without support for more than 200 metres with minimal "crouch" gait
Botulinum toxin injection is one of the treatments to reduce muscle tightness or stiffness of a specific affected muscle.
An injection of botulinum usually relaxes the muscle for 4-6 months, depending on the intensity of physiotherapy. Without intensive exercise, the muscle may become stiff sooner, making earlier re-injection necessary.
All the treatments are usually individualized and tailored to the child's needs to help him cope better with the activities of daily living.
6. How can parents help?
Parents should be closely involved in the process and the decisions made in their child's treatment.
Parents play the key role in assisting their child in the day-to-day rehabilitation programmes.
A child with cerebral palsy needs lots of love, understanding, support and encouragement NOT sympathy or overprotection.
A child with cerebral palsy needs lots of love, understanding, support and encouragement NOT sympathy or overprotection.
Parents play the key role in assisting their child in the everyday rehibilitation programmes.
