Cerebral Palsy In Children
A pregnant woman in her 30th week of pregnancy got infected with German measles or Rubella. After delivery the baby was found to have severe jaundice. As the months progressed, the infant started showing developmental delays. The infant had difficulty in swallowing, crawling, and later on, in walking and also speech development. After series of diagnostic tests conducted by the doctor, the child was confirmed to be having cerebral palsy.
Understanding Cerebral Palsy
Cerebral palsy is not a disease but it is a group of disabilities that affect children very early in life. It may be mild or severe in nature. Children with cerebral palsy have weak or stiff muscles resulting in uncoordinated muscle movements and difficulty in controlling the muscle movements.
Cerebral palsy can occur at any stage- in the fetus stage, during delivery or after birth of the child. During pregnancy, if infections like chicken pox or rubella affect the mother, then there is a chance that there can be brain damage to the developing fetus, resulting in cerebral palsy. If there is disruption of blood supply to the developing fetus, then a fetus stroke occurs resulting in cerebral palsy.
In case of a difficult delivery, there can be lack of oxygen to the baby’s brain resulting in its damage leading to cerebral palsy. Severe jaundice (yellow discoloration of skin due to bile pigment), meningitis (swelling of membranes around brain and spinal cord), and viral encephalitis (swelling of brain due to viral infection) can cause cerebral palsy in infants. The other causes of cerebral palsy in infants include malnutrition, lead poisoning, shaken baby syndrome (baby shaken as an infant), and trauma to head during a car accident.
Types of Cerebral palsy
There are three types of cerebral palsy. In Spastic Cerebral Palsy, a single leg on one side or both legs and arms can be affected, and the child may have difficulty in movement as the muscles become stiff. In Athetotic Cerebral Palsy, the entire body is affected and the body shows slow movements which are not controlled. Ataxic Cerebral Palsy is the least common of the three types. In this type, there is no coordination and balance in the body.
A child with cerebral palsy may have stiff or floppy muscles with no muscle coordination (ataxia), and involuntary movements or tremors. The reflexes may be exaggerated, a condition called as spasticity, and there could be writhing movements that are slow (athetosis). The child may have delay in sitting up or crawling, and face difficulty in walking, eating or sucking, and speaking. The child may use only one side of body like reaching things with only one hand. The other problems associated with cerebral palsy included mental retardation, disability in learning, difficulty in hearing, vision problems, seizures, dental problems, and involuntary leakage of urine.
The doctor may conduct a series of tests to check for brain damage. To get 3D cross sectional image of the brain, a magnetic resonance imaging procedure is done in which radio waves and a magnetic field is used to produce required images of the brain. This is a painless procedure and takes about one hour to complete. The child is given a mild sedative for the procedure. Another procedure that is used is cranial ultrasound in which sound waves of high frequency are used to produce detailed images of the brain. In a procedure known as computerized tomography (CT scan), X rays are used to get cross sectional images of the child’s brain. It takes about 20 minutes for this procedure and the child is given a mild sedative so that he or she remains still during the procedure. If the child has seizures, then an EEG (electro encephalogram) is taken to check for the electrical activity of the child’s brain.
To rule out underlying problems that can cause cerebral palsy, lab tests like blood tests and assessment tests by specialists are done. The tests are done to find out if the child has any problems like blood clotting disorders, hearing impairment, vision problem, speech delays, mental retardation, and developmental delays.
There is no cure for cerebral palsy. However, the doctor may advise therapies that are beneficial for the child. Physical therapy involves muscle training and exercise to help the child develop balance, coordination, flexibility, and strength of muscles. The child also learns to sit on a wheel chair, use crutches, braces, and splints which will improve the child’s walking ability. In occupational therapy, the child is taught how to do normal activities at home and school like writing and improving on motor skills. In speech therapy, the child is taught how to speak in words or sign language and how to eat and swallow.
Muscle relaxants may be prescribed to reduce the stiffness of muscles. They include drugs like baclofen, dantrolene (dantrium), tizanidine (zanaflex), diazepam (diazepam, intensol, valium). In case of seizures, the doctor prescribes anticonvulsant. To reduce spasticity of muscle, Botox injections are directly given into the muscle or nerve.
Orthopedic surgery is recommended in children who have deformed bones and joints. The surgery helps in placing bones and joints in correct positions, and also to lengthen muscles and tendons that become too short due to contractures. Nerves that innervate the spastic muscles are surgically cut to relax the muscles and reduce pain.
Inspiring Jerry Traylor
‘Twelve individuals have landed on the moon and only one has jogged across America on crutches’. This one sentence says a lot about Jerry Traylor who is a well known motivational speaker with Cerebral palsy. When Jerry was just 6 years of age, he spent a year at the hospital getting 14 corrective surgeries done for his walking disability caused due to cerebral palsy. Jerry went on to participate in 35 marathons and climbing the top of 14,110 foot Pike’s Peak overcoming his disability. In Jerry’s own words he says, “Success is learning to control our limitations, rather than those limitations to gain control over us.”