Introduction to Cerebral Palsy
Cerebral palsy (CP) is an immature brain damage. Cp is not a separate disease; it’s
an umbrella term involves multiple symptoms. Cp is a group of disorder which
effect on posture and movement development. The word “Cerebral palsysis” used
first time by the English orthopedic Surgeon William little more than 170 years
when he faces a difficult labor, neonatal hypoxia with limb spasticity and
consequently musculoskeletal deformities.
Definition:
Cerebral palsy is a non-progressive permanent disorder of movement and posture
caused by lesion in developing brain either in fetal or neonatal life and causes
sensory and motor impairment and consequently mental retardation, speech
impairment and hearing problem.
Cerebral palsy may have several other coexisting problems including epilepsy,
musculoskeletal problems, feeding difficulties and visual impairments.
Etiology and Risk factors:
Exact cause of cerebral palsy is uncertain. More than one cause may present. As
CP in caused by injury to the brain so brain damage can occur during pregnancy
(prenatal), at the time of birth(natal) or even after the birth(post-natal).
Kinds of Brain damages:
Hemorrhage
hypoxia
Trauma to brain
Brain malformation
Infection
Hyperpyrexia
Toxins
Dehydration due to diarrhea and vomiting
In 70% cases brain damage occurs prenatally. Natally there is only 5-10% chances
and 10-18% accounts for neonatal period. A lot of risk factors contributes to
different causes. And these risk factors are all categories as following.
Possible indicators of CP:
Cp child have delayed milestones.
Even after two months of age child have:
Poor head and neck control
Legs become stiff and scissors when picked up
Unable to smile by 3 months
After six months:
Continually have difficulty in head control when lift up
Floppy posture
Feeding issues, gaggling and choking
After ten months:
Commando crawling
Unable to sit without support
After one year:
Inability to crawling
Without support not capable to stand
After two years:
Inability to walk
Prevalence of CP:
Studies over the world which are population based proclaimed that approximated
prevalence of cp ranges from 1.5 to more than 4 per 1000 live births. Also, various
other studies indicate cp prevalence is higher in developing countries as
compared to developed ones.
Cerebral palsy classification:
According to American academy of cerebral palsy there is a variety of cerebral
palsies. CP traditionally classified based on the location of symptoms and type of
damage. CP is classified into different types and subtypes as its essential for
treatment purposes.
There are four approaches that are used for classifying Cerebral palsy.
1. SCPE classification (Surveillance of Cerebral Palsy in Europe).
2. Topographical or Ingram’s Classification.
3. Functional classification (Gross Motor Function Classification System)
(GMFC).
4. According to Severity.
Cerebral palsy is subcategory into spastic, dyskinetic, hypotonic,
ataxic, and mixed forms from a treatment perspective.