Cerebral Palsy is defined as a condition marked by impaired muscle coordination (spastic paralysis) and/or other disabilities, typically caused by damage to the brain before or at birth. Although Cerebral palsy is not contagious, a person can intentionally or unintentionally increase the possibility a child will develop Cerebral Palsy through abuse, medical malpractice, negligence, or the spread of a bacterial or viral infection (Stern, 2017).
Cerebral palsy was first introduced in the mid 1800’s by Dr. William John Little, whom suffered from several illnesses. He wrote the first medical descriptions, detailing a disorder that caused a spastic, stiff muscular disorder within children. Cerebral Palsy made it difficult for children to do simple tasks like crawling, grasping objects, and walking. He also noticed that as the children began to age, their symptoms would only worsen (Brody, 2005). Little reasoned that most of the children diagnosed with this disease were known to be premature or were involved in a complicated birth.
He concluded that extended time in a woman’s birth canal, resulted in lack of oxygen, which meant oxygen shortage damaged sensitive brain tissues responsible for a person’s muscle movement. What was originally known as Little’s Disease, is now known as Spastic Diplegia Cerebral Palsy. In 1897, Little’s theory was challenged by a world famous psychiatrist known as Sigmund Freud. Freud believed that the condition was caused by problems such as mental retardation, visual disturbances, and seizures. Furthermore , he believed that the condition could stem from the brains development in the womb.
During a government study, scientists analyzed 35,000 births and realize that only 20 percent came from birth complications and 10 percent were a result of after birth (Brody, 2005). Today, Cerebral Palsy is the most common motor disability in childhood. Population based studies from around the world report prevalence estimates of CP ranging from 1. 5 to more than 4 per 1,000 live births. About 1 in 323 children has been identified with CP according to estimates from CDS’s Autism and Developmental Disabilities Monitoring Network.
Cerebral Palsy is caused by traumatic injury to the developing brain, including the parts of the brain responsible for motor control, coordination and balance. Damages to different parts of the brains motor control centers determines the different types of Cerebral Palsy. Statistically, about 70 percent of all Cerebral Palsy cases were caused by prenatal injuries and only 10 percent were caused by injuries after birth (Bochek, 2017). There are several incidents that can cause damage to the developing brain, including severe untreated jaundice which can turn into a condition known as Kernicterus.
Kernicterus is the buildup of bilirubin, which is toxic to the human brain. Additionally, Asphyxiation can occur when oxygen is unavailable to the brain, cofactors include the earl detachment of the placenta, a ruptured uterus during birth or the umbilical cord getting pinched off causing oxygen deprivation (Kingsley, 2012). Causes are determined by the location of brain damage, the areas of the brain that control motor skills and movement are the motor cortex, pyramidal tract, cerebellum, and the basal ganglia. The first type of Cerebral Palsy is known as Spastic (pyramidal), Spastic Cerebral Palsy is caused by damage to the motor cortex.
A person with Spastic Cerebral Palsy will experience tight muscles, due to affected joints becoming stiff and difficult to move. Usually, a person has trouble controlling their movements, balance, talking and eating (Kim,2014). Non Spastic (extrapyramidal) Cerebral Palsy includes Dyskinetic and Ataxic Cerebral Palsy. Dyskinetic affects the neck, arms, legs, hands, feet and torso, patients experience slow uncontrollable movements involuntarily. Ataxic is the rarest type and involves the entire human body. Patients are unable to button their clothes, balance, or walk without their feet being unusually far apart (Pellegrino,2014).
Lastly, some children experience symptoms of more than one type, including spastic legs (spastic diplegic cerebral palsy) and facial muscle control (dyskinetic cerebral palsy). Those with mixed conditions experienced injuries to multiple controls centers of the brain (Health Wise Staff, 2014). Confirming Cerebral Palsy takes an immense amount of time, a child is usually diagnosed around the age of 18 months to 5 years old. Several imaging tests such as a magnetic resonance image (MRI), computed tomography scan (CT), electroencephalogram (EEG), and a cranial ultrasound are used for diagnostics.
MRI’s produce 3D images of a patient’s brain, which can reveal abnormalities that contribute to motor function complications. CT’s in infants help to identify Congenital Malformations, Intracranial Hemorrhage, and Periventricular Leukomalacia or early Craniosynostosis. Furthermore, EEG’s are important because they can reveal seizure disorders a patient may not be experiencing awake. Lastly, Cranial ultrasounds can be performed in the early neonatal period to delineate clear cut structural abnormalities in a child’s brain and show evidence of hemorrhage or Hypoxic-ischemic injury.
All tests discussed help doctors diagnose a patient with physiological and or metabolic effects occurring in a patient’s body. Metabolic effects that occur in a patients growth and nutritional disorder are common in children with Cerebral Palsy. One of the major causes of poor growth is malnutrition, and since nutrition is an important area of managing a child’s CP, it is imperative to understand the rule of nutrition and to maintain the health of a patient. Malnutrition results in increased circulation and diminished cardiac work capacity, as well as leading to diminishment of the immune system functions.
Immune System diminishment results in the weakening of muscle strength which affects the impairment of motor function and respiratory musculature. Furthermore, these result in impaired cough and predisposition to pneumonia (Kelly,1984). Studies showed undernourished children show lower levels of exploratory activity and attachment behavior which may affect a child’s social and emotional development. A significant contributor to malnutrition is because patients with CP have a difficult time of eating because they have no control over their muscles in their oral cavity.
Most patients are fed through tubes and are given a liquid diet full of everyday vitamins they do not receive on a daily basis. In a study of 171 children, results show that 38 % were below the third percentile for weight, 30 % of children had triceps skin folds below the third percentile and liner with weight and head circumference was significantly low (Stevenson,2010). Signs and symptoms that can help assist in the diagnosis of patients with CP include muscle tone, coordination, reflex, posture, balance, gross motor function, fine motor function, and oral motor function.
Proper muscle tone allows the limbs of the human body to bend and contract easily. This allows an individual to bend and stand while maintaining posture without assistance. In an individual with CP, improper muscle is common and when this happens muscles do not coordinate together. For example, the biceps and triceps work in pairs, however due to CP those muscles contract and relax at the same time (Stevenson,2010). Furthermore, resulting in impaired posture and inability to sit or move. Oral motor function is also a common symptom, patients experience difficulty using their lips, tongue or jaw.
According to the My Child website, 90 % of preschool aged children were unable to swallow, speak, chew and continuously drooled. This is known as Apraxia, which is the inability of the brain to effectively transmit proper signals to the muscles used in speaking (Stern,2017). It is difficult to make predictions about prognosis in a child with CP before the age of 2, because children are constantly growing physically and mentally. However, there are several tests that can predict an outcome of a child with CP.
By taking images of the brain, a doctor can identify any intellectual abilities, this is called neuroimaging. Cerebral Palsy is not a degenerative condition, but there is also no cure. The only benefit of CP is that the disease is not progressive and usually does not worsen. Children and their parents will have to come to terms on how to deal with the diagnoses and may seek a professional opinion. Most children with CP will live a long and happy life, depending on who their caretaker is. Patients may need regular physician visits, prescribed medication, therapy and in severe cases surgery.
Children with Cerebral Palsy will most likely be offered special education assistance, and require special technology to cope with impairments. Unfortuntly inproper management of CP will result in severe conditions and a short life expectancy. It has come to the conclusion that curing Cerebral Palsy is not impossible. Because Cerebral Palsy derives from the different areas of the brain, it is possible to use stem therapy. One might ask why stem cells are so important, to answer that question stem cells are simple cells that give rise to differentiated cells in the body.
Scientists have basically figured out a way to grow new cells in a controlled lab. Furthermore, the brains motor control center is full of billions of brain cells, if doctors can repair those damaged cells with new stem cells, then those new cells can work to produce more new cells and replace the damaged ones. To contribute to this hypothesis, stem cells have been beneficial in chemotherapy, growing organs, and heart transplants. There is a cure out there for Cerebral Palsy and it starts with listening, learning and discovering.
