Spastic Cerebral Palsy
In cases of spastic cerebral palsy, a child’s movements may appear stiff or jerky. Kids with spastic cerebral palsy often have trouble moving their limbs, and may find it difficult to grasp or let go of objects.
Most children diagnosed with cerebral palsy will have primarily spastic-type symptoms. Estimates vary on the incidence of spastic cerebral palsy, but most studies, including research reported by the US Centers for Disease Control & Prevention, place the range between 61% and 77%.
Athetoid Cerebral Palsy
Athetoid (or “dyskinetic”) cerebral palsy is marked by involuntary movements of the limbs and trunk, which are often slow but uncontrollable. An associated disorder, called chorea, involves small, rapid movements that are also uncontrollable.
Low muscle tone is a hallmark sign, although some children will have highly-developed muscle tone in the muscles that are directly affected by their condition. An inability to maintain posture and balance while sitting, standing or walking is common, as are speech and language disorders.
Ataxic Cerebral Palsy
Ataxic cerebral palsy is characterized by a lack of coordination. A child’s movements may appear clumsy or imprecise, disorganized or unsteady. Balance and depth perception are greatly impaired in this type of cerebral palsy.
A small number of children will be diagnosed with mixed forms of cerebral palsy, in which two or more forms of the condition are present together.
What Causes Cerebral Palsy?
Cerebral palsy is caused by damage to the brain’s extrapyramidal system, a network of neurons that trace through much of the basal ganglia and cerebellum. These two portions of the brain are largely dedicated to controlling voluntary movements and motor control.
Every case of cerebral palsy is unique. While most brain injuries that are considered “palsies” will affect a child’s muscle control, coordination, reflex response and muscle tone to some extent, the specific symptoms in any one case are highly dependent on why – and how – the brain was injured.
- Spastic cerebral palsy is caused by injury to the brain’s motor cortex, a section of the cerebral cortex on the top of the brain. Neural signals to move, which will eventually reach the spinal cord, originate here.
- Athetoid cerebral palsy is caused by damage to the basal ganglia, which lie deep inside the brain above the brain stem. These structures act like a relay station, transmitting information from the brain’s movement center to the spinal cord. The basal ganglia is instrumental in regulating voluntary movement.
- Ataxic cerebral palsy is believed to be caused by injury to the brain’s cerebellum, which serves to calibrate fine motor skills, maintain balance and coordinate movements carried out by separate body parts simultaneously.
While cerebral palsy is considered a “nonprogressive” brain disorder, which means the brain damage itself does not worsen over time, a child’s symptoms can change as they age. Sometimes the symptoms, like fine motor skill impairment, get better over time, while in other cases, they worsen.
Cerebral Palsy & Birth Injury Malpractice
Most cases of cerebral palsy are caused by brain injuries that develop during pregnancy. These cases, known collectively as “congenital” (or “from birth”) cerebral palsy, are often difficult to explain. Researchers have proposed a variety of causal factors that may play a role in the development of congenital cerebral palsy, including:
- infections like rubella and toxoplasmosis that can harm a fetus’ growing nervous system
- Rh incompatibility, a blood condition that causes a mother’s body to produce immune system cells that attack a fetus’ blood cells
- inadequate myelination of nerve cell fibers, in which the coating that normally protects nerve cells as they transmit electrical information throughout the brain is compromised for some reason
In some cases, like that of Rh incompability, there is little that doctors can do to prevent an infant from developing cerebral palsy. But that isn’t always true.
A significant minority of cerebral palsy cases, between 10% and 20%, are ultimately attributed to injuries sustained during the birthing process itself, WebMD reports. Many of these cases are the result of medical negligence.
Primary among these causes is birth asphyxia, in which an infant is deprived of oxygen at the time of delivery or during labor. Oxygen deprivation is a leading cause of brain injuries among newborns, and often comes as the result of inappropriate medical care.
Infants can also sustain head trauma, and suffer brain damage, during particularly difficult deliveries – when physicians should, but don’t always, use the appropriate care in handling a child’s delicate head. Breech births, when babies enter the birth canal feet or buttocks first, are a particular risk factor for both birth asphyxia and cerebral palsy.
Another potential cause is jaundice, the common condition that causes many newborns to appear yellow right after birth.
When babies are born, their kidneys often need a little time to catch up. Normally, the organs filter waste products out of body fluids, including bilirubin, the pigment that gives bile its yellowish appearance. But in many infants, these waste products actually build up during the first few days of life, because the kidneys haven’t matured yet. The issue usually resolves itself after the kidneys have begun filtering bilirubin appropriately.
Jaundice sometimes requires medical treatment, though, especially in severe cases of the condition. If the need for an appropriate therapy isn’t recognized promptly, excessive amounts of bilirubin can lead to brain damage, and potentially cerebral palsy.
How Is Cerebral Palsy Diagnosed?
Cerebral palsy disorders can be difficult to diagnose. While several tests can be used to confirm brain injury immediately after a child’s birth, there’s no single test to confirm or rule out the development of cerebral palsy itself.
That can be frustrating, and time-consuming, for parents, many of whom have noticed that their child has failed to meet a developmental milestone. Delays in diagnosis can also be detrimental for children, since catching the disorder early allows more time to establish effective treatment options.
Diagnosis is usually made within the first two years of a child’s birth. Mild forms of the disorder may not be noticed until the brain has developed more fully, between the ages of three and five. Irregularities in muscle tone development and growth delays are often early indicators that cerebral palsy is a possibility. To confirm a diagnosis, doctors will use a variety of reflex and coordination tests. Diagnostic tests, like cranial ultrasound and MRI, can also be helpful.
Is There A Cure For Cerebral Palsy?
No, there’s no cure for cerebral palsy disorders. Many of the impairments connected to cerebral palsy, however, can be managed effectively.
Most children with cerebral palsy benefit from the services of a team of medical professionals, rather than a single general practitioner. Most families will rely on an occupational therapist and physical therapist to help their child meet full potential, although more severe cases generally require a wide range of specialists, from speech pathologists to pediatric neurologists.
Surgical interventions are often indicated for children with spastic cerebral palsy, who have increased muscle tone that can stiffen limbs and restrict movement. A wide range of prescription medications can also be helpful for kids with cerebral palsy, including antispastic drugs like baclofen and anticonvulsant medications like gabapentin.
There’s no one-size-fits-all treatment method for cerebral palsy. Every treatment plan will be tailored to a child’s specific impairments.