Cerebral palsy is a disorder that affects movement and muscle tone, caused by a damage that occured on a brain at a young age. The affected part of the brain can not control some muscles, which is why they are stiff and difficult to use.
The degree of disorder is different. Some limbs are completely immobile, and sometimes the child’s movements are weak and it is almost impossible to manage them. Simple movements, such as stretching a hand to take a cup of coffee can be accompanied by twitching, and the movement can be carried out only after a few unsuccessful attempts. These are so called spastic forms of disorders. Many such children are somewhat mentally retarded, though some may be very intelligent. Spastic children can be partially deaf. Visual disturbances also occur, most commonly squint and spasms.
The exact cause of cerebral palsy in most children is not known. It is known that it is not hereditary, so you do not have to fear that your second child will have paralysis if you already have a child with celebral palsy. Cerebral palsy can be a consequence of disturbed development or brain damage before, during or shortly after birth. At a later age, brain damage can occur due to brain injury, meningitis (see meningitis in infants and children), or severe convulsions.
In many cases, the symptoms can be noticed whrn the baby is six (or more) months old. Inactive muscles may be the starting sign of this disorder, but many spastic infants do not have this symptom. The most important symptom, limb stiffness, occurs only when the infant is at least 6 months old. When this happens, normal muscular balance is disturbed and limbs take a typical abnormal position. For example, the affected arms are usually ”attached” to the body with bent elbows and joints. The legs can be crossed like scissors, and the foot is facing downward from the ankle joint. The infant is barely moving and every movement, if the baby makes it, is very awkward. In addition, it may be difficult for a child to suck and swallow.
Normal turning points in child development, such as walking and speech, can be late. Children who begin to walk late (or do not walk at all) will not be able to explore the environment and learn from experience in this vital stage of their development, and the situation will worsen if the sight or hearing is damaged.
If the child talks with a great delay – which often happens when the child is deaf – speech can be distorted and very incomprehensible. Children of average or high intelligence can become very frustrated because they are deprived of normal development and communication skills, and ultimately may have emotional discomfort.
Spastic cerebral palsy is the most common disease in childhood. The disease affects (around the world) about one in every 300 children. It is somewhat more common in premature babies or very small infants (below 2500 g).
Even stronger muscle stiffness can more and more restrict the child’s movements. The baby may not be able to walk sometimes and needs to be in a wheelchair.
It is also very dangerous to ignore the intelligence of the child, especially if his/hers movements and communication are very difficult. It is therefore extremely important to regularly evaluate the child’s mental capacity and development, and to examine the sight and hearing as this is important for the ability to learn.
Cerebral palsy does not always affect the entire body. Sometimes only legs are affected, and this condition is known as paraplegia. In about one-third of all paraplegic children one side of the body is affected, which is called hemiplegia. Quadriplegia is a condition in which all limbs are affected.
What to do?
Contact your doctor if you are concerned about the development of your child. Parents of spastic children can go to the Social Work Center in their municipality, which initiates the procedure of examination and categorization for all handicapped persons in their area.
Brain disorders (such as those that cause cerebral palsy) usually do not aggravate, but cannot be alleviated. But that does not mean that you can not do anything for your child. First of all, it is necessary to determine the degree of disturbance – physical, mental, visual or auditory – and, with treatment, minimize them them to the smallest possible extent.
Of course, healing and treatment of a child with cerebral palsy requires teamwork of parents, doctors, physiotherapists, speech therapists, teachers and, in some cases, work therapy specialists.
Physical therapy is performed in special schools, clinics and at home and is aimed at preventing the development of permanent deformations by exercising for loosening muscular muscles and finding the most favorable positions of the affected limbs. Thanks to physical therapy, children who never walked are able to walk with the help of devices such as walkers and parallel bars.
Speech therapy does not only improve the child’s speech but also allows easier feeding and swallowing.
Operations performed by orthopedists can correct the stiffness of deformed limbs and facilitate movements. Surgical treatment allows some children, who would otherwise be accustomed to a disability chair, to walk with various orthopedic devices. Deafness in many paralyzed children can be reduced by hearing aids. Squints (strabismus) can be corrected by a surgical procedure, and for other eye disorders glasses are usually prescribed. Muscle relaxants are also sometimes prescribed to reduce limb stiffness, as well as various medications against cramps.
A child is regularly examined by a pediatrician or a primary health care physician (general practitioner) with the help of a school psychologist. They evaluate the child’s overall progress and intelligence, and they recommend to parents the education that would be best for their child.
Many children with mild form of cerebral palsy are on average or almost average intelligent and can attend regular schools. The average intelligent children with moderate or severe disabilities will have to go to a special school for physically disabled children. For children with below the average intelligence, there are schools with a living room for the intelectually disabled children.
To parents, the development of their child may seem slow, and improvement may seem almost unattainable. But never let impatience ”allures” you into some unhealthy treatment, especially if you have not discussed it in detail with a team of experts who are treating your child.
The prospects for children with spastic cerebral palsy depends on the degree and type of disability. Children who can attend a regular school should not have much trouble. Most of them grow up and live in a relatively normal social life. Most children who are attending school for physically disabled children have more difficulties. However, modern equipment in these schools still allows children to communicate with others and to actively participate in social life when they grow up, although in many cases they will require an environment tailored to their special needs.