Cerebral Palsy is a disorder impairing control of movement that appears in the first years of life. This condition does not improve with age although it may change its character and whilst cerebral palsy treatment can never repair the damage done it can improve quality of life. Most incidences of this condition occur naturally however about 10% of cases are due to medical negligence usually during labor and/or delivery. If your child suffers from CP and you suspect that your delivery was carried out negligently you should contact a medical negligence lawyer as soon as possible. There are time limits dependent on location – you need to instruct a medical negligence lawyer in your vicinity without delay.
Medical practitioners classify this condition according to the number of limbs involved as follows:
- Quadriplegia – all 4 of the limbs are involved
- Diplegia either – both legs or both arms are involved
- Hemiplegia – one side of the body is affected
- Triplegia – 3 limbs are involved
- Monoplegia – 1 limb is affected
The condition is caused by damage to the brain which disrupts the ability to control movement and posture and may cause seizures or mental impairment. It may be naturally occurring or may be as a result of medical negligence. Affected children are frequently slow to reach developmental milestones and may show typical cerebral palsy symptoms.
There are four main categories:
- Spastic is the most common form, affecting 70-80% of patients and the muscles remain in a constant state of increased involuntary reflex.
- Athetoid affects 10-20% of patients and causes involuntary, purposeless movements, especially in the face, arms, and trunk.
- Ataxic affects 5-10% of patients and is characterised by poor muscle tone and altered sense of balance and depth perception, leading to slow, uncoordinated, unsteady and shaky movement.
- Mixed is usually a combination of spasticity and athetoid although any combination can occur.
Cerebral Palsy Symptoms
The existence of some of the cerebral palsy symptoms outlined below does not necessarily mean that a child has CP. Children under the age of six months with CP may demonstrate some or all of the following:
- Trembling of the arms and legs
- Hand held in tight fist
- Feeding difficulties
- Seizures, staring spells, eye fluttering or body twitching
- Abnormal crying
- Abnormal posture
- Changing muscle tone from floppy to very stiff
- Abnormal reflexes
- Poor muscle tone
- Asymmetry of movement
Other conditions may mimic CP and certain tests are used to reach a definite diagnosis prior to starting cerebral palsy treatment:
- Chromosome analysis may show genetic problems.
- Thyroid function tests may reveal low levels of thyroid hormone causing congenital defects and mental retardation.
- An electroencephalogram (EEG) can reveal a seizure disorder.
- Declining motor skills may indicate genetic disease, muscle or metabolic disorder, or tumour in the nervous system.
- Imaging tests may diagnose hydrocephalus, structural abnormalities, and tumours.
- Ultrasound can detect cysts and abnormal structures in the brain.
- Electromyography and nerve conduction studies can identify a nerve or muscle disorder.
- A head CT scan can show congenital malformations, haemorrhage, and periventricular leukomalacia in infants.
- A high level of ammonia in the blood is toxic to the central nervous system.
- Magnetic resonance imaging (MRI) defines abnormalities of white matter and motor cortex.
Children over the age of six months with CP are often slow to reach developmental milestones and parents are more likely to notice if this is not their first child. The medical profession is reluctant to make an early diagnosis of CP based on the existence of clear cerebral palsy symptoms as the child’s central nervous system may recover and instead of using the term ‘CP’ at the outset, doctors and consultants may use broader terms such as:
- Developmental delay
- Central nervous system dysfunction
- Static encephalopathy
- Motor disability
- Neuromotor dysfunction
Cerebral Palsy Treatment
Cerebral palsy treatment cannot undo the irreversible injury to the brain which causes CP and may result in difficult medical, social and educational challenges. It may be possible to improve quality of life by managing and controlling physical and mental disability by physical therapy, psychological treatment and drug therapy. The following therapies can help to reduce the effects of cerebral palsy symptoms and may be implemented as part of the treatment tailored to the individual’s particular needs.
Physical therapy is usually started in the early years of a child’s life to prevent contracture complications by stretching the affected muscles which may improve motor development and prevent the muscles from becoming weakened due to lack of use.
- Regular exercise in conjunction with physical therapy can help to reduce muscle contractures and deformity.
- Behaviour therapy involving psychological techniques can improve quality of life.
- Speech therapy may help communication skills.
- Tranquilisers may be used to relax tightened muscles.
- Antispasmodics may be used to reduce spasms.
- Anticonvulsant medication may reduce seizures.
Some contractures can to be so severe that orthopaedic surgery can be appropriate to lengthen affected muscles.
Neuro surgery may be used in severe cases in order to reduce the amount of nervous stimulation that can reach the muscles.
There is a lot that can be done to help cerebral palsy children to control their muscular action and to prevent deformity from muscle contractures. Apart from the cerebral palsy treatment outlined above, those with severe problems can attend schools dedicated to their special needs. A range of health professionals are available to help people with cerebral palsy such as speech therapists, neurologists, physiotherapists and paediatricians, as well as GPs and community nurses.