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Cerebral palsy

Cerebral palsy

 


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Description
Cerebral palsy is not a disease or an illness. It is the description of a brain injury that causes physical impairment that affects movement, posture and coordination. It is not a progressive condition, as it does not get worse, but some of the secondary problems such as speech difficulties may get worse. The movement problems vary from barely noticeable to extremely severe. No two people with cerebral palsy are the same; it is as individual as people themselves.

Cerebral palsy includes a variety of conditions. The three main types correspond to injuries to different parts of the brain:

People with spastic cerebral palsy find that some muscles become very stiff and weak, especially under effort. This can affect their control of movement.

People with athetoid or dyskinetic cerebral palsy have some loss of control of their posture, and they tend to make unwanted movements.

People with ataxic cerebral palsy usually have problems with balance. They may also have shaky hand movements and irregular speech

In recent years there has been a slight increase in the proportion of children who have cerebral palsy; currently about one in every 400 is affected. Occasionally, children who appear to have cerebral palsy lose the signs as they get older. Most importantly, having a disability does not mean that someone cannot lead a full and independent life.
Causes
Cerebral palsy is caused by damage to the developing brain either during pregnancy (approximately 75% of cases), during childbirth (approximately 5% of cases) or after birth up to the age of 3 years (approximately 15% of cases).

The exact cause of the brain damage is not known, but in some cases it may be due to a lack of oxygen to the brain during pregnancy, premature birth, a low birth weight, complications during labour, or illness just after birth.

Improvements in maternity services and neonatal care have meant that fewer babies develop cerebral palsy as a result of lack of oxygen (from difficulties at birth) or jaundice. However, these improved services have also meant that more premature babies with very low birth weights survive and these are more likely to have cerebral palsy.

Infections during pregnancy, in infancy and early childhood, eg meningitis or encephalitis, can also cause cerebral palsy. Occasionally cerebral palsy is due to an inherited disorder and in such cases genetic counselling may be helpful.

It is sometimes possible to identify the cause of cerebral palsy, but not always.
Symptoms
The main effect of cerebral palsy is difficulty in movement. Many people with cerebral palsy are hardly affected, others have problems walking, feeding, talking or using their hands. Some people are unable to sit up without support and need constant help.

Sometimes other parts of the brain are also affected, resulting in sight, hearing, perception and learning difficulties. Between a quarter and a third of children and adolescents with cerebral palsy, and about a tenth of adults with cerebral palsy, are also affected by epilepsy.

People with cerebral palsy often have difficulty controlling their movement and facial expressions. This does not necessarily mean that their mental abilities are in any way impaired. Some are of higher than average intelligence. Other people with cerebral palsy have moderate or severe learning difficulties. Most, just as people without cerebral palsy, are of average intelligence.
Treatment
Cerebral palsy cannot be cured, but correct treatment from an early age can ease its effects. Treatments are different for each person and usually are a combination of physiotherapy, drugs, and possibly surgery. With help, most children with cerebral palsy overcome obstacles allowing them to be included in society and to lead independent lives.

Children with cerebral palsy do best when they get special help from an early age. As soon as cerebral palsy is diagnosed, a child can begin therapy for movement, learning, speech, hearing, social and emotional development. Speech and language therapy helps with speech development and also with eating, drinking, and swallowing. Physiotherapy can help improve posture and muscle strength, thereby improving movement and slowing progression of disability. In extreme circumstances surgery may be used to ease severe muscle spasms that may twist the body into an awkward shape.Occupational therapy helps children overcome difficulties in performing everyday tasks, encourages social and emotional development and allows them to lead independent lives.

Muscle stiffness can be eased with drugs such as baclofen, dantrolene and diazepam. These drugs help relax muscle and allow the person to regain posture and movement. Injections of botulinum toxin may be used to relieve severe muscle spasm. Epilepsy is treated with a range of different anti-convulsant drugs.
When to consult your pharmacist
Your pharmacist will be able to advise you on the medicines your child is taking either to relieve the muscle spasms or to treat the secondary problems that result from cerebral palsy.

The pharmacist also provides a 'sign-posting' service, to put you in touch with the whole range of specialists who are able to provide treatment, help and advice.
When to consult your doctor
As cerebral palsy affects people differently and to varying extents, your doctor will work closely with you to ensure that your child gets access to a specialist team including doctors, nurses, physiotherapists, psychologists and speech therapists.
Further information
If you need information, advice or just someone to talk to, get in touch with Scope, a registered charity providing advice and support for people affected by cerebral palsy.

From Scope's Early Years initiative (http://www.scope.org.uk/earlyyears/index.php) that addresses young children's communication needs, through to Scope's special schools for 18 to 25 year olds (http://www.scope.org.uk/education/index.php) that empower students to take responsibility for their own lives, Scope strives to overcome barriers to ensure that children with cerebral palsy are included in society and are able live a full life.

Call free on 0808 800 3333 or email response@scope.org.uk

Mailing address: SCOPE, 6 Market Road, London N7 9PW

Telephone 020 7619 7100

Website: http://www.scope.org.uk/index.shtml

Reviewed on 27/11/2009


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