Cerebral Palsy (CP)

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 Cerebral Palsy (CP)

is a group of disorders that affect a baby’s/ kid’s ability to move and maintain the balance and posture.Main Cause of CP:
:black_small_square:CP is caused by * a brain injury (birth injury) or
* brain problem that occurs
during pregnancy or during birth or within the first 2 to 3 years of child’s life.
:black_small_square:CP can result if there is severe oxygen depriviation to the brain or significant trauma to the head during labour or delivery.
:black_small_square:Birth complications as e.g., detachment of placenta, uterine rupture or problems with umbilical cord during birth can obstruct a baby’s oxygen supply and ultimately it may result in CP.
:black_small_square:In majority of cases, it may occur in “premature babies” as most of the newborns are not getting enough blood, oxygen or other essential nutrients before or during birth.
:black_small_square:CP causes :
* impaired movements with
* exaggerated reflexes
* floppiness or
* spasticity of the limbs and trunk
* unusual posture
* involuntary movements
* unsteady walking * or some combination of any of the characteristics mentioned above.
3 early signs of CP:
(i) Developmental Delays :
The child is slow to reach the milestones as e.g., neck holding, rolling over, crawling, sitting, talking and walking etc. !
(ii) Abnormal Muscle Tone :
Either the baby’s body parts are floppy or too stiff.
(iii) Abnormal Posture.
Types of CP:
(i) Spastic CP.
(ii) Dyskinetic CP (including athetoid, choreoathetoid, dystonic and hypotonic CP).
(iii) Ataxic CP.
(iv) Mixed CP.
=>These are classified based on morbility.
=> Each type can vary in severity, symptoms and treatment.
CP is commonly seen in the following age groups :
* In a baby, younger than 6 months of age.
* In a baby, older than 6 months of age.
* In a baby, older than 10 months of age.
Signs of CP in babies:-
* Low muscle tone (baby feels floppy, when picked up).
* Unable to hold his/her head, while lying in their stomach or in a supported sitting position.
* Muscle spasms or stiffness of different body parts is usually experienced.
* Poor muscle control, reflexes and posture.
* Delayed development (can’t hold the neck, can’t sit up or independently rollover by 6 months).
:black_small_square: About 75 to 85% of children with CP have Spastic CP; that means :
their muscles are stiff with the result their movements become awkward.
:black_small_square: Around 50 to 60% of children with CP, can walk independently.
:black_small_square: About 1 in 10 children diagnosed with CP, walk using a hand-held mobility device.
:black_small_square: Severe CP can reduce life expectancy due to significant physical and intellectual impairments and associated health conditions.
:black_small_square::point_right: Studies have shown that regular doses of Folic Acid reduce the risk of prematurity, which is a significant cause of CP.
:black_small_square: Signs and Symptoms of CP:
(i) A baby’s inability to lift his/her head by appropriate age of development.
(ii) Poor muscle tone in baby’s limbs resulting in heavy or floppy arms and legs.
(iii) Stiffness in baby’s muscles and joints or uncontrolled movements in baby’s arms or legs.
:black_small_square:It is essential to know the Signs of Mild CP to prevent complications from progression.
* Abnormal walking
* Walking on toes or heels
* Continuous bending of the knees
* Walking with toes pointing inward or outward or there may be slight limping in the child’s gait etc. !Some Facts About Cerebral Palsy (CP):
* Chronic mild stress in pregnant mothers may increase the risk that their offspring will develop CP (a group of neurological disorder marked by physical disability).
* All developmental tasks are delayed in premature babies.
* CP is typically diagnosed in babies and toddlers between 18 to 24 months ; although signs and symptoms may be present much earlier.
* CP is a brain disorder in which muscles are flaccid and ultimately leads to improper movements.
* Although it’s a permanent disorder, but CP is non-progressive.
* CP is a permanent condition with no known cure and a child can’t outgrow CP. This means that no matter what the symptoms are, the underlying cause of symptoms will never go away.
* “CP” does not, on it’s own, affect a person’s intelligence.
* Children with CP have limited mobility or lack of coordination of their arms and legs.
* Children with CP commonly have feeding disorders and swallowing problems and in many instances place them at risk for aspiration or even “aspiration pneumonia” with oral feeding ! They also commonly have reduced nutrition and their hydration status is also not satisfactory, thereby having prolonged stressful meal times. To summarize all, it should be briefly mentioned that
babies with CP often do not feed easily or sleep well ; fussiness is another sign to watch for.
* Social and Emotional Milestones in a CP Child are not always easy to assess but delays in these can also indicate that a child has CP or another developmental disorder.
* Cerebral Palsy (CP) can not be detected before birth. However, if the foetus is in a high-risk category for developing CP, performing an ultrasound can detect an abnormality.
This allows doctors and parents to start therapy early to assist in somewhat better development at later stages.
* “Tummy Time” (placing the baby on his/her stomach only; while awake as it will help the baby to develop strong neck and shoulder muscles which ultimately promote motor skills). It’s a really helpful position for the children with any physical disability including CP.
* A child with CP may struggle to get the hours of sleep they so desperately need. It may take hours to fall asleep or such children keep waking up for multiple times during the night. They could be up for long stretches or can’t calm down without the presence of his/her mother.
*The most common visual problems in children with CP are strabismus (“cross eyed”; a condition in which the eyes do not line up with one another).
* A wide range of rolling behaviour is typical and most babies roll over for the first time between 2 to 4 months of age. However, when babies roll over very early or seem to have another uncontrolled movements, it may be a sign of CP !
Early rolling can signal characteristic differences in reflexes.
* The babies at greater risk of developing CP :
(i) Male babies are at greater risk rather than the female babies.
(ii) Premature babies.
(iii) Low Birth Weight Babies.
(iv) Twins, triplets and higher multiple births.
*CP patients go on to live a healthy normal life as transition goes on to adulthood.
* Severe CP patients have a decreased life expectancy due to significant physical and intellectual impairments and associated health conditions. According to another school of thought “Children born with CP can expect to live between 30 to 70 years on the average”.