Question

Define Cerebral palsy. Then state Etiology, Prognosis, Symptoms, Signs and Complications for this condition.

Answer 1

CEREBRAL PALSY (CP)

Definition : CP is a term used for a group of non progressive disorders of movement and posture caused by abnormal development or damage to motor control centers of the brain.

ETIOLOGY

Causes of CP can be broadly classified into prenatal, perinatal and postnatal factors.

1. Prenatal - before birth

* Congenital abnormality in brain development

* Infection in mother during pregnancy such as TORCH infection, hiv etc

2. Perinatal - during birth

* Brain injury due to oxygen deficiency during difficult labour.

* Brain haemorrhage in premature babies.

3.Postnatal - after birth

* Infections of the brain such as encephalitis and meningitis

* Head trauma causing concussion or brain haemorrhage.

PROGNOSIS

Cerebral palsy is not a worsening or degenerative condition, but there is no cure for the condition . The children as well as the parents will have to come to terms with living with the condition despite its permanent and irreversible nature.

Children with mild forms of cerebral palsy have a normal life expectancy ,when compared with a patient who has severe disease. Children with quadriplegia,severe epilepsy,severe mental retardation, and other medical complications like reflux and pulmonary disease have worst outcome.

SIGNS AND SYMPTOMS

1.Physical signs

* Poor head control after 3 months of age

* Still or rigid arms or legs

* Pushing away or arching back

* Floppy body posture

* Cannot sit up without support by 8 months

* Clenched hands after 3 months

* Leg scissoring

* Seizures

* Sensory impairment ( hearing, vision)

2.Behavioural signs

* Extreme irritability or crying

* Feeding difficulties

* Little interest in surroundins

* Excessive sleeping

COMPLICATIONS

1. Musculoskeletal complications and delayed development

Contractures are common complications . Contractures also cause deformities in joints and bones.Spinal deformities can include scoliosis, kyphosis, lordosis.

Deformed and misaligned joints contribute to osteoporsis and osteopenia.

Children with cerebral palsy do not meet the same developmental milestones as their peers.

2. Neurological conditions

* Seisure disorders

* sleeping disorders

3. Intelletual ,language , learning disabilities

4.Vision and hearing impairment

5. Chronic diseases and infections

Heart disease, lung disease and pneumonia are common in people with CP.

6.Psychiatric conditions

People with CP are at higher risk of depression,anvxiety and mood disorders. They may also experience feeling of isolation and stigma , particularly if they treated differently.

7.Facial motor and oral problems

An inability to fully control mouth muscles , as of those of lips, jaw, throat and tongue leads to drooling,difficulty in chewing or swallowing.These problems interfere with healthy eating, which leads to malnutrition,poor growth and development, and poor weight gain.

Difficulty with fine motor skills and controlling oral muscles make dental hygiene harder. Therefore gum disease and cavities are common.