Abnormalities of movement and posture caused by damage to the immature brain
- Age as a risk factor depends on the cause
- Gender, genetics, and lifestyle are not significant factors
Cerebral palsy is not a specific disease but a general term used to describe a group of disorders affecting movement and posture. These disorders all result from damage to the developing brain either before or during birth or during a child’s early years. Children with cerebral palsy lack normal control of limbs and posture, but their intellect is often unaffected. Although the damage to the brain does not progress, the disabilities it causes change as a child grows. Many children have symptoms that are hardly noticeable, but other children may be severely disabled. Cerebral palsy affects about 1 in 400 children born in the UK.
What are the causes?
In many cases of cerebral palsy, there is no obvious cause. However, the fetus can be damaged by an infection, such as rubella or cytomegalovirus, transmitted from the mother during pregnancy (see Congenital infections). Cerebral palsy may also result if a baby is deprived of oxygen during a difficult birth (see Problems during delivery). The disorder can develop in premature babies, whose immature brains are often prone to abnormal bleeding (see Problems of the premature baby). During early childhood, cerebral palsy can develop after meningitis, an infection of the membranes around the brain (see Meningitis in children), or after a head injury.
What are the symptoms?
If brain damage has occurred during pregnancy or birth, a newborn baby may be limp and unable to feed properly. Even if the symptoms are vague, such as a reluctance to settle down, parents may suspect that there is a problem from an early age. More commonly, symptoms do not appear until after 6 months of age and may include:
Weakness or stiffness affecting one or more limbs.
Reluctance to use a limb.
Abnormal, uncontrolled movements.
Delay in achieving normal milestones in motor development (see Developmental delay).
Difficulty in swallowing.
Chronic constipation (see Constipation in children).
Many children have vision disorders, such as squint (see Strabismus), and impaired hearing (see Congenital deafness). About 1 in 2 children has a learning disability (see Generalized learning disabilities).
Are there complications?
If a child with cerebral palsy has stiff limbs, he or she may experience difficulty in walking and have an abnormal posture. The disorder can also increase the risk of dislocated joints, particularly the hips. Sometimes, children with cerebral palsy develop epilepsy. Behavioural problems may develop if a child becomes frustrated because of his or her physical disabilities and inability to communicate clearly. Children with severe cerebral palsy are particularly susceptible to chest infections because they cannot cough effectively.
What might be done?
The diagnosis of cerebral palsy is often difficult to make in a very young child. As a child becomes older, the symptoms become more obvious. Once the condition is suspected, tests such as CT scanning or MRI may be carried out to identify brain damage.
Once the diagnosis is confirmed, the whole family has to adjust to the lifestyle changes that are often associated with caring for a child with cerebral palsy. Many affected children have only mild disabilities, requiring some physiotherapy, but children who have more severe disabilities usually need long-term therapy and specialist support. Emphasis is placed on assessing individual needs and helping a child to achieve his or her maximum potential. Physiotherapy to encourage normal posture plays a major part in the care of an affected child. Parents can encourage a child to play in a way that exercises the muscles and develops coordination.
If a child has only a minor physical disability, he or she may be able to attend a normal school. Children who have more severe disabilities or whose intellectual ability is affected may benefit from special schooling.
Complications and problems associated with cerebral palsy will be treated as necessary. For example, if your child has impaired hearing, he or she may require a hearing aid. Caring for a disabled child at home is stressful, and occasional residential care or residential schools can provide respite.
What is the prognosis?
Children with mild physical disabilities can usually lead active, full, and long lives and often live independently as adults. Severely disabled children, especially those with swallowing difficulties who are more prone to serious chest infections, have a lower life expectancy.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.
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