Cerebral Palsy
Medical Terminology
Constance Nye
11/26/2022
Cerebr/o - : brain Palsy: slight or moderate paralysis
Condition marked by impaired muscle coordination (spastic paralysis) and/or other disabilities, typically caused by damage to the brain before or at birth.
Signs & Symptoms
Signs & Symptoms
Movement & Coordination
- Stiff muscles with exaggerated or normal reflexes
- Variation of muscle tone
- Lack of balance and muscle coordination
- Tremors or involuntary movements
- Difficulty walking
- Difficulty with fine motor skills
- Favoring one side of the body
Speech & Eating
- Delays in speech movement
- Difficulty speaking
- Difficulty sucking, chewing, or eating
- Excessive drooling or problems with swallowing
Development
- Delays in reaching motor skills milestones, such as sitting up or crawling
- Learning difficulties
- Intellectual disabilities
- Delayed growth, resulting in smaller size
Other Neurological Symptoms
Other Neurological Symptoms
- Seizures (epilepsy)
- Difficulty hearing
- Problems with vision and abnormal eye movements
- Abnormal touch or pain sensations
- Bladder and bowel problems (constipation or urinary incontinence)
- Mental health conditions (emotional disorders and behavioral problems)
Management/Treatment
- A pediatrician, rehabilitation specialist (physiatrist), pediatric neurologist, and a variety of therapists and mental health specialists will provide care
Management/Treatment
Medications
- Muscle or nerve injections: Botox or another agent may be injected every 3 months to treat tightening of a specific muscle. Side effects: pain at injection site, mild flu-like symptoms, or difficulty breathing or swallowing
- Oral Muscle Relaxants: Baclofen, Zanaflex, Valium, or Dantrium may be used. In some cases a Baclofen pump can be implanted under the skin of the abdomen and pumped into the spinal cord.
- Medication to Reduce Drooling: Botox into the salivary glands may be given.
Therapies
Therapies
- PT: Muscle training and exercise help strengthen flexibility, balance, motor development and mobility
- OT: help gain independence with home and school routine through adaptive equipment
- Speech & Language: help improve ability to speak, communicate using sign language, or teach the use of communication devices
- Recreational: regular or adaptive recreational or competitive sports, such as horse back riding or skiing to improve motor skills, speech and emotional well-being
*1-2 years after birth both physical and occupational therapists work on issues such as head and trunk control, rolling, and grasping. Later, both types of therapists are involved in wheelchair assessments.
Surgical Procedures
Surgical Procedures
- Orthopaedic Surgery: Severe contractures or deformities may require surgery on bones or joints to place the arms, spine, hips or legs in their correct positions. Lengthening of muscles and lengthening or repositioning tendons that are shortened by contractures can also be done improving pain and mobility.
- Selective Dorsal Rhizotomy: Severe cases may require the specific nerves in the spastic muscles be cut if other treatments have not helped. This relaxes the legs and reduces pain but may cause numbness.
Who? How long?
Epidemiolgy
Cerebral Palsy effects infants especially those born prematurely and with low birth weight. These children are effected for their whole life.
Why?
Causes: gene mutations, maternal infections (ruebella, herpes, syphilis, zika virus, and exposure to toxins), fetal stroke, bleeding to the brain, infant infections (bacterial meningitis, viral encephalitis, severe or untreated jaundice, and bleeding to the brain), traumatic head injury, and lack of oxygen to the brain
*Low birth weight, multiple babies, premature birth, and delivery complications may also cause CP
Where?
- Study conducted using data from 20 population-based CP registries in Europe reported that the overall prevalence of CP declined from 1.90 to 1.77 per 1,000 live births between 1980 and 2003.
- Study of CP trends in Australia reported that CP prevalence declined between 1995 and 2009, as did the percentage of children with moderate-to-severe disability.
- Study in the Autism & Developmental Disabilities Monitoring CP Network reported that the prevalence of CP among 8-year-old children declined from 3.5 to 2.9 per 1,000 between 2006 and 2010.
Estimated lifetime care cost for individual with CP = about $1 million.
Medical costs for children with only CP are 10x higher than those without children with CP or any intellectual disability.
Medical costs for children with CP and intellectual disability were 26x more than those without CP or intellectual disability.
Economic Costs
Citations
1. Cerebral palsy. Mayoclinic.org. Published September 1, 2021. Accessed November 26, 2022. https://www.mayoclinic.org/diseases-conditions/cerebral-palsy/diagnosis-treatment/drc-20354005
2. CDC. Data and statistics for Cerebral Palsy. Centers for Disease Control and Prevention. Published May 2, 2022. Accessed November 26, 2022. https://www.cdc.gov/ncbddd/cp/data.html