Cerebral Palsy

Cerebral palsy (CP) is a group of disorders that affect a person’s ability to move and maintain balance and posture. CP is the most common motor disability in childhood. Cerebral means having to do with the brain. Palsy means weakness or problems with using the muscles. The word cerebral means something to do with the brain (cerebrum (say se-ri-brum)). Palsy means a weakness or problems in moving the body. People who have cerebral palsy have a type of brain damage which causes trouble controlling the movements of their body.

The motor disorder (i.e., muscle coordination and body movement) is caused by an injury or non-progressive malformation of the brain that occurs in the developing foetus (traditionally considered so until the age of 2 years) or during infancy. It affects muscle control and tone, posture, balance, fine and gross motor skills, and oral motor functioning. Persons with Cerebral Palsy may suffer from chronic and acute pain, experienced most commonly in joints such as knees and ankles, hips, upper and lower back.

Most children with this disability are capable of walking, with approximately 10% requiring an aid to walk, and 30% using a wheelchair. Further, 1 in 5 people with Cerebral Palsy have difficulties in communication.

How is Cerebral Palsy diagnosed?

It is mostly diagnosed in children during the first 2 years of their life. However, in certain situations where a child exhibits mild symptoms of Cerebral Palsy, it may not be easy for a doctor to reach a reliable diagnosis before the age of 4 – 5 years.

Techniques that enable doctors to study the brain including neuro-imaging methods such as magnetic resonance imaging (MRI), cranial ultrasound, computed tomography (CT) scan, electro-myogram (EMG) and electro-encephalogram (EEG), can be used to diagnose this.

Unfortunately, there is no single test available to confirm Cerebral Palsy definitively. Lab tests can recognise other disorders that cause similar symptoms to those related to this. Even though the symptoms can change over a period of time and it is non-progressive in nature.  Doctors may require regular visits and a series of tests to monitor and evaluate the child’s development and motor skills. This would also help the doctor to rule out other conditions that result in symptoms similar to Cerebral Palsy.Whom should I approach for diagnosis?

It is recommended to seek expert consultation from:

  • Development Paediatrician
  • Ophthalmologist
  • Child Neurologist
  • Otologist
  • Educational Psychologist

What should I do post-diagnosis?

A diagnosis of Cerebral Palsy in a child can be overwhelming. You may find it helpful to hear from other parents – for example, through Parent Support Groups. Learning from their experiences can be a reassuring way to adapt to the diagnosis.

Once Cerebral Palsy is diagnosed and the type is determined, health care professionals can design an appropriate treatment plan to enhance and sustain the capabilities of a child. A customised treatment plan to tackle the fundamental issues that affect the child’s quality of life is important. Therapeutic options such as physical therapy, occupational therapy, recreational therapy and language and speech therapy are recommended for children.

Oral medications such as diazepam, baclofen, dantrolene sodium, and tizanidine are often used as the first line of treatment to help relax contracted, overactive or stiff muscles.[3]

In case stiffness and spasticity are severe enough to stifle mobility or make it painful to move, an orthopedic surgery may be recommended. Orthopedic surgeries may also be undertaken to improve the gait or the appearance of how persons with Cerebral Palsy walk.

If the more conservative therapies and treatments fail to relieve a child with Cerebral Palsy from chronic pain and severe spasticity, selective dorsal rhizotomy, a surgical procedure that involves cutting the nerves is recommended.

Frequently Asked Questions

Q: Is Cerebral Palsy treatable?

There is no cure for Cerebral Palsy, but interventions, including treatment, therapy, special equipment, and, in some cases, surgery can help children with Cerebral Palsy.

Q: Is Cerebral Palsy life-threatening?

With the exception of a few cases of severe Cerebral Palsy, most children with the condition are expected to live well into adulthood.

Q: What are other related conditions that a child with Cerebral Palsy is likely to have?

Some conditions that accompany Cerebral Palsy are seizures, problems with vision, hearing or speech, changes in the spine, joint problems or Intellectual Disability. Because of the Cerebral Palsy, they may also have hypertension, incontinence, bladder dysfunction and difficulty in swallowing.

Q: Does a person with Cerebral Palsy suffer from depression?

Persons with Cerebral Palsy are three to four times more likely to have depression. The level of emotional support, and how one copes with the stress can both have a significant impact on his/her mental health.