Cerebral palsy is defined as "a group of permanent disorders of the
development of movement and posture, causing activity limitation, that are
attributed to non-progressive disturbances that occurred in the developing fetal
or infant brain." While the central feature of CP is a disorder with movement,
difficulties with thinking, learning, feeling, communication and behavior often
occur along with cerebral palsy. Of those with CP, 28% have epilepsy, 58%
have difficulties with communication, at least 42% have problems with their
vision, and 23–56% have learning disabilities.
Cerebral palsy is characterized by abnormal muscle tone, reflexes, or motor
development and coordination. There can be joint and bone deformities and
contractures . The classical
symptoms are spasticities, spasms, other involuntary movements , unsteady gait,
problems with balance, and/or soft tissue findings consisting largely of
decreased muscle mass. Scissor walking and
toe walking are
common among people with CP who are able to walk, but taken on the whole, CP
symptomatology is very diverse. The effects of cerebral palsy fall on a
continuum of motor dysfunction, which may range from slight clumsiness at the
mild end of the spectrum to impairments so severe that they render coordinated
movement virtually impossible at the other end of the spectrum.
Babies born with severe CP often have an irregular posture; their bodies may
be either very floppy or very stiff. Birth defects, such as spinal curvature, a
small jawbone, or a small head sometimes occur along with CP. Symptoms may
appear or change as a child gets older. Some babies born with CP do not show
obvious signs right away. Classically, CP becomes evident when the baby reaches
the developmental stage at 61⁄2 to 9 months and is starting to mobilise, where
preferential use of limbs, asymmetry, or gross motor developmental delay is
seen.
Resulting conditions can include seizures, epilepsy, apraxia, dysarthria or
other communication disorders, eating problems, sensory impairments,
intellectual disability, learning disabilities, urinary incontinence, fecal
incontinence, and/or behavioural disorders.
Symptoms of Cerebral Palsy
Language
Speech and language disorders are common in people with cerebral palsy. The
incidence of dysarthria is estimated to range from 31% to 88%. Speech problems
are associated with poor respiratory control, laryngeal and velopharyngeal
dysfunction, and oral articulation disorders that are due to restricted movement
in the oral-facial muscles. There are three major types of dysarthria in
cerebral palsy: spastic, dyskinetic (athetosis), and ataxic.
Overall language delay is associated with problems of intellectual
disability, hearing impairment, and learned helplessness. Children with cerebral
palsy are at risk of learned helplessness and becoming passive communicators,
initiating little communication. Early intervention with this clientele, and
their parents, often targets situations in which children communicate with
others so that they learn that they can control people and objects in their
environment through this communication, including making choices, decisions, and
mistakes.
Skeleton
In order for bones to attain their normal shape and size, they require the
stresses from normal musculature. Osseous findings will therefore mirror the
specific muscular deficits in a given person with CP. The shafts of the bones
are often thin (gracile) and become thinner during growth. When compared to
these thin shafts (diaphyses), the centres often appear quite enlarged
(ballooning). With lack of use, articular cartilage may atrophy, leading to
narrowed joint spaces. Depending on the degree of spasticity, a person with CP
may exhibit a variety of angular joint deformities. Because vertebral bodies
need vertical gravitational loading forces to develop properly, spasticity and
an abnormal gait can hinder proper and/or full bone and skeletal development.
People with CP tend to be shorter in height than the average person because
their bones are not allowed to grow to their full potential. Sometimes bones
grow to different lengths, so the person may have one leg longer than the
other.
Pain and sleep
Pain is common and may result from the inherent deficits associated with the
condition, along with the numerous procedures children typically face. Pain is
associated with tight or shortened muscles, abnormal posture, stiff joints,
unsuitable orthosis, etc. There is also a high likelihood of chronic sleep
disorders secondary to both physical and environmental factors.[
Eating
Those with CP may have difficulty preparing food, holding utensils, or
chewing and swallowing due to sensory and motor impairments. An infant with CP
may not be able to suck, swallow or chew. Children with CP may have too little
or too much sensitivity around and in the mouth. Fine finger dexterity, like
that needed for picking up a utensil, is more frequently impaired than gross
manual dexterity, like that needed for spooning food onto a plate.Grip strength
impairments are less common.
Prevention For Cerebral Palsy
In those at risk of an early delivery magnesium sulphate appears to decrease
the risk of cerebral palsy. It is unclear if it helps those who are born at
term.
Cooling high-risk full-term babies shortly after birth may reduce
disability.
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