What is cerebral Palsy?
Cerebral palsy is a group of disorders that affect movement and muscle tone or posture. It’s caused by damage that occurs to the immature, developing brain, most often before birth.
Signs and symptoms appear during infancy or preschool years. In general, cerebral palsy causes impaired movement associated with exaggerated reflexes, floppiness or spasticity of the limbs and trunk, unusual posture, involuntary movements, unsteady walking, or some combination of these.
People with cerebral palsy can have problems swallowing and commonly have eye muscle imbalance, in which the eyes don’t focus on the same object. They also might have reduced range of motion at various joints of their bodies due to muscle stiffness.
The cause of cerebral palsy and its effect on function vary greatly. Some people with cerebral palsy can walk; others need assistance. Some people have intellectual disabilities, but others do not. Epilepsy, blindness or deafness also might be present. Cerebral palsy is a lifelong disorder. There is no cure, but treatments can help improve function.
Signs and symptoms of cerebral palsy can vary greatly from person to person. Cerebral palsy can affect the whole body, or it might be limited primarily to one or two limbs, or one side of the body. Generally, signs and symptoms include problems with movement and coordination, speech and eating, development, and other problems.
Types of Cerebral Palsy
Doctors classify CP according to the main type of movement disorder involved. Depending on which areas of the brain are affected, one or more of the following movement disorders can occur:
- Stiff muscles (spasticity)
- Uncontrollable movements (dyskinesia)
- Poor balance and coordination (ataxia)
- There are four main types of CP:
Spastic Cerebral Palsy
The most common type of CP is spastic CP. Spastic CP affects about 80% of people with CP.
People with spastic CP have increased muscle tone. This means their muscles are stiff and, as a result, their movements can be awkward. Spastic CP usually is described by what parts of the body are affected:
- Spastic diplegia/diparesis―In this type of CP, muscle stiffness is mainly in the legs, with the arms less affected or not affected at all. People with spastic diplegia might have difficulty walking because tight hip and leg muscles cause their legs to pull together, turn inward, and cross at the knees (also known as scissoring).
- Spastic hemiplegia/hemiparesis―This type of CP affects only one side of a person’s body; usually the arm is more affected than the leg.
- Spastic quadriplegia/quadriparesis―Spastic quadriplegia is the most severe form of spastic CP and affects all four limbs, the trunk, and the face. People with spastic quadriparesis usually cannot walk and often have other developmental disabilities such as intellectual disability; seizures; or problems with vision, hearing, or speech.
- Dyskinetic Cerebral Palsy (also includes athetoid, choreoathetoid, and dystonic cerebral palsies)
- People with dyskinetic CP have problems controlling the movement of their hands, arms, feet, and legs, making it difficult to sit and walk. The movements are uncontrollable and can be slow and writhing or rapid and jerky. Sometimes the face and tongue are affected and the person has a hard time sucking, swallowing, and talking. A person with dyskinetic CP has muscle tone that can change (varying from too tight to too loose) not only from day to day, but even during a single day.
Ataxic Cerebral Palsy
People with ataxic CP have problems with balance and coordination. They might be unsteady when they walk. They might have a hard time with quick movements or movements that need a lot of control, like writing. They might have a hard time controlling their hands or arms when they reach for something.
Mixed Cerebral Palsy
Some people have symptoms of more than one type of CP. The most common type of mixed CP is spastic-dyskinetic CP
Causes and Risk factors
CP is caused by abnormal development of the brain or damage to the developing brain that affects a child’s ability to control his or her muscles. There are several possible causes of the abnormal development or damage. People used to think that CP was mainly caused by lack of oxygen during the birth process. Now, scientists think that this causes only a small number of CP cases.
The abnormal development of the brain or damage that leads to CP can happen before birth, during birth, within a month after birth, or during the first years of a child’s life, while the brain is still developing. CP related to abnormal development of the brain or damage that occurred before or during birth is called congenital CP. The majority of CP (85%–90%) is congenital. In many cases, the specific cause is not known. A small percentage of CP is caused by abnormal development of the brain or damage that occurs more than 28 days after birth. This is called acquired CP, and usually is associated with an infection (such as meningitis) or head injury.
Treatment and Intervention Services
There is no cure for CP, but treatment can improve the lives of those who have the condition. It is important to begin a treatment program as early as possible.
After a CP diagnosis is made, a team of health professionals works with the child and family to develop a plan to help the child reach his or her full potential. Common treatments include medicines; surgery; braces; and physical, occupational, and speech therapy. No single treatment is the best one for all children with CP. Before deciding on a treatment plan, it is important to talk with the child’s doctor to understand all the risks and benefits.
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