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Cerebral palsy

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Cerebral palsy

Description

Cerebral palsy means "brain paralysis". This means that parts of your brain are not working well. Is is a disability that affects movement and body position.

Causes

Cerebral palsy is not a disease, condition or an illness. It is caused by many factors that may occur before, during or after birth. Not all causes have been identified.

Causes before birth include:

  • Infections during pregnancy (e.g. German measles and shingles)
  • Blood type incompatibility of mother and child
  • Health problems during pregnancy (e.g. diabetes)

Causes during birth include:

  • Lack of oxygen because of a difficult or very long labour or other complications
  • Injuries during birth
  • Premature birth

Causes in the neonatal period:

  • Respiratory distress
  • Very high fever
  • Bleeding in the brain
  • Metabolic problems (e.g. low blood sugar)

Causes in early childhood:

  • Severe dehydration because of diarrhoea and vomiting
  • Brain infections (e.g. meningitis, encephalitis)
  • Head injuries
  • Lack of oxygen because of e.g. near-drowning, gas poisoning, etc
  • Poisoning
  • Bleeding or blood clots in the brain
  • Uncontrolled fits (seizures).

Signs & Symptoms

  • A baby that is limp and floppy at birth
  • Soon after birth the baby’s arms, legs and head become stiff
  • Delayed breathing and crying at birth
  • Slow development compared to other babies (slow to hold head steady, sit and move around)
  • Feeding problems (difficulty with sucking, swallowing and chewing)
  • A baby that is difficult to hold or carry because he or she is too stiff or too floppy and has poor head control
  • Communication difficulties (the baby does not respond, cry or make sounds/words like other babies)
  • Delayed intelligence (the baby may look dull and do not respond to toys, etc.)
  • Hearing and sight may be affected
  • Fits (epilepsy, seizures, convulsions) may occur in some children
  • Restless behaviour (behaviour changes from laughing to crying, baby has fears or bouts of anger and is otherwise difficult).

Risks

Prevention

  • Eat enough healthy food before and during your pregnancy
  • Plan your pregnancy
  • Avoid taking medicines during pregnancy
  • Go for regular health check-ups during your pregnancy
  • Make sure your baby is vaccinated as advised by the clinic
  • Prevent seizures (uncover the baby when he or she has fever)
  • Know the signs of meningitis (stiff neck, vomiting, high fever and irritability) and get treatment quickly
  • Good perinatal care
  • Good neonatal care.

Treatment

Physiotherapy – These programmes will encourage the child to improve control of their movements in order to sit, move around, play and interact with people and the environment. It is aimed at maintaining the range of movement in all the joints so the child’s abilities are not limited by joint stiffness.

Occupational therapy – These programmes are aimed at helping the child to be as independent as possible in activities like playing, learning, eating, dressing, bathing and toileting. The treatment focuses on improving control of movement, using devices to help make activities easier and modifying the child’s home or school environment.

Orthotic devices – Many different kinds of devices are used to improve posture, ambulation and function.

Speech therapy – These programmes are aimed at helping the child to control the muscles of the mouth, tongue and jaw to optimise feeding and to help the child to communicate and interact with people and the environment. This therapy is specific to each child and may include alternative ways of feeding and communicating.

Audiology – Here therapists aim to optimise a child’s ability to hear by preventing/managing ear infections, screening of hearing abilities and using devices and strategies to optimise hearing and communication.

Dieticians – These healthcare professionals aim to make sure that the child is nutritionally healthy and growing well so that he or she has the energy to develop and play as other children do. They work very closely with speech therapists to help the child with feeding problems. It is very important to prevent malnutrition in children with cerebral palsy.

Medical science – Reduce spasticity of the muscles, provide optimal seizure control, control oesophageal reflux and prevent constipation.

Surgery – Involves one or a combination of loosening tight muscles and releasing fixed joints; bone procedures to maintain posture and ambulation; straightening abnormal twists of the bones; and cutting nerves of the limbs most affected by movements and spasms.

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