Cerebral Palsy is the broad description of a physical impairment which effects motor functions (movement). The actual cause of Cerebral Palsy is not known although it is usually the result of a part of the brain being damaged or not developing properly, either before or during birth or in early childhood. Other causes of CP include blocked blood vessels or a head injury resulting in subdural hematoma.

• Possible causes before birth include maternal infections (especially German measles/rubella), radiation, anoxia (oxygen deficiency), toxemia, and maternal diabetes.

• Causes at the time of birth include trauma in delivery, anoxia, prematurity, multiple birth (especially for infants born last in a multiple birth) and a lack of oxygen during birth.

• Causes during infancy include brain infection, viruses (e.g. meningitis or encephalitis), head trauma, anoxia, brain tumor, and cerebral vascular lesions.

Types

    Cerebral Palsies are divided in to four groups. The three main types correspond to injuries to different parts of the brain:

• Spastic - around 60%. Causes the muscles to become very stiff and weak, or even paralyzed, more so when they are being extensively used (i.e. during sport). Spastic Cerebral Palsy may be in the form of hemiplegia, which effects all four limbs equally, or diplegia, which effects the legs to a greater extent than the arms.

• Athetoid (also known as Dyskinetic) - 20%. This causes a lack of posture control and a tendency to make writhing, involuntary movements. Such movements often occur in parts of the body furthest from the torso (i.e. feet, lower legs, arms and hands) and may also effect the trunk itself. Jerky movements can also be seen in some cases, resembling the movements of people with chorea. It is possible that these movements may disappear during sleep and it is almost always the case that they increase under tension.

• Ataxic - approx. 10%. Involves problems with balance and coordination. They may also have shaky hand movements, tremors or irregular speech.

• The remaining 10% of people with Cerebral Palsy have a mixture of these three strains.

Defects in vision, convulsive seizures, and mental disabilities may be present in any of these types and a mixture of types or a mixture of CP with other disabilities is common.

Effects

    The main effect of CP is difficulty in movement. Some people with CP are hardly affected, others have problems walking, feeding, talking or using their hands. Some people are unable to sit up without support and need constant assistance. A common finding with people who have CP is spasticity (increased muscle tone/reaction) which may affect a single limb, one side of the body (spastic hemiplegia), both legs (spastic diplegia) or both arms and legs (spastic quadriplegia). People with CP often have difficulty controlling their movements and facial expressions. Therefore speech difficulties are common and seizures may occur.

    An important point that has to be made is that Cerebral Palsy is NOT a condition which can be caught or inherited. It is not a progressive condition and so anything which is a direct result of the disability will not get worse. It also has absolutely NO effect on life expectancy.

Treatment

    As CP isn't a disease or illness, there is no 'magic cure', but we do know that the correct treatment from an early age can ease the effects of CP. Abilities need to be recognised and developed to the fullest - as much stimulation as possible should be offered, and simple, loving patience must always be shown. People with Cerebral Palsy must be taught to develop maximum independence within the limits of their individual physical limitations. CP may not be detected immediately at birth - it can take up to two year for CP to be fully diagnosed. Occasionally children who appear to have CP lose the signs as they get older. Drugs can sometimes be helpful to treat related problems; for example, seizures can be controlled with anticonvulsants. Physical therapy is needed to teach the person with CP how to develop muscular control and maintain balance. Problems with speech can be helped greatly by speech therapy. For children who cannot speak at all, sophisticated techniques and devices have been developed to teach them how to communicate non-verbally. Occupational therapy, the use of braces or other mechanical devices and orthopaedic surgery may all be of great benefit. Most importantly, having Cerebral Palsy does not mean that someone cannot lead a full and independent life.

Facts

• The incidence of cerebral palsy is approximately 2 to 4 babies for every 1000 births.

• Premature infants have a slightly higher rate of Cerebral Palsy - around 1%.

• In over 90% of cases the damage occurs before or at birth. Probably the most common cause is cerebral hypoxia (poor oxygen supply to the brain).

• Many affected children are also effected mentally, although a proportion are of normal or high intelligence.

• Currently about one in every 400 children are affected - i.e. around 0.2% of children have some form of CP.

    I gathered the information for the text above from a huge variety of online sources, electronic media, printed media and personal knowledge although the entire text was written personally. If any parts appear to have been copied directly, it is pure coincidence! Also, I cannot be held responsible for the accuracy of the information given above although I've done my best to make sure it's right. Anyone who thinks any kind of error has been made in what I've said above or who has something to add to this section should e-mail Comments.tra@cableinet.co.uk!