Cerebral Palsy

Introduction

Cerebral Palsy is the term given for a group of neurological conditions characterized by motor disability that is due to injury to the brain during pregnancy or at the time of birth or within the first few years of life. By definition these are non progressive conditions (non degenerative neurological disorders).

Various types of motor dysfunction are seen with varying severity and cognitive function may be normal or abnormal.

CP is not synonymous with mental retardation (MR) although some of these patients do have some MR.

Almost any type of brain insult around the above age can result in CP and includes infections, strokes, traumatic injuries, congenital infections etc.

Types of CP

The following are the 4 major types of CP;

• Spastic
• Cerebellar/ataxic
• Extrapyramidal type or athetoid/dyskinetic
• Hypotonic

Spastic type is the most common comprising about 70 to 80 percent of all CP and results due to damage to the motor cortex and/or corticospinal tracts. There are subgroups like monoplegic, diplegic, quadrioplegic etc depending upon how many limbs and what limbs are involved.

How does a patient present?

Kids with CP have difficulty in picking up predominantly motor milestones. They exhibit delayed milestones rather than regression of the milestones and that helps in differentiating CP from a progressive or degenerative neurological disease. Patients commonly also have language delay, learning disabilities and some patients have MR. Majority of the patients have spasticity (a type of increased muscle tone). Later patients will also present with joint and bone deformities.

Diagnosis

The diagnosis is made clinically however sometimes a CT or MRI of the brain is obtained to look any treatable conditions like a subdural hygroma or hematoma, hydrocephalus, tumor etc.

Treatment

There is no cure for any CP as whatever brain damage has happened is permanent. Future complications may be reduced or avoided by physical therapy. Many of the patients require assistive devices and orthopedic surgical intervention.



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