Cerebral palsy: Symptoms, diagnosis, treatment
What is cerebral palsy?
Cerebral palsy, or CP, is a group of neurological conditions affecting movement and co-ordination because of problems with the brain and the body's nervous system.
Symptoms of cerebral palsy include muscle stiffness, floppiness, weakness, uncontrolled body movements and problems with balance and co-ordination.
Cerebral palsy is one of the most common causes of chronic childhood disability, affecting around one in every 400 people in the UK.
Cerebral palsy usually appears in children before they are three years old.
Although the brain damage doesn't worsen over a person's lifetime, symptoms can vary in their severity.
Children with cerebral palsy may have an accompanying seizure disorder and may have some level of learning disability, vision, speech, hearing or language problems.
What causes cerebral palsy?
Causes of cerebral palsy include:
- Infections during pregnancy that may damage the nervous system of a developing foetus. These include rubella (German measles), cytomegalovirus (a type of herpes virus) and toxoplasmosis (an infection caused by a parasite that can be carried in cat faeces or undercooked meat). Other infections in pregnant women that may go undetected are now being recognised as important causes of developmental brain damage in the foetus.
- Severe jaundice in the baby. Jaundice is caused by excessive bilirubin in the blood. Normally, bilirubin is filtered out by the liver. But often a, newborn baby’s livers needs a few days to start doing this effectively, so it's not uncommon for babies to have jaundice for a few days after birth. In most cases, phototherapy (light therapy) clears up jaundice and there are no lasting health effects. However, in rare cases, severe untreated jaundice can damage brain cells.
- Rh (rhesus) incompatibility between mother and baby. With this blood condition, the mother's body produces antibodies that destroy the foetus's blood cells. This, in turn, leads to a form of jaundice in the baby and may cause brain damage.
- The physical and metabolic trauma of being born. This can precipitate brain damage in a foetus whose health has been threatened during development.
- Severe oxygen deprivation to the brain or significant trauma to the head during labour and delivery.
Some children with cerebral palsy acquire the disorder after birth. It results from brain damage in the first few months or years of life. Cerebral palsy often follows infections of the brain, such as bacterial meningitis or viral encephalitis, or it may be the result of a head injury.
Risk factors that increase the possibility of a child later being diagnosed with cerebral palsy include the following:
- Breech births (when the feet, knees or buttocks of a baby come out first).
- Vascular or respiratory problems in the baby during birth.
- Physical birth defects such as faulty spinal bone formation, groin hernias or an abnormally small jaw bone.
- Receiving a low Apgar score 10 to 20 minutes after delivery. An Apgar test provides a basic, immediate assessment of a newborn baby’s physical health. The test evaluates the baby’s heart rate, breathing, muscle tone, reflexes and colour, and gives each a score from 0 (low) to 2 (normal).
- A low birth weight (less than 2,500 grams or 5 lbs 7.5 oz) and premature birth (born earlier than 37 weeks of pregnancy).
- Being a twin or one of a multiple birth.
- A congenital nervous system malformation such as an abnormally small head (microcephaly).
- Seizures shortly after birth.
Mothers who had bleeding or severe proteinuria (excess protein in the urine) late in their pregnancy, have a higher chance of having a baby with cerebral palsy. The same applies to mothers who have hyperthyroidism or hypothyroidism or seizures.
Not all children who are exposed to these risk factors develop cerebral palsy. However, parents and doctors should be aware of these risks and watch such a child's development carefully.