Cerebral palsy: Symptoms, diagnosis, treatment
What is cerebral palsy?
Cerebral palsy (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 include muscle stiffness, floppiness, weakness, uncontrolled body movements, and problems with balance and co-ordination.
It is one of the most common causes of long-term childhood disability with types of the condition estimated to affect around 1 in 400 babies born in the UK.
Signs usually appear in children before they are 3 years old.
Although the brain damage doesn't worsen over a person's lifetime, symptoms can vary in 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.
It is a lifelong condition that cannot be cured. However, treatment can improve an affected person's capabilities, increasing motor function, and independence.
Causes of cerebral palsy include:
Infections during pregnancy. These 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 poo or undercooked meat). Other infections in pregnancy 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 liver 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.
Birth trauma or development complications that can cause brain damage, severe oxygen deprivation to the brain, or significant trauma to the head during labour and delivery.
Some children 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 being diagnosed later include:
- 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 - this 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 premature birth, or being 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 the condition. However, parents and doctors should be aware of these risks and monitor the child's development carefully.