Cerebral Palsy Information
March of Dimes Birth Defects Foundation
1275 Mamaroneck Avenue
White Plains, NY 10605
(888) 663-4637 or (914) 428-7100
National Center on Birth Defects and Developmental Disorders
National Dissemination Center for Children with Disabilities
PO Box 1492
Washington, DC 20013
(800) 695-0285 or (202) 884-8200
Pathways Awareness Foundation
200 East Randolph Street
Chicago, IL 60601
(800) 955-2445
United Cerebral Palsy
1660 L Street NW, Suite 700
Washington, DC 20036-5602
(800) 872-5827 or (202) 776-0406
Saturday, May 14, 2011
Thursday, April 14, 2011
ORIGINS OF CEREBRAL PALSY
ORIGINS OF CEREBRAL PALSY
A young practitioner named Sigmund Freud, before he turned to the human unconscious as his life’s work, first hypothesized that cerebral palsy may be closely associated with natal deveopments. It was several decades before his conjectures became widely accepted. Still, depending on which source you are using, the causes of cerebral palsy has been suggested to be anywhere from 20% to 50% unknown. This is partially because though there are many associated markers or conditions associated with the disease, and evidence of those conditions or risk factors don’t guarantee that they are, indeed, the cause.
In the 1970s obstetricians suggested that if the sequence was altered by making care more ‘optimal’ (which they defined as emergency caesarean section for abnormalities on the electronic fetal monitor) then the cerebral palsy would be avoided (Quilligan and Paul 1975). The major effects of electronic monitoring on the fetal heart in labour are an increase in caesarean section rates and a reduced rate of neonatal seizures; it has had no effect on the rates of cerebral palsy (Stanley and Watson 1993, Nelson et al. 1996). This may be because few cases of cerebral palsy result from this pathway. Even those cases in which brain damage is caused by excessive intrapartum hypoxia, clinical signs sufficient to warrant emergency caesarean section may only be recognizable after the damage is done. And of course caesarean section may not be the ‘optimal’ response.? (Stanley, Blair & Alberman, p. 107)
Children that acquire cerebral palsy later in childhood from influences unconnected to natal or birth trauma are the easiest cases to clearly isolate the cause. Many factors contribute to the difficulty is discerning cause for children already born with the condition or later exhibit the symptoms from events before they were born or during the birth process. We strongly suggest the book (004) for the details of this difficult search. Literally thousands of researchers are exploring for clues to decrease the occurrence of this malady. Huge strides have been made in the developed world reducing the various ways that cerebral palsy does occur. The only reason that there has not been a stready decline in the percentage of children exhibiting the disease is that Western strides in the ability to keep alive and bring to health extremely premature infants has also increased the number of children who contract cerebral palsy, children whom 30 years ago would have never made it to their first birthday.
A profound challenge to researchers in this field is teasing out the difference between a specific cause or causes from epiphenomena, or events associated with causes but not the causes themselves. For example periventricular leukomalacia (PVL) is the strongest predictor of cerebral palsy in extremely preterm infants. Yet many of the variables associated with PVL could be assigned to either cause or epiphenomena depending on the situation. A particular insult, when it occurred and where specifically in the brain it occurred, complicated by an understanding of the extent of the resources available to combat the damage, all contribute to a determination on how specifically cerebral palsy was created in a specific case. It is important to understand how several variables can ally themselves in different constellations to contribute to an outcome. For example a very preterm infant is vulnerable to outside influences a full term baby would be unhindered by. A small number of those preterm infants might suffer a combination of assaults that would result in later diagnosis. At the same time, a genetic defect might not evidence itself with a healthy child until that child was exposed to any number of effects including infection or physical trauma.
The researchers and practitioners in this field are often nothing less than compassionate detectives following a very old trail exploring events that have unfolded in the tinest portion of a human brain.
Consider the outline below, from (Geralis, p. 14), for an introduction to the risk factors associated with cerebral palsy.
Pregnancy Risk Factors
• Maternal diabetes or hyperthyroidism
• Maternal high blood pressure
• Poor maternal nutrition
• Maternal seizures or mental retardation
• Incompetent cervix (premature dilation) leading to premature delivery
• Maternal bleeding from placenta previa (a condition in which the placenta covers a portion of the cervix leads to bleeding as the cervix dilates) or abruptio placenta (premature separation of the placenta from the uterine wall)
Delivery Risk Factors
• Premature delivery (less than 37 weeks gestation)
• Prolonged rupture of the amniotic membranes for more than 24 hours leading to fetal infection
• Severely depressed (slow) fetal heart rate during labor, indicating fetal distress
• Abnormal presentation such as breech, face, or transverse lie, which makes for a difficult delivery
Neonatal Risk Factors
• Premature birth – the earlier in gestation a baby is delivered, the more likely she is to have brain damage
• Asphyxia – insufficient oxygen to the brain due to breathing problems or poor blood flow in the brain.
• Meningitis – infection over the surface of the brain
• Seizures caused by abnormal electrical activity of the brain
• Interventricular hemorrhage (I. V. H.) – bleeding into the interior spaces of the brain or into the brain
tissue
• Periventricular encephalomalacia (P.V.L.) – damage to the brain tissue located around the ventricles
(fluid spaces) due to the lack of oxygen or problems with blood flow
Some of the techniques used to prevent cerebral palsy include constant monitoring of blood pressure and gases in the neonate and the mother, intubation, handling, suction or the airways, administering sodium bicarbonate, “blood volume expansion, pressors to reduce blood supply, sedatives, unbilical artery catheter placement, heparinization of catheters, ductal ligation, super oxide dismutase.” (Stanley, Blair & Alberman, p. 161) In the developing nations iodized salt and vaccinations have had a profound effect on lowering the incidence of cerebral palsy. All through this site you will discover interventions and supplements that have resulted in the birth and growth and of humans free of cerebral palsy.
A young practitioner named Sigmund Freud, before he turned to the human unconscious as his life’s work, first hypothesized that cerebral palsy may be closely associated with natal deveopments. It was several decades before his conjectures became widely accepted. Still, depending on which source you are using, the causes of cerebral palsy has been suggested to be anywhere from 20% to 50% unknown. This is partially because though there are many associated markers or conditions associated with the disease, and evidence of those conditions or risk factors don’t guarantee that they are, indeed, the cause.
In the 1970s obstetricians suggested that if the sequence was altered by making care more ‘optimal’ (which they defined as emergency caesarean section for abnormalities on the electronic fetal monitor) then the cerebral palsy would be avoided (Quilligan and Paul 1975). The major effects of electronic monitoring on the fetal heart in labour are an increase in caesarean section rates and a reduced rate of neonatal seizures; it has had no effect on the rates of cerebral palsy (Stanley and Watson 1993, Nelson et al. 1996). This may be because few cases of cerebral palsy result from this pathway. Even those cases in which brain damage is caused by excessive intrapartum hypoxia, clinical signs sufficient to warrant emergency caesarean section may only be recognizable after the damage is done. And of course caesarean section may not be the ‘optimal’ response.? (Stanley, Blair & Alberman, p. 107)
Children that acquire cerebral palsy later in childhood from influences unconnected to natal or birth trauma are the easiest cases to clearly isolate the cause. Many factors contribute to the difficulty is discerning cause for children already born with the condition or later exhibit the symptoms from events before they were born or during the birth process. We strongly suggest the book (004) for the details of this difficult search. Literally thousands of researchers are exploring for clues to decrease the occurrence of this malady. Huge strides have been made in the developed world reducing the various ways that cerebral palsy does occur. The only reason that there has not been a stready decline in the percentage of children exhibiting the disease is that Western strides in the ability to keep alive and bring to health extremely premature infants has also increased the number of children who contract cerebral palsy, children whom 30 years ago would have never made it to their first birthday.
A profound challenge to researchers in this field is teasing out the difference between a specific cause or causes from epiphenomena, or events associated with causes but not the causes themselves. For example periventricular leukomalacia (PVL) is the strongest predictor of cerebral palsy in extremely preterm infants. Yet many of the variables associated with PVL could be assigned to either cause or epiphenomena depending on the situation. A particular insult, when it occurred and where specifically in the brain it occurred, complicated by an understanding of the extent of the resources available to combat the damage, all contribute to a determination on how specifically cerebral palsy was created in a specific case. It is important to understand how several variables can ally themselves in different constellations to contribute to an outcome. For example a very preterm infant is vulnerable to outside influences a full term baby would be unhindered by. A small number of those preterm infants might suffer a combination of assaults that would result in later diagnosis. At the same time, a genetic defect might not evidence itself with a healthy child until that child was exposed to any number of effects including infection or physical trauma.
The researchers and practitioners in this field are often nothing less than compassionate detectives following a very old trail exploring events that have unfolded in the tinest portion of a human brain.
Consider the outline below, from (Geralis, p. 14), for an introduction to the risk factors associated with cerebral palsy.
Pregnancy Risk Factors
• Maternal diabetes or hyperthyroidism
• Maternal high blood pressure
• Poor maternal nutrition
• Maternal seizures or mental retardation
• Incompetent cervix (premature dilation) leading to premature delivery
• Maternal bleeding from placenta previa (a condition in which the placenta covers a portion of the cervix leads to bleeding as the cervix dilates) or abruptio placenta (premature separation of the placenta from the uterine wall)
Delivery Risk Factors
• Premature delivery (less than 37 weeks gestation)
• Prolonged rupture of the amniotic membranes for more than 24 hours leading to fetal infection
• Severely depressed (slow) fetal heart rate during labor, indicating fetal distress
• Abnormal presentation such as breech, face, or transverse lie, which makes for a difficult delivery
Neonatal Risk Factors
• Premature birth – the earlier in gestation a baby is delivered, the more likely she is to have brain damage
• Asphyxia – insufficient oxygen to the brain due to breathing problems or poor blood flow in the brain.
• Meningitis – infection over the surface of the brain
• Seizures caused by abnormal electrical activity of the brain
• Interventricular hemorrhage (I. V. H.) – bleeding into the interior spaces of the brain or into the brain
tissue
• Periventricular encephalomalacia (P.V.L.) – damage to the brain tissue located around the ventricles
(fluid spaces) due to the lack of oxygen or problems with blood flow
Some of the techniques used to prevent cerebral palsy include constant monitoring of blood pressure and gases in the neonate and the mother, intubation, handling, suction or the airways, administering sodium bicarbonate, “blood volume expansion, pressors to reduce blood supply, sedatives, unbilical artery catheter placement, heparinization of catheters, ductal ligation, super oxide dismutase.” (Stanley, Blair & Alberman, p. 161) In the developing nations iodized salt and vaccinations have had a profound effect on lowering the incidence of cerebral palsy. All through this site you will discover interventions and supplements that have resulted in the birth and growth and of humans free of cerebral palsy.
Saturday, August 14, 2010
Cerebral Palsy Symptoms
Cerebral Palsy Symptoms
The signs of cerebral palsy are usually not noticeable in early infancy but become more obvious as the child’s nervous system matures. Early signs of cerebral palsy include the following:
* Delayed milestones such as controlling head, rolling over, reaching with one hand, sitting without support, crawling, or walking
* Persistence of “infantile” or “primitive” reflexes, which normally disappear 3-6 months after birth
* Developing handedness before age 18 months: This indicates weakness or abnormal muscle tone on one side, which may be an early sign of CP.
Problems and disabilities related to Cerebral Palsy range from very mild to very severe. Their severity is related to the severity of the brain damage. They may be very subtle, noticeable only to medical professionals, or may be obvious to the parents and other caregivers.
* Abnormal muscle tone: Muscles may be very stiff (spastic) or unusually relaxed and “floppy.” Limbs may be held in unusual or awkward positions. For example, spastic leg muscles may cause legs to cross in a scissor-like position.
* Abnormal movements: Movements may be unusually jerky or abrupt, or slow and writhing. They may appear uncontrolled or without purpose.
* Skeletal deformities: People who have cerebral palsy on only one side may have shortened limbs on the affected side. If not corrected by surgery or a device, this can lead to tilting of the pelvic bones and scoliosis (curvature of the spine).
* Joint contractures: People with spastic cerebral palsy may develop severe stiffening of the joints because of unequal pressures on the joints exerted by muscles of differing tone or strength.
* Mental retardation: Some, although not all, children with cerebral palsy are affected by mental retardation. Generally, the more severe the retardation, the more severe the disability overall.
* Seizures: About one third of people with cerebral palsy have seizures. Seizures may appear early in life or years after the brain damage that causes cerebral palsy. The physical signs of a seizure may be partly masked by the abnormal movements of a person with cerebral palsy.
* Speech problems: Speech is partly controlled by movements of muscles of the tongue, mouth, and throat. Some individuals with cerebral palsy are unable to control these muscles and thus cannot speak normally.
* Swallowing problems: Swallowing is a very complex function that requires precise interaction of many groups of muscles. People with cerebral palsy who are unable to control these muscles will have problems sucking, eating, drinking, and controlling their saliva. They may drool. An even greater risk is aspiration, the inhalation into the lungs of food or fluids from the mouth or nose. This can cause infection or even suffocation.
* Hearing loss: Partial hearing loss is not unusual in people with cerebral palsy. The child may not respond to sounds or may have delayed speech.
* Vision problems: Three quarters of people with cerebral palsy have strabismus, which is the turning in or out of one eye. This is due to weakness of the muscles that control eye movement. These people are often nearsighted. If not corrected, strabismus can lead to more severe vision problems over time.
* Dental problems: People with cerebral palsy tend to have more cavities than usual. This results from both defects in tooth enamel and difficulties brushing the teeth.
* Bowel and/or bladder control problems: These are caused by lack of muscle control.
Cerebral Palsy
Cerebral Palsy Causes
Cerebral Palsy Causes
Cerebral palsy results from damage to certain parts of the developing brain.
* This damage can occur early in pregnancy when the brain is just starting to form, during the birth process as the child passes through the birth canal, or after birth in the first few years of life.
* In many cases, the exact cause of the brain damage is never known.
At one time, problems during birth, usually inadequate oxygen, were blamed for cerebral palsy.
* We now know that fewer than 10% of cases of cerebral palsy begin during birth (perinatal).
* In fact, current thinking is that at least 70-80% of cases of cerebral palsy begin before birth (prenatal).
* Some cases begin after birth (postnatal).
* In all likelihood, many cases of cerebral palsy are a result of a combination of prenatal, perinatal, and postnatal factors.
Risk factors linked with cerebral palsy include the following:
* Infection, seizure disorder, thyroid disorder, and/or other medical problems in the mother
* Birth defects, especially those affecting the brain, spinal cord, head, face, lungs, or metabolism
* Rh factor incompatibility, a difference in the blood between mother and fetus that can cause brain damage in the fetus.
* Certain hereditary and genetic conditions
* Complications during labor and delivery
* Premature birth
* Low birth weight (especially if less than 2 pounds at birth)
* Severe jaundice after birth
* Multiple births (twins, triplets)
* Lack of oxygen (hypoxia) reaching the brain before, during, or after birth
* Brain damage early in life, due to infection (such as meningitis), head injury, lack of oxygen, or bleeding.
Cerebral Palsy..
cerebral-palsy-overview.
Types of Cerebral Palsy
Types of Cerebral Palsy
Types of cerebral palsy are as follows:
* Spastic (pyramidal): Increased muscle tone is the defining characteristic of this type. The muscles are stiff (spastic), and movements are jerky or awkward. This type is classified by which part of the body is affected: diplegia (both legs), hemiplegia (one side of the body), or quadriplegia (the entire body). This is the most common type of CP /cerebral palsy, accounting for about 70-80% of cases.
* Dyskinetic (extrapyramidal): This includes types that affect coordination of movements. There are 2 subtypes.
o Athetoid: The person has uncontrolled movements that are slow and writhing. The movements can affect any part of the body, including the face, mouth, and tongue. About 10-20% of cerebral palsy cases are of this type.
o Ataxic: This type affects balance and coordination. Depth perception is usually affected. If the person can walk, the gait is probably unsteady. He or she has difficulty with movements that are quick or require a great deal of control, such as writing. About 5-10% of cases of cerebral palsy are of this type.
* Mixed: This is a mixture of different types of cerebral palsy. A common combination is spastic and athetoid.
Many individuals with cerebral palsy have normal or above average intelligence. Their ability to express their intelligence may be limited by difficulties in communicating. All children with cerebral palsy, regardless of intelligence level, are able to improve their abilities substantially with appropriate interventions. Most children with cerebral palsy require significant medical and physical care, including physical, occupational, and speech/swallowing therapy.
Despite advances in medical care, cerebral palsy remains a significant health problem. The number of people affected by cerebral palsy has increased over time. This may be because more and more premature infants are surviving. In the United States, about 2-3 children per 1000 have cerebral palsy. As many as 1,000,000 people of all ages are affected. Cerebral palsy affects both sexes and all ethnic and socioeconomic groups.
Types of cerebral palsy are as follows:
* Spastic (pyramidal): Increased muscle tone is the defining characteristic of this type. The muscles are stiff (spastic), and movements are jerky or awkward. This type is classified by which part of the body is affected: diplegia (both legs), hemiplegia (one side of the body), or quadriplegia (the entire body). This is the most common type of CP /cerebral palsy, accounting for about 70-80% of cases.
* Dyskinetic (extrapyramidal): This includes types that affect coordination of movements. There are 2 subtypes.
o Athetoid: The person has uncontrolled movements that are slow and writhing. The movements can affect any part of the body, including the face, mouth, and tongue. About 10-20% of cerebral palsy cases are of this type.
o Ataxic: This type affects balance and coordination. Depth perception is usually affected. If the person can walk, the gait is probably unsteady. He or she has difficulty with movements that are quick or require a great deal of control, such as writing. About 5-10% of cases of cerebral palsy are of this type.
* Mixed: This is a mixture of different types of cerebral palsy. A common combination is spastic and athetoid.
Many individuals with cerebral palsy have normal or above average intelligence. Their ability to express their intelligence may be limited by difficulties in communicating. All children with cerebral palsy, regardless of intelligence level, are able to improve their abilities substantially with appropriate interventions. Most children with cerebral palsy require significant medical and physical care, including physical, occupational, and speech/swallowing therapy.
Despite advances in medical care, cerebral palsy remains a significant health problem. The number of people affected by cerebral palsy has increased over time. This may be because more and more premature infants are surviving. In the United States, about 2-3 children per 1000 have cerebral palsy. As many as 1,000,000 people of all ages are affected. Cerebral palsy affects both sexes and all ethnic and socioeconomic groups.
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