Cerebral Palsy

What is it?
Cerebral palsy, also referred to as CP, is a term used to describe a group of chronic conditions affecting body movement and muscle coordination. It is caused by damage to one or more specific areas of the brain, usually occurring during fetal development; before, during, or shortly after birth; or during infancy. Thus, these disorders are not caused by problems in the muscles or nerves. Instead, faulty development or damage to motor areas in the brain disrupt the brain's ability to adequately control movement and posture.

"Cerebral" refers to the brain and "palsy" to muscle weakness/poor control. Cerebral palsy itself is not progressive (i.e., brain damage does not get worse); however, secondary conditions, such as muscle spasticity, can develop, which may get better over time, get worse, or remain the same. Cerebral palsy is not communicable. It is not a disease and should not be referred to as such. Although cerebral palsy is not "curable" in the accepted sense, training and therapy can help improve function.

What are the symptoms?
While the brain injuries that cause CP do not become worse, the symptoms may develop and change over time. Some symptoms include:

  • Unusually weak or tight muscles - As a result of not using both sides equally.
  • Difficulty with balance.
  • Poor coordination.
  • Delay in developing motor skills such as sitting or walking.
  • In addition, about half of children with CP will develop seizures.

The type and severity of abnormal muscle control are used to classify different types of CP:

Contrary to common belief, CP does not always cause a profound handicap. While a child with severe cerebral palsy might be unable to walk and need extensive, lifelong care, a child with mild cerebral palsy might only be slightly awkward and require no special assistance. Cerebral palsy is not contagious, nor is it usually inherited from one generation to the next.

How is it treated?
Cerebral palsy can not be cured, but treatment can often improve and help control a child’s symptoms. Physical therapy will help improve the child's ability to move in his or her environment through strengthening and joint mobility.

Other treatment strategies include: medication to control seizures and muscle tone; special orthosis to compensate for muscle imbalance; surgery; mechanical aids assist with mobility; counseling for emotional and psychological needs; and occupational, speech, and behavioral therapy.

As the symptoms of CP vary, so do the treatment strategies. No single treatment plan will work for all patients. Physical therapists first evaluate the child in an individual assessment and then create an individual treatment plan to addresses specific needs.

The earlier treatment begins, the better chance a child has of overcoming developmental disabilities and of learning new ways to accomplish difficult tasks. If neurological problems are properly managed, many patients can enjoy near-normal lives.

References
Mulliken, Ruth K., John J. Buckley. Assessment of Multihandicapped and Developmentally Disabled Children. London: Aspen, 1983.

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