Cerebral palsy ( CP) is a general term for a
group of permanent, non-progressive
movement disorders that cause physical
disability, [1] mainly in the areas of body
movement. [2] There may also be problems
with sensation, depth perception, and
communication ability. Difficulty with
cognition and epilepsy is found in about
one-third of cases. There are a number of
subtypes including a type characterized by
spasticity , a type characterized by poor co-
ordination, and types which feature both
symptoms or neither.
Cerebral palsy is caused by damage to the
motor control centers of the developing
brain and can occur during pregnancy,
during childbirth, or after birth up to about
age three.[3][4] About 2% of all cerebral
palsy cases are believed to be due to a
genetic cause.[5] Cerebral palsy is not an
infectious disease and is not contagious.
Most cases are diagnosed at a young age
rather than during adolescence or
adulthood.
Improvements in the care of newborns has
helped reduce the number of babies who
develop cerebral palsy and increased the
survival of those with very low birth
weights. [6][7] There is no known cure, with
efforts attempting to treat and prevent
complications. It occurs in about 2.1 per
1,000 live births. [8]
Cerebral refers to the cerebrum , which is
the affected area of the brain. The disorder
may often involve connections between the
cortex and other parts of the brain such as
the cerebellum . The root word "palsy"
means " paralysis". In medicine, this is often
used in reference to the paralysis or
weakness that often accompanies nerve
damage, loss of sensation or muscle
disorders involving uncontrollable
movements i.e. trembling or shaking.
Signs and symptoms
Cerebral palsy is defined as "a group of
permanent disorders of the development of
movement and posture, causing activity
limitation, that are attributed to non-
progressive disturbances that occurred in
the developing fetal or infant brain." [1]
While the central feature of CP is a disorder
with movement, difficulties with thinking,
learning, feeling, communication and
behavior often occur along with cerebral
palsy. [1] Of those with CP, 28% have
epilepsy, 58% have difficulties with
communication, at least 42% have problems
with their vision, and 2356% have learning
disabilities. [9]
Cerebral palsy is characterized by abnormal
muscle tone, reflexes, or motor
development and coordination. There can be
joint and bone deformities and contractures
(permanently fixed, tight muscles and
joints). The classical symptoms are
spasticities, spasms, other involuntary
movements (e.g., facial gestures), unsteady
gait, problems with balance, and/or soft
tissue findings consisting largely of
decreased muscle mass. Scissor walking
(where the knees come in and cross) and toe
walking (which can contribute to a gait
reminiscent of a marionette) are common
among people with CP who are able to walk,
but taken on the whole, CP symptomatology
is very diverse. The effects of cerebral palsy
fall on a continuum of motor dysfunction,
which may range from slight clumsiness at
the mild end of the spectrum to
impairments so severe that they render
coordinated movement virtually impossible
at the other end of the spectrum.
Babies born with severe CP often have an
irregular posture; their bodies may be
either very floppy or very stiff. Birth
defects, such as spinal curvature, a small
jawbone, or a small head sometimes occur
along with CP. Symptoms may appear or
change as a child gets older. Some babies
born with CP do not show obvious signs
right away. Classically, CP becomes evident
when the baby reaches the developmental
stage at 6 1 ⁄2 to 9 months and is starting to
mobilise, where preferential use of limbs,
asymmetry, or gross motor developmental
delay is seen.
Resulting conditions can include seizures ,
epilepsy , apraxia, dysarthria or other
communication disorders, eating problems,
sensory impairments, intellectual disability,
learning disabilities, urinary incontinence,
fecal incontinence , and/or behavioural
disorders.
Language
Speech and language disorders are common
in people with cerebral palsy. The incidence
of dysarthria is estimated to range from
31% to 88%. [10] Speech problems are
associated with poor respiratory control,
laryngeal and velopharyngeal dysfunction,
and oral articulation disorders that are due
to restricted movement in the oral-facial
muscles. There are three major types of
dysarthria in cerebral palsy: spastic,
dyskinetic (athetosis), and ataxic.
Overall language delay is associated with
problems of intellectual disability, hearing
impairment, and learned helplessness.[2]
Children with cerebral palsy are at risk of
learned helplessness and becoming passive
communicators, initiating little
communication. [2] Early intervention with
this clientele, and their parents, often
targets situations in which children
communicate with others so that they learn
that they can control people and objects in
their environment through this
communication, including making choices,
decisions, and mistakes. [2]