Cerebral Palsy - Neurology

Cerebral Palsy

Overview

Cerebral palsy, often known as CP, is caused by damage to areas of the brain that control muscles and muscle movement. Various degrees of disability are experienced with individuals diagnosed with the condition, depending on the areas of the brain affected and the severity of injury or damage to those brain areas.

Cerebral palsy is relatively common among children, caused by a multitude of factors before birth, including lack of oxygen, infections, and genetic disorders. Brain infections such as meningitis, head injury and/or seizures may cause development of cerebral palsy as children develop.

It should be noted however, that any injuries to the nervous system that cause cerebral palsy will not worsen as the child ages, although muscles affected may become tight, limiting movement and range of motion.

Types of Cerebral Palsy

In the past, several types of cerebral palsy are identified and classified in three categories:

• Spastic – Also known as pyramidal, defining muscle tone. This classification of CB causes stiffened and contracted muscles, limiting movement and range of motion. When muscle tone fluctuates, the condition may be classified as non-spastic or extrapyramidal.

• Dyskinetic (athetoid) - causes uncontrollable thrashing movements. Under this classification, one might be diagnosed with dystonia, which affects the trunk muscles, causing a twisting motion of the body.

• Ataxic - results in poor coordination and gait. Balance and posture are also affected under this classification, as can fine motor skills.

Today, classifications are based on different classifications, depending on the doctor or team of doctors seeing the same patient, such as orthopedic surgeon, neuroradiologist, neurosurgeon, neurologist, etc. In such cases, patients and caregivers may hear terms like mild, moderate or severe classification. Attempting to universalize the classification, medical experts often base their diagnosis on a Gross Motor Function Classification System or GMFCS for consistency in across-the-board medical care and approaches. Such approaches also take into consideration the patient’s motor function and muscle tone.

Some children may have a combination of one or all three types of cerebral palsy. In addition, the condition can be mild or severe and affect limbs on one side of the body and not the other, known as hemiplegia. When all four limbs are affected, the condition causes quadriplegia, while when only the legs are affected, the condition is called diplegia.

Treatment Options for Cerebral Palsy

Again, cerebral palsy cannot be cured. Traditional treatment options for cerebral palsy focus on improving physical and mental potential. Physical and occupational therapy to improve coordination, posture and loosening tightened tendons that lead to scar tissue have been the focus.

Certain medications may help reduce spasticity, as can some neurosurgery procedures.

Common treatments and therapies employed in the treatment of cerebral palsy include but are not limited to:

• Aqua therapy
• Physical and occupational therapy and physiotherapy, as well as speech and language therapy
• Behavioral therapy
• Hippotherapy (horseback riding to develop physical and cognitive abilities)
• Sensory integration therapy
• Massage therapy

In the United States, clinical trials are underway, including the use of hyperbaric oxygen and hyperbaric air treatments in children, as well as clinical trials studying the safety and efficacy of cord blood stem cell infusions. A randomized study of autologous umbilical cord blood infusion in children with cerebral palsy is also underway at Duke University Medical Center, although stem cell treatments and therapies utilizing stem cells are currently ongoing in countries around the world with positive results.

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