Treatments for Cerebral Palsy

Cerebral Palsy is a developmental disorder that will require a degree of long term care with a medical care team. The treatment is also a multi-dimensional process.  The team of people who may be involved with the care of an individual with cerebral palsy include: physical therapist, occupational therapists, speech therapists, pediatricians or physiatrists, pediatric neurologists, orthopedists, developmental specialists, a mental health provider, social worker and/or a special education teacher, family members, as well as other natural and formal supports. Treatments may also include the use of medications to control seizures, alleviate pain or reduce symptoms of spasticity attributed with cerebral palsy. Individuals with cerebral palsy may at some point need corrective surgery to correct abnormalities to the body. There are also several other mechanisms that may aid the individual such as: walkers, communication aids, computers with voice synthesizers and the like. Let us look at some of these treatments in a little bit more detail to understand how they help individuals with cerebral palsy and what the treatments entail. It is important to remember that cerebral palsy is not curable and therefore, treatments are usually symptomatic and focuses on helping the individual to develop as many motor skills as possible or to learn how to get around the difficulties that they face in daily life due to their disabilities.

Let us first discuss medications. The medications for people with cerebral palsy aim to lessen the tight muscles afflicting people with CP which can hopefully improve their ability to function. These medicines also treat pain and manage the complications related to spasticity.  The use of Botox is also common to treat spasticity when it is isolated to one muscle group. The Botox is shot directly into the muscle or nerve or both. Some side effects include weakness, difficulty breathing as well as difficulty with swallowing. However, if the whole body is affected, the use of oral muscle relaxants may help.  They are named diazepam ( Diazepam Intensol, Valium), tizanide (Zanaflex), dantrolene (Dantrium), and baclofen. With medicine comes a risk of dependence and parents should definitely consult with your doctor as to whether medical treatments are appropriate for the child’s needs.

Physical therapy is designed to encourage and assist the individual to build strength in order to improve their gait and movement, together with stretching programs to limit contractures. This therapy is very important to maintenance of muscle tone, bone structure and the prevention of joint dislocations. It is important to begin physical therapy at an early age, even in infancy. Physical therapy consists of stretching, positioning and strengthening the body. Physical therapy focuses on activities with the legs, like walking with braces and crutches as well as strengthening the body following surgery.

Speech therapy can help people with cerebral palsy to improve their speech patterns so they can be understood clearly by others. Some people with speech problems are also taught to use sign language. Speech therapist may also be able to teach people to use communication tools like a board coved with pictures of everyday items and activities, where they point to pictures to communicate their wants and needs. Speech therapy also comes in handy with individuals who have difficulty using the muscles in their tongue making chewing and swallowing difficult. The ability to be understood is very important for human beings. We get meaning from life around us through our social interactions and as children there is an even greater need to utilize these skills. Playing with other children is already difficult to achieve because of mobility issue, they do not need to add communication difficulties to the already long list of disabilities. Even though people with cerebral palsy may have normal intelligence they may have these communications issues that speech therapists can help with and in doing so, help those with speech difficulties utilize their intelligence.

Occupational therapy enables individuals with cerebral palsy to engage in activities of daily living that are meaningful to them. Because the symptoms of cerebral palsy interfere with the ability to engage in daily activities, self-management, productivity and leisure the goal of the occupational therapist is to evaluate, the physical and psychiatric conditions through selected activities In order to get people to function as closely to normal as possible. The goal is also to get them as close as possible to independence and helps them cope with their disability because there are still many things that they can do and they should be able to do them for themselves. This gives them a sense of worth and brings them joy knowing that they are able to be productive despite their disabilities.

 There are also many surgical procedures that can be done to aid people suffering with cerebral palsy. Children with severe deformities or contractures may need these surgeries on their bones and/or joints to place their legs and arms in the correct positions. Surgery is able to lengthen muscles that may be too short which may alleviate some pain, improve mobility and make it easier to walk with the use of braces or crutches or walkers.

There are many other treatments available to aid people with cerebral palsy but parents should also, remember that they are also a vital support that can aid in the treatment for their children with cerebral palsy. Parents should remember to try and foster independence within their children. If they can do something for themselves, let them. This allows them to grow and learn just like every other child. Be an advocate. Go out there and get information that will help you help yourself and your child with cerebral palsy. Speak up and find as many support networks as you can. There are many services, counseling centers and groups around, maybe even in your own communicate that can help your child benefit from what is available to everyone else inside and outside of the community.

Work Cited: www.originsofcerebralpalsy.com
                    www.mayoclinic.com/health/cerebral-palsy
                   www.en.wikipedia.org/wiki/cerebral_palsy

Tests and Diagnosis for Cerebral Palsy

There are certain steps that parents should take if they know that there were certain significant risks involved with their pregnancy or during the birth process. If a parents suspects that something may be wrong with their child they should be sure to take every available opportunity to take their child to their wellness visits as well as any annual appointments that should be made during their early childhood years. There, the child’s physician can monitor the child’s developments in key areas, such as: Growth, muscle tone, muscle strength, coordination, and posture. They can also check for age-appropriate motor skills and sensory abilities such as, their sense of hearing, vision and touch. Chances are that you have already seen that your child is not developing adequately or at an appropriate rate in these areas, so you yourself should also be monitoring your child’s development in these areas.

During these visits with your child’s physician you should be able to answer certain questions brought to you by the doctor about your child’s development such as:

·         What concerns you have about your child’s growth or development?

·         How well does your child eat?

·         How does your child respond to touch or other physical stimuli?

·         Have you observed that your child favors one side of their body?

·         Is your child crawling if they are at the age where they are supposed to?

·         Does your child push up on their hand or roll over?

·         If they are at the age where they should be able to speak or walk, do they do it?

Parents should also ask questions about what test will need to be run in order to diagnose their child. How long will it take should be another question to ask and may reduce a parent’s anxiety while waiting for results to come in. parents should also ask about other specialist that they may need to see. Sometimes, children diagnosed with cerebral palsy may also carry other disorders associated with CP. Ask for tests that will determine if your child may qualify for a dual diagnosis, such as, vision impairment, hearing impairment, speech delays or impairments, mental retardation or intellectual disabilities or other developmental delays.

There are many tests that professionals can use to determine a diagnosis of cerebral palsy. Doctors may order brain scans for the child. This technology allows physicians to see the areas of damage or abnormal development in the brain. Some of these tests use MRI scans which are painless but can take up to an hour to complete. The child will most likely be given a mild sedative. MRI is also usually the preferred imaging test. A Cranial Ultrasound may also be used. It doesn’t produce a detailed image but it is quick, inexpensive and can be a valuable tool in assessing the brain for abnormalities. A CT scan is a specialized x-ray technology that allows doctors to view cross sections of the brain. It is painless and takes about 20 minutes. If doctors use this tool, the child will need to be given a mild sedative, because they need to be very still during the test. Blood tests may also be done for differential diagnosis purposes.

Work Cited: www.mayoclinic.com/health/cerebral-palsy/

Symptoms Of Cerebral Palsy

           The signs and symptoms associated with cerebral palsy appear during the preschool years and even infancy. Because cerebral palsy is a condition that impairs movement, the symptoms that a child might have cerebral palsy may be the presence of exaggerated reflexes exhibited by a child or rigidity in the limbs and the trunk. Children may also have abnormal posturing, involuntary movements, unsteadiness of walking, or a combination of these symptoms. Not all children have the same kind of symptoms and these symptoms may not be exhibited to the same degree in everyone with the disability.
         People with cerebral palsy may not necessarily have diminished intellectual capacity but in some cases they may have intellectual disabilities. They may also have seizures as well as difficulties with vision and hearing. Some symptoms and signs associated with cerebral palsy occur because of the individual's  difficulties with movement and coordination. Some of these symptoms include:

• Variations in muscle tone- muscles can either be too stiff or floppy
• Stiff muscles and exaggerated reflexes (spasticity)
• Stiff muscles and normal reflexes  (rigidity)
• Lack of muscle coordination (ataxia)
• Tremors or involuntary movements
• Slow, writhing movements (athetosis)
• Delays in reaching one's motor skills milestones, such as pushing up on arms, or sitting up, crawling
• Favoring one side of the body, such as reaching with only one hand or dragging a leg while walking
• Difficulty walking, toe walking, grouched gait, scissor-like gait with knees crossing or a wide gait
• Excessive drooling or difficulty with swallowing
• Difficulty with sucking or eating
• Delays in speech or difficulty speaking
• Difficulty with precise motions, such as picking up a pencil or fork

These difficulties affecting the child with cerebral palsy may affect only one side of the body or the whole body. Since the brain injury doesn't change over time, the symptoms do not usually get worse as the child grows. However, the muscles may become more rigid if they are not treated regularly. It is important to mention that regression can occur if treatment is not consistent or discontinued.

Work Cited: www.mayoclinic.com/health/cerebral-palsy

A simple picture of different motor dysfunctions in CP

How is motion affected in Cerebral Palsy?

I was on a website that listed the different forms of cerebral palsy and under the form Spastic, there were 6 sub-headings. I wasn't sure if these terms were thought of as subtypes or they were simply features of the spastic form. What I am talking about is; Diplegia, Hemiplegia, Double Hemiplegia, Quadriplegia, Monoplegia, and Triplegia. So, what I did was start out by defining the term –plegia. -Plegia is a combining form meaning “paralysis, cessation of motion,” in the limbs or region of the body specified by the initial element: cardioplegia; hemiplegia; quadriplegia. Now I have a better understanding of what I am talking about, so let me go into further detail.

 Children suffering with diplegia form of cerebral palsy are primarily affected in their legs. They have spasticity and have a hard time with balance and coordination. Delayed muscle growth and spasticity cause their leg muscles to be short. Because of this, their range of motion can decrease as they grow and their joints also become stiff. Their feet and ankles present difficulties in their attempt at walking because their Achilles tendons are short and tight. This can lead to toe walking. The severity of this diplegia may vary from mild to severe. The difference may mean that some may be able to walk without the use of aids while others may require aid in walking even a short distance. Aids such as wheelchairs may be necessary to help with mobility.

Children suffering with hemiplegia are affected in one arm and one leg on the same side of the body. Usually, children with hemiplegia have a problem with motion where the arm is more involved than the leg and the end of the limbs have more problems. The wrist and hand have more physical problems than the shoulder, with the elbow literally somewhere in the middle. Also, the ankle and foot will exhibit more difficulties than the knee. Those with hemiplegia also have problems with spasticity. Special braces and splints may be necessary to help the child learn to use both hand to play and perform other tasks. Children with hemiplegia may start walking late and walk on their toes but they also grow out of it. Children with hemiplegia are not intellectually impaired. They go to regular school and have relatively normal function as other adults.

Term double hemiplegia is applied inconsistently so it is usually avoided. However, it is said to refer to those with cerebral palsy that affects all four limbs asymmetrically between the right and the left sides. It is also sometimes used in instances where there is more involvement in the arms than in the legs.

Quadriplegia is a term used to describe when all four limbs are affected and more often than not, accompanied by more severe motor dysfunction than occurs in the other forms. It is also important to know than mental retardation is higher for children with quadriplegia. In order to not misdiagnose children thought to have mental retardation, the child should be seen by a professional. Many children do not really have mental retardation, but simply a difficulty in communicating due to their motor impairment. There are also kinds of quadriplegia which may render some children more mobile than others. These children may also have difficulty in eating so the use of a nutritionist may be vital.

Monoplegia is a rare form of the condition which is used to describe when a child has the use of only one limb. It is usually thought of as Hemiplegia with very mild involvement of the other limbs on the affected side of the body. These difficulties are caused by trauma to the brain and should not be confused with disabilities caused by a nerve injury. With hemiplegia the arm is the site of the motor dysfunction and physicians and therapists work with the children, helping them to use both hands, which can lead to improvement.

Last but not least is triplegia, where the child is affected in the use of three limbs. Usually these three limbs will be the two legs and one arm. This form is often thought of as Quadriplegia with less severe involvement of one of the arms.

This information was cited from: www.originsofcerebralpalsy.com

Spastic Cerebral Palsy

Types of Cerebral Palsy

Different Forms of Cerebral Palsy

There are four different types of cerebral palsies which may have their own set of different symptoms and challenges that they present on the lives of the people who suffer with them.

          One form of cerebral palsy is called athetoid cerebral palsy. Ten to twenty percent of individual who suffer from cerebral palsy have this type. It is characterized by uncontrolled, writhing, slow movements. Two risk factors are associated with this type: hyperbilirubinemia; which is jaundice and RH incompatibility with the mother. These factors are now routinely diagnosed and treated which has brought down the number of cases of athetoid type cerebral palsy. In infants, this Athetoid is very dangerous. Due to the symptoms, if an infant is placed in an upright sitting position and has an exterior spasm, the child may be at risk for falling or jerking backwards hitting their head. Proper alignment and support of the hips, trunk and shoulders are crucial for these children. To reduce these involuntary movements, the body, when placed in a sitting, standing or symmetrical position should be positioned with attention to the midline. This gives them more control of the movements in their arms, which are the limbs most affected.

         Quadriplegic patterns are very common in children with C.P. Aside from their arms, they can use their extremities well enough to take care of their daily activities by themselves and can walk, except in children with severe athetoid who may not be able to walk independently, but may be able to assist others in transferring them in and out of wheelchairs. Some people have a hard time in feeding themselves and sitting without the use of special equipment to give them support. Even though C.P. does not hinder cognitive ability, the difficulties presented from athetoid may make speech and communication in these individuals difficult, even with the use of therapy. Therefore the use of augmentative communication devices is encouraged, as they may necessary to help the child to function more normally.

        Another form of cerebral palsy is called Ataxia. Ataxia is characterized by a lack of balance or impairment in the ability to perform smooth coordinated voluntary movements. It is rarely the primary motor dysfunction but is frequently seen as a contributing difficulty in one of the other forms of the condition. Ataxia results from damage to the brain’s cerebellum, which is the major center for balance and coordination. This may affect the limbs, trunk, eyes and other parts of the body. For children with C.P. the signals in the brain do not work together correctly, resulting in limitations of balance capabilities. Children with ataxia usually have an uncoordinated manner of walking or gait. They may walk quickly to compensate so they do not lose their balance. They have difficulty standing in place for long periods of time. However there are no drugs or medications that can assist with this particular disability. Practice is the best way to improvement in areas of balance and daily self care. Physical therapists can assist in balance exercises and other activities to improve their abilities.

         The Mixed form of cerebral palsy is used to describe a form of cerebral palsy that does not fit neatly into one of the other forms of classification. There are different types of movement disorders that may exist within the individual at the same time. Because this mixture of movement disorders, individuals do not fully fit into one category or another. The mixed term is used less frequently than other descriptions. The forms that are most commonly classified as mixed are Spastic and Athetoid forms of CP. In order to obtain this combination, there has had to have been damage to the cerebral cortex (spastic) and the basal ganglia (athetoid) areas of the brain.

         Spastic Hypertonia is characterized by abnormal control of voluntary limb muscles and by exaggerated reflexes, sometimes in association with a reduction in muscle tone in the trunk of the body. The muscles are stiff and permanently contracted which makes their movements awkward and presents varying degrees of difficulty depending on the severity of the form. In spastic hypertonia when a joint is moved passively, maximum resistance is felt after a few degrees. In the most severe forms of spastic hypertonia, the affected part of the muscles will be rigid whether they are flexed or extended. It is important to also note that these symptoms are lessoned during sleep and are exacerbated by stress or voluntary movement.

work cited: www.originsofcerebralpalsy.com