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

                                  

Causes of Cerebral Palsy

What is cerebral palsy and what are its causes you may be asking.

Cerebral palsy is a type of developmental disorder. If we break down the term we can get a hint as to what this disability entails. The word cerebral comes from the word cerebellum, which is an area in the brain that is affected by the disorder. The word palsy is used to refer to a movement disorder.

There are various reasons why this disability may occur. In short, cerebral palsy is injury to the brain that can occur before birth, during birth or after the birth of the child. It is the failure of the brain to develop properly
or neurological damage done to the child's developing brain that results in this developmental brain malformation. The Mayo Clinic ( www.mayoclinic.com/health/cerebral-palsy.com )breaks down these causes of cerebral palsy down even better. They list the causes of cerebral palsy
as such:
- Random mutations in genes that control brain development.

- Maternal infections that affect the developing fetus.

- Fetal stroke, a disruption of blood supply to the developing brain.

- Lack of oxygen to the brain related to difficult labor or delivery (asphyxia).

- Infant infections that cause inflammation in or around the brain.

- Traumatic head injury to an infant from a motor vehicle accident, fall or child abuse.

The severity of the cerebral palsy on the child depends on the type of injury to the brain as well as when the injury first occurred. Babies that are very premature may suffer bleeding to the brain which is known as intraventrical hemorrhage which can result in extensive damage to the brain. Asphyxia which is one of the causes of cerebral palsy causes damage to brain tissue. Between 10 and 15 percent of reported cases of cerebral palsy are caused from brain injury, bleeding in the brain and asphyxia. Thousands of occurrences of cerebral palsy are due to medical malpractice and were preventable.

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