Kirk Garrett, Jr.

Cerebral Palsy: An Introduction

Cerebral Palsy (CP) is a disorder caused by damage to the brain, especially affecting the ability to control movement and posture. Palsy suggests paralysis; however, weakness (paresis) more aptly describes the most common muscular symptoms and the inability to make voluntary movements and to suppress involuntary or spasmodic movements.

Cerebral Palsy is not progressive, communicable, inherited or a primary cause of death. It is not a disease.

Exact figures are difficult to obtain because of the wide variation in the condition and lack of reporting requirements of doctors.
However, the United Cerebral Palsy Association estimates that approximately 3000 infants are born with CP each year. In the United States, 500,000 adults and children have one or more of the symptoms associated with CP.

These symptoms may include:

• Retention of primitive reflexors, involuntary reactions to certain stimuli that are usually found only in newborns.
• Muscular weakness and floppiness (hypotonia).
• Assumption of abnormal, awkward positions, which can lead to skeletal disorders.
• Favoring one side of the body over the other.
• Poor muscle control and lack of coordination.
• Muscle spasms or seizures.
• Problems with sucking, chewing, or swallowing.
• Unusual tenseness and irritability in infancy.
• Inability to control bladder and bowels (incontinence).
• Difficulty in speaking.
• Difficulty in concentrating.
• Difficulty in interpreting sense perceptions, such as touch.
• Other sensory deficits including hearing and vision.

Cerebral Palsy is caused by an injury to the brain before, during or shortly after birth. Many times the cause of the brain injury is unknown. However, one important cause is an insufficient amount of oxygen reaching the fetal or newborn brain. The supply of oxygen can be the result of premature separation of the placenta from the wall of the uterus, awkward birth position of the baby, prolonged or abrupt labor or circulatory problems of the umbilical cord. Certain diseases (such as German measles) in the mother can seriously affect the unborn baby. Premature birth, low birth weight, RH or A.B.O blood type incompatibility between mother and child and microorganisms that attack the central nervous system of the infant also are risk factors contributing to Cerebral Palsy.

People with CP have damage to the area of the brain that controls muscle tone. Muscle tone is what lets us control our body position; like sitting with our heads up. The muscle tone may be too tight, too loose or both.

Types of Cerebral Palsy:

• Spastic Cerebral Palsy: People with spastic CP have stiff and jerky movements because their muscles are too tight. Mobility and handgrip are difficult to control. This is the most common type of CP and affects half of all people with CP.
• Ataxic Cerebral Palsy: Low muscle tone and poor coordination of movements is described as ataxic. Shakiness or tremors make writing, page turning or using a keyboard difficult to perform. Poor balance and unsteady walking requires extra mental concentration or more time to complete the movements.
• Athetoid Cerebral Palsy: Athetoid refers to a type of CP involving mixed muscle tone, too high or too low. Random, involuntary movements result in movements of the face, arms and upper body. Walking, sitting upright and maintaining posture control takes extra work and concentration. About one fourth of people with CP have athetoid CP.
• Mixed Cerebral Palsy: When muscle tone is too low in some muscles and too high in other muscles, the type of CP is called mixed. About one fourth of all people with CP have this type.

Treatments:

Various appropriate therapies can help persons with CP to reach full potential. Among these are:

• Physical therapy uses exercises and activities to improve range of motion and other gross motor functions. Instruction in the use of mobility assistance devices, such as walkers and wheelchairs are important.
• Biofeedback techniques can improve control over body movements by increasing concentration of mind over body.
• Occupational therapy usually focuses on fine motor skills often resulting in more independence.
• Speech and language therapy helps children communicate with others. Speech communication devices, voice synthesizers and special computer modifications are available.
• Orthopedic devices such as walkers, rolling walkers with adjustable seating, wheelchairs, powered wheelchairs and electric scooters are examples of mobility assistance products.
• Writing aids, automatic page-turners and speakerphones are a few examples of products designed to improve fine motor activities.