Cerebral Palsy

Overview

Cerebral Palsy (CP)

is a general term for damage to the parts of the brain that control muscle activity. Movement and coordination are often affected. The disability can be mild, moderate, or severe. Some children can walk by themselves. Others need help from braces, crutches, walkers, or wheelchairs.

Symptoms:

Children with CP may be slow to meet developmental targets such as rolling over, sitting up, crawling, and walking. Your child may demonstrate other symptoms. CP may affect may body systems other than motor skills. For example:

• Developmental delay including learning disabilities or speech problems
• Seizures
• Vision or hearing difficulties
• Problems with teeth, swallowing, or constipation
• Curvature of the spine (scoliosis)
• Joint contractures or hip dislocations

Evaluation & Examination

Early signs of CP include being late in learning to roll over, sit up, crawl, or walk. Sitting up by oneself usually happens between 6 and 8 months of age. Walking by yourself usually starts by 18 months of age. If your child is slow to do these things, you should ask your paediatrician about possible developmental delay. Paediatric neurologists (brain and nerve doctors) and/or paediatric orthopaedic surgeons also help with the evaluation and diagnosis. Sometimes your doctor will order a magnetic resonance imaging (MRI) test of your child’s brain to look for abnormalities or ask for x-rays for their bone and joint problems.

Treatment

In the early years (before the age of 3), treatment is to help the child gain his/her milestones like walking. Early intervention programs (EIP) offer physical therapy (PT), occupational therapy (OT), and speech therapy (ST). As the child grows treatment shifts to keeping function with various options such as Botox or Soft tissue or bone corrective surgeries.

FAQ

Q: What causes Cerebral Palsy?

Cerebral Palsy has been associated with many causes, but sometimes there is no definite cause. Premature birth and low birth weight are the most well-known associations with CP, but not all premature or tiny babies are affected. Infections - before birth or in infancy - have been associated with CP.

Q: When should I take my child to the doctor for Cerebral Palsy?

Early signs of CP include delays in meeting milestones, such as learning to roll over, sit up, crawl or walk. Sitting up alone usually happens between 6 and 8 months of age. Walking independently usually starts by 18 months of age.

Q: Will Botox help?

Botox can be helpful in select patients. It's most useful in patients who have very tight muscles, but still have full motion in their joints. Botox won't help once the joints are stiff.

Q: Will my child need special shoes or braces?

Special shoes are rarely needed. However, braces are an important part of treatment for some children. Braces can help keep the feet flat on the ground and improve stability. Braces may also keep the muscles stretched out, which may help avoid the need for surgery.

Q: Will my child need surgery?

Remember that CP is a general term for patients with different disabilities. Some patients with CP only have one leg or arm involved, and some patients have both legs and arms involved. It is difficult to predict if your child will need surgery because each CP patient is different.

Q: Will activities make my child’s Cerebral Palsy worse?

No. You do not need to limit your child’s activities t need to limit your child or apart of overall good health.

Q: Does Cerebral Palsy get worse over time?

This is an important question. There is no cure for CP, and the underlying brain injury does not get worse over time; however, many of the other impairments - seizures, tight muscles, scoliosis, etc. - will change as your child grows.