It is a non
progressive neuromuscular disorder causing mild to severe disabilities
throughout life.This condition is manifested as a group of persisting
qualitative motor disorders which appear in young children due to damage to the
brain during delivery or due to some pathological conditions in the
intrauterine life.
The neuroligical problems are multiple but non progressive in
nature.Approximately 2 per 100 live birth is having this problem.This disease
is having no hereditary tendency.
Causes of cerebral
palsy:
1) Injury to the brain
during delivery.
2) As a complication
of forceps delivery.
3) Lack of oxygen
supply to the baby during delivery.
4) Infections during
delivery.
Signs and symptoms of
cerebral palsy:--
The signs and symptoms
may not be similar in all babies affected.Depending upon the damage to the
brain there may be mild to severe lesions.
Mild cases:- 20%
children will have mild disability.
Moderate cases:-50%
cases are having moderate disability.The affected children require self help
for assisting their impaired ambulation capacity.
Severe cases:-About
30% of the affected children are totally incapacited and bedridden and they
allways need care from others.
Abnormal findings in
cerebral palsy:-
1,Abnormal neonatal
reflexes.
2,Stiffness of all
muscles with awkward motion.
3,Extention of
extremities on vertical suspension of the infant.
4,Scissoring of the
lower limbs due to spasm of the adductor muscles of the thigh.
5,In severe cases the
back bend backwards like and arch.
6,May have total or
partial paralysis.
7,Arrest of
neurological and behavioral developement.
8,Swallowing may be
difficult in some cases.
9,Drooling of saliva.
10,Mild to severe
mental retardations.
11,Abnormal movements
are seen in some cases.
12,Tremors with
typical movements.
13,If cerebellum is
affected there will be loss of muscle tone with difficulty in walking.
14,Complete or partial
loss of hearing.
15,Speech may be
affected.
16,Squint and other
visual problems may be associated.
17,Convulsions may be
seen in some children.
Cerebral palsy is
diagnosed by detailed clinical examination and by eliminating other similar
diseases like brain tumour, progressive atrophy ect.All investigations like CT
scan,MRI and routine investigations are needed to ruleout other diseases.
Management of carebral
palsy:--
General management:
This includes proper
nutrition and personal care. Symptomatic
medicines are needed to reduce convulsions and muscle stiffness. Diazepam can reduce spasticity and athetosis.
Dantrolene sodium
helps to relax skeletal muscles.
Physiotherapy:
Here massage,exercise,
hydrotherapy and ect are needed.Special training is given to train
walking,swallowing and talking.The affected children are also trained to hold
articles for routine activities.
Rehabilitation:
Moral and social
support should be given to these children.They should be send to special
schools where special training can be given by trained staff.Mentally retarded
children need special training.Depending up on the disabitity special
instruments and machines are given for locomotion and to assist their daytoday
activities.
Occupational therapy:
This is given by
occupational therapists.They train the disabled people to do some suitable
works so that these people can have their own income.
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written by:
Agus Kurniawan - Tuesday, October 2, 2012