A. ‘Cerebral Palsy’ (CP) is a disorder that affects a child’s ability to control his/her muscles. It is caused by damage to the parts of the brain that control movement and co-ordination.
‘Cerebral Palsy’ is a general term to describe a very wide spectrum of disorders. There are three important things to understand in a child who has CP
- How the affected parts behave
- Which parts are affected
- In terms of how the affected parts behave:
Spastic CP – This is the most common form. In this, the affected muscles are in spasm i.e. the are very tight and do not relax easily.
Dystonic CP – In this form, the child’s arms or legs repetitively move in abnormal twisting movements. This may occur whenever the child attempts to use the arm/leg, or may even occur continuously when the child is at rest.
Hypotonic – In this type, the affected parts are limp and floppy. It is like how the limbs are in a person who is paralyzed.
- In terms of the parts of the child’s body that are affected the most:
CP Hemiplegia – When one half of the body i.e., the arm and leg on one side are affected.
CP Diplegia – Both legs are affected maximally. Usually, there are some problems in both arms as well, but this is very mild.
CP Quadriplegia – Both arms and both legs are equally affected. Very often, the trunk is also weak.
Q. What causes cerebral palsy?
A. CP occurs due to some damage to a small child’s growing brain. This damage may occur while the child is in the womb or may occur around the time of birth – children who are born prematurely or who have a very low birth weight, babies who do not breathe immediately after birth and need to be resuscitated. Finally, the damage may occur soon after birth as well – babies who have trouble breathing and need to be kept on a ventilator, those who suffer from jaundice, or have bleeds in their brain.
All these are the known risk factors for CP, however the exact cause may not be known in many cases.
Q. What are the symptoms of cerebral palsy?
A. The initial symptom of CP is usually a child who is slow to meet his/her developmental targets. CP also affects other body systems besides the movement problems:
- Learning disabilities
- Speech, vision and hearing problems
- Epilepsy (seizures or fits)
- Curvature of the spine and poor posture
- Joint and gait problems
Q. Which are the specialists that will be needed to treat my child?
A. The diagnosis of CP is usually made by your paediatrician or a neurologist. You may also need to consult a number of other specialists:
- Paediatric Orthopaedic surgeons – to treat the problems with muscles, joints and gait
- Eye specialists – For visual problems
- ENT specialists – For problems in hearing
- Physiotherapists – To help improve movement and strength
- Occupational therapists – To help your child learn daily living skills such as eating, dressing
- Speech therapists – To help with communication problems
- Nutritionists – To help give your child type of diet he/she needs
- Orthotists – To provide braces and aids to help your child walk and do other activities
Q. How is cerebral palsy treated?
A. The treatment of a child with CP consists of a combination of medications, physical therapy, bracing and surgery.
Q. Does cerebral palsy get worse over time?
A. The injury in the brain which results in CP remains the same and does not change over time. However, as the child grows, the problems with movement and other impairments do change and worsen.
Q. What is ‘Botox’? Will Botox injections help?
A. ‘Botox’ or ‘Botuminum toxin’ is a chemical that relaxes tight muscles when injected into them. The effect of botox lasts for only a few months. However, if you regularly do physiotherapy and use the necessary braces, the beneficial effects of botox can be prolonged by several months.
Q. Will my child need special shoes or braces?
A. Yes, braces and splints are very important in the treatment of CP.
Q. Will my child need surgery?
A. The need for surgery will depend on many factors. Regular exercise and use of braces can help in delaying the need for surgery, however, most children with severe CP need surgery eventually.
Q. Can stem cell injections help?
A. NO. Stem cell injections have NOT been proven to be effective in cerebral palsy.