Cerebral palsy refers to conditions that affect co-ordination and movement. It is caused by a problem in the brain usually occurring before, during or soon after birth. In the UK one in 400 children are affected with life expectancy the same as anyone else.

Most often, it is down to abnormal development of the baby’s brain whilst it is growing in the womb such as damage to the white matter due to reduction in the baby’s blood or oxygen supply. It may also occur as a result of infections caught by the mother such as chickenpox or rubella.

The risk of developing cerebral palsy is increased in babies being born prematurely or at low birth weight. If the mother is over 35 or has abnormal blood pressure the risk also increases. 10% of cerebral palsy cases are due to injuries at birth such as asphyxiation, a lack of oxygen reaching the brain during birth.

There are 3 main types of cerebral palsy with most people having a combination.

1. Spastic Cerebral Palsy caused by damage to the motor cortex and characterised by tight and stiff muscle tone, reducing a person’s movement range, which can be painful. Muscles often spasm causing exaggerated jerky movements. Damage to the motor cortex can also cause problems with sight.

2. Dyskinetic Cerebral Palsy caused by damage to cerebellum or basal ganglia resulting in uncontrolled, involuntary muscle contractions. Patients may find it difficult to maintain an upright position or control the tongue, vocal chords and breathing affecting speech and language.

3. Ataxic Cerebral Palsyis a type of cerebral palsy which due to the inability to activate the correct pattern of muscles during movement affects balance and spatial awareness. Most people can walk but will be unsteady with shaky movements. Ataxia can also affect speech and language. It occurs due to damage to the cerebellum which is responsible for coordination and fine motor skills.

Symptoms are usually noticeable within the first 2-3 years of a child life and affects people in different ways. They include:

• Weak arms or legs or random uncontrolled movements
• Delays in reaching developmental milestones such as not sitting by eight months or walking by 18 months

If you are concerned about the development of your child; speak to the GP in the first instance. The GP can help by referring your child to a specialist team to check for any problems. The specialist team may conduct several tests which could include brain scans such as cranial ultrasound, MRI’s and CT scans.

There is currently no cure for cerebral palsy, but treatment aims to help people with the condition to live a normal and independent life.

• Physiotherapy is one of the most important treatments that can help improve movement. It involves stretches and exercises to encourage movement and increase muscle strength.
• Speech therapy helps children who struggle with communication by allowing themto practise their speech with exercises, or teaching them an alternative method of communication, such as sign language or pictures.
• Occupational therapy can be useful to children in boosting a child’s self-esteem and independence as they can identify problems that your child has in carrying out everyday tasks by improving fine motor skills such as picking up small objects.

There are medications to help manage the condition and relieve symptoms. These include medications that help with muscle stiffness, sleeping, drooling and gastro intestinal complaints. Many children develop epilepsy due to the brain damage and may require ant-seizure medication.

Some patients have difficulty swallowing food which can be a problem, as it increases the risk of choking or chest infection. In this case swallowing techniques and exercises can be taught. Dietary changes, such as eating soft foods can also be helpful.

Support groups available across the country ensure children and parents have access to the resources they need. These include:

• March of Dimes- Their mission is to improve health and wellness for new mothers and babies.
• The Cerebral Palsy Foundation- contributes millions each year to cerebral palsy research
  

References

1. https://www.nhs.uk/conditions/cerebral-palsy/

2. https://www.scope.org.uk/support/disabled-people/ageing

https://www.cerebralpalsyguide.com/treatment/medications/