Cerebral palsy in children

20/08/2022

What is cerebral palsy?
Cerebral palsy is the most common motor disability of childhood. This term describes a group of disorders resulting from damage to the brain during development that affects a person’s ability to control their muscle function. This damage can occur during pregnancy, childbirth or the first years of the child’s life, which is, in short, during the period of maximum growth and maturation of the brain. Cerebral palsy only includes cases where the damage to the brain does not progress but remains stagnant, without getting better or worse. However, what changes is the clinical picture of the child as they grow up.
On the one hand, they may develop musculoskeletal problems as they grow, but on the other hand, therapeutic intervention can help them avoid deformities as much as possible and train them to improve their mobility and functionality.

Types of cerebral palsy
Cerebral palsy is classified into four main categories based on the quality of muscle tone and the nature of the movement disorder:

1. Spastic form: This is the most common type, characterized by increased muscle tone leading to spasticity. Muscles are often tight and constantly contracted, resulting in weakness and difficulty in movement.

2. Athetosis form: Athetosis refers to the inability to maintain a stable position or posture due to disruptions in muscle tone. Individuals with this form struggle to hold steady positions while sitting or standing, experiencing involuntary and sudden movements across a wide range that they cannot control.

3. Ataxic form: Ataxia entails difficulty in executing movements accurately, often accompanied by tremors when attempting to move. Movements may either overshoot the target, such as when trying to grasp an object, or fall short. Children with ataxia commonly face challenges with balance.

4. Hypotonic form: In this type, there is generalized hypotonia characterized by decreased muscle tone and loose joints. It is a relatively rare form of cerebral palsy.

5. Mixed forms: Combination of the types mentioned above.

Accompanying problems that may exist in children with cerebral palsy include:
• Hearing problems
• Vision problems
• Epilepsy
• Intellectual disability
• Gastroesophageal reflex
• Orthopedic problems
• Sensory- perceptual difficulties
• Nutritional challenges
• Constipation
• Frequent respiratory infections
• Speech difficulties
• Learning challenges

Treatment of cerebral palsy
In terms of treatment, individuals with cerebral palsy require therapeutic interventions from infancy and early childhood. Research indicates that early intervention and effective treatment improve the quality of life for the children and their families. It also helps prevent the accumulation of musculoskeletal deformities and serious complications that may necessitate prolonged hospitalizations or surgeries.
Cerebral palsy care places significant demands on health and social care systems due to the chronic and often severe nature of the condition.

Treatment approaches are tailored to each individual’s specific needs, considering the severity of the movement issues and any accompanying problems. Generally, the following treatments are necessary:
1. Physiotherapy, which should commence in the early years of life, ideally soon after diagnosis.

2. Occupational therapy, also beginning early in life.

3. Speech therapy to enhance both verbal and non-verbal communication abilities.

4. Interventions for feeding and saliva management issues, common among many patients.

5. Participation in physical education programs, sports activities, and creative endeavors to promote socialization among children.

Enhanced care for children with cerebral palsy not only improves their quality of life and that of their families but also fosters the realization of their potential for leading more fulfilling lives.

Sources: Cerebral Palsy: a guide for parents, PlusMED
What is cerebral palsy and how is it treated, IASO

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