What is Cerebral Palsy? Symptoms, Causes, and Treatment Methods

What is Cerebral Palsy? What are the Symptoms?

Cerebral palsy is the most common cause of physical disability in childhood. It occurs due to damage to the cerebral motor cortex, which directs muscle movements in the brain. Cerebral palsy symptoms and treatments vary significantly. Although a permanent cure is not possible, procedures that alleviate the patient's symptoms and improve their quality of life can be applied.

What is Cerebral Palsy?

Cerebral palsy is a developmental disorder caused by the incomplete development of the relevant areas of the brain before, during, or after birth. It is a pathological condition characterized by movement, balance, and other postural disorders, which is common in childhood and causes disabilities. In addition to developmental disorders, visual, auditory, and behavioral problems may also develop. In some cases, patients may experience difficulties during speech, eating, and learning actions. The types of cerebral palsy are as follows:

Spastic Cerebral Palsy: This is the most common type of the disease. It is the type of cerebral palsy where muscle tone increases, muscles stiffen, movements become difficult, and it causes awkward movements. It can affect the arm, leg, torso, and face, one side of the body, or the entire body.

Dyskinetic Cerebral Palsy: Dyskinetic type cerebral palsy is the type where muscles cannot be controlled. The patient may not be able to sit upright. If the facial and tongue muscles are affected, speech and eating actions become difficult. This condition may cause drooling.

Ataxic Cerebral Palsy: In this type, balance and coordination problems are experienced. Movements can be jerky, leading to an unsteady gait and hand tremors.

Mixed Cerebral Palsy: It develops when symptoms belong to more than one type.

What Are the Symptoms of Cerebral Palsy?

There are many different types and levels of disability in cerebral palsy. Therefore, symptoms may vary in each patient. Usually appearing in the first months of life, symptoms can rarely develop up to about two years after diagnosis. Cerebral palsy affects the entire body in some patients. In some cases, symptoms may appear in only one or two limbs or on one side of the body. Symptoms do not worsen with age, but they may become more pronounced as the child grows. Cerebral palsy symptoms can be briefly mentioned as follows:

Symptoms related to movement and coordination are as follows:

Stiff muscles and exaggerated reflexes,

Muscle tone that is too stiff or too loose,

Rigidity,

Lack of balance and muscle coordination,

Tremors and uncontrolled jerky movements,

Slowness in movements,

Tendency to use one side of the body,

Walking problems,

Scoliosis and other bone abnormalities,

Experiencing problems with fine motor skills such as buttoning clothes.

Symptoms related to speech and eating are as follows:

Delay in speech development,

Trouble speaking,

Problems during sucking, chewing, or eating actions,

Drooling and swallowing difficulties.

Some children with cerebral palsy may develop the following developmental symptoms:

Delays in motor skills such as sitting and crawling,

Learning disabilities,

Intellectual disabilities,

Growth delays.

Other neurological symptoms related to brain damage are as follows:

Epilepsy-like seizures,

Hearing problems,

Vision problems and changes in eye movements,

Sensation of pain during touch,

Bladder and bowel problems such as constipation and incontinence,

Mental health conditions such as emotional conditions and behavioral disorders.

What Causes Cerebral Palsy?

Cerebral palsy occurs when there is damage to the developing brain. The affected part of the brain is the region called the motor cortex, which controls muscle tone. The damage usually occurs while the baby is a fetus. Low oxygen levels, poor blood circulation, improper development of the baby's brain in the womb, infection, and trauma can cause injury to the fetus. Babies born early or with low birth weight, exposed to infection in the womb, having a birth defect, and having severe jaundice are at higher risk of developing cerebral palsy. There are also certain genetic conditions that can cause the disease to develop. Additionally, drowning in early childhood, other brain injuries, and exposure to toxins can also lead to cerebral palsy. Prenatal damage accounts for about 80% of the causes, while postnatal damage accounts for about 10%.

What Are the Risk Factors for Cerebral Palsy?

There are certain risk factors that can cause the development of cerebral palsy and increase the likelihood of it happening. These risk factors can be briefly listed as follows:

Premature births, especially those occurring before the 28th week,

Low birth weight below 1.5 kilograms,

Substance abuse by pregnant women,

Multiple pregnancies such as twins, triplets, etc.,

The mother contracting infections such as cytomegalovirus, rubella, herpes, and syphilis or being exposed to toxins,

Conceiving via in vitro fertilization or assisted reproductive technologies,

Thyroid problems in the pregnant parent,

Severe jaundice,

Infections affecting the placenta and amniotic fluid.

How is Cerebral Palsy Diagnosed?

Diagnosis of cerebral palsy may not be made until several months or years after birth. If symptoms are mild, the diagnosis may be made even later. Symptoms become more prominent over time. Doctors evaluate the medical history of the patient children and perform a physical examination. During appointments, the child's growth and development are monitored. Children with brain and nervous system disorders may be referred to pediatric neurologists and pediatric physical medicine and rehabilitation specialists. Tests that can be used for the diagnosis of cerebral palsy are as follows:

Magnetic Resonance Imaging (MRI): If cerebral palsy is suspected, 3-dimensional images of the brain are obtained with an MRI. Images in MRI are produced using radio waves and a magnetic field. It is a painless test but noisy, and in some cases, it can take up to an hour. Therefore, pediatric patients may be administered a sedative or anesthetic in advance.

Cranial Ultrasound: High-frequency sound waves are used to obtain brain images. Although ultrasound does not create a detailed image, it is a fast procedure and allows for a preliminary evaluation of the brain.

Electroencephalography (EEG): Electrical activity of the brain is recorded by attaching a series of electrodes to the scalp. This procedure may be resorted to if the child is suspected of having a seizure.

Laboratory Tests: Blood, urine, and skin tests can be applied to screen for genetic and metabolic conditions.

Additional Tests: Tests for vision, hearing, speech, mental, developmental, and other medical conditions can be applied.

How is Cerebral Palsy Treated?

Child and adult patients with cerebral palsy may need lifelong care because there is no permanent cure for cerebral palsy. However, there are treatment options available to help improve the patient's daily functioning. The earlier the disease is diagnosed, the more successful the treatment. Cerebral palsy treatment methods can be briefly mentioned as follows:

Medications: Various medications can be used to improve muscle function and reduce tightness. Additionally, complications caused by pain, spasticity, and other symptoms can be managed with medical treatments. Muscle or nerve injections, oral muscle relaxants, and medications that reduce drooling can be prescribed by physicians.

Physical Therapy: Muscle training and exercises can assist patients with strength, flexibility, balance, motor development, and mobility. A pediatric physiotherapist provides children with necessary information on how to meet their daily needs. This information may be related to the child's feeding and bathing.

Occupational Therapy: Occupational therapists try to help children gain independence in daily activities at home, school, and in the community. They may recommend equipment such as walkers, broad-based canes, standing and seating systems, or motorized wheelchairs.

Speech and Language Therapy: Speech therapists can help children develop communication skills using speech and sign language. These therapies can also resolve problems related to eating and swallowing. Therapists can also teach the use of computers and voice synthesizer communication devices in cases where communication is difficult.

Orthopedic Surgery: Children with muscle tissue shortening may need surgery. Operations performed on bones and joints can place the arms, spine, hips, and legs in correct positions. Through surgical methods, muscles can be lengthened, or shortened tendons can be lengthened or repositioned.

Cutting Nerve Fibers: This is a procedure that can be applied in cases where walking or moving is difficult and painful. It is resorted to when other treatments are insufficient. Surgeons cut the nerves serving specific spastic muscles. In this way, the muscles in the legs relax and pain decreases.

Frequently Asked Questions About Cerebral Palsy

Cerebral palsy usually develops due to other risk factors, but genetics can also contribute to the development of the disease. Therefore, diagnostic tests covering the examination of relevant genes may be applied during the diagnosis of the disease. Cerebral palsy seizures can develop in mild or severe forms. In mild seizures, there is usually no loss of consciousness, and symptoms such as speech interruptions, fluttering eyelids, blank stares, and lip smacking develop. In severe seizures, loss of consciousness, severe muscle contractions, and abnormal electrical activity developing all over the body occur. Cerebral palsy and epilepsy are different disorders. Cerebral palsy is a muscle control disorder that occurs due to the brain's failure to complete its development, while epilepsy is a neurological disorder dependent on abnormal electrical activity developing in brain cells. Seizures can develop in both diseases. Symptoms can develop a few months or years after birth. Symptoms such as lack of coordination in movements, developmental delay in the infant, and impairment in sucking-swallowing functions may develop. No, the defect in the brain structure does not progress over time, so the disease does not progress either. However, symptoms may become more pronounced with age. Depending on the severity of the disease, patients with cerebral palsy can have a normal life expectancy with necessary health arrangements. In severe forms of cerebral palsy, a normal and near-normal life expectancy can be expected with close medical follow-up and rapid intervention to complications.

Cerebral palsy is generally a congenital disease, and in some cases, symptoms appear later. It is not a degenerative disease; meaning its effect on the brain does not worsen over time. However, there is no permanent cure for it. Therefore, early diagnosis and appropriate treatment approaches are of great importance in terms of increasing the quality of life of patients.

If you observe symptoms of cerebral palsy in your baby or a relative, it is recommended that you consult a specialist physician without wasting time. At Hisar Hospital Intercontinental, we are by your side in the diagnosis and treatment process of cerebral palsy with our doctors who are experts in their fields and our multidisciplinary treatment approach. Click immediately to get an online appointment.