Cerebral Palsy Children
Cerebral palsy is one the commonest cause of severe physical disability in children. In the world, nearly 15 million and in India 3 million children are affected with this problem. Nearly 1.5 to 3 of every 1000 live births can be affected with cerebral palsy. Cerebral palsy is disorder of movement & posture and often accompanied with problem in sensation, perception, cognition, communication, behavior, speech & seizure. Suspicion of cerebral palsy can be made in very early age of life. This suspicion can be made with the history of high risk birth, low birth weight & premature delivery, abnormal social & motor response. Cerebral palsy children are usually delayed in achieving milestones. They can also have lots of other associated medical problem. Cerebral palsy children have a problem in crawling, standing & walking. These children need intensive therapy at very early age and when they get sufficient progress then they need maintenance therapy for long duration. These children some time also denied their right to get admission in main stream school, intermingle with normal children & participation in all social activity, sports. These cerebral palsy children can do much better in the study because they are confined to indoor with less outdoor activity.
What is Cerebral Palsy in Children?
Cerebral palsy is group of neuro-motor disorder it affect new born as well upto 2.5 year of age but persist for whole life. It occurs because of brain insult in early phase of life. It contain problem in sitting, crawling, walking, poor coordination, sensation, speech, vision, hearing, movement disorder, epilepsy, growth disturbance etc. Brain insult remains static but disability can increase decrease static depending upon many factors. These children can have good quality of life if they are given early intervention by good rehab measure. Cerebral palsy can present in variety of manner according to site of lesion in brain. It can present as spastic, dystonic, athetotic, mixed, ataxic, hypotonic etc. Hypotonic cerebral palsy convert in dyskitec or spastic variety.
What Causes Cerebral Palsy in Children?
Cerebral palsy occurs because of some brain insult in-utero, after delivery and up-to 2.5 year of age. Most of the time causes are not known. Genetic factor play a major role. Other important causes are hypothyroidism of mother, eclampsia, intrauterine infection before delivery. Asphyxia, aspiration pneumonia, kernicterus, infection, birth trauma are few causes in new born. Very low birth weight, premature baby, second baby of twins and triplets are prone to brain insult.
How is Cerebral Palsy Diagnosed in Children?
Most of the time diagnosis of cerebral palsy is self evident with clinical evaluation of child. Now with careful history and examination we can make diagnosis of cerebral palsy as early as 6 months of life by taking history event at birth, history of brain insult, delayed milestone, abnormal reflexes, abnormal tone in body, abnormal response to stimuli history of epilepsy etc. MRI brain is needed to see feature of brain insult and other problem. Careful history and detail evaluation is important for correct diagnosis. Physiological Delayed milestone, syndromes, genetic, metabolic problems, muscular dystrophy are few differential diagnosis.
What Problem Does CP cause in Children?
Cerebral palsy cause many neuro-motor disorders in child including delayed milestone, abnormal movement disorder, abnormal tone of body, speech problem, epilepsy, vision problem, hearing issue, dribbling of saliva, growth abnormality, feeding problem. These children can have difficulty in crawling, standing and independent walking. Severity of disability is based on extent of brain insult. These children can have range of severity from trivial problem to very sever disability. Cerebral palsy can affect one limb to whole body. According to extent of involvement it can be classified in hemiplegic, diplegic, triplegic, quadriplegic etc. This child can also have behavioural problem and mental retardation. But mental retardation is found in 30-40% children only. These children also have lack of immunity so recurrent infection is common. Adult affected with cerebral palsy can also have premature aging that lead to early onset of aging problem which occur in old age.
How is CP Treated In Children?
Cerebral palsy can’t be cured. But by various modality of rehab, we can decrease their disability and can increase ability so that they can be integrated in mainstream of society. Physical and occupational therapy is the main stay in treatment plan of these children. Many advance rehab measure have develop in last two decade it include NDT, SI, CIMT, Strength training, gait training, mirror therapy, yoga etc. Traditional therapy doesn’t help but do much harm to these children. Other accessory instrument are required for support which include Braces in the form of AFOs & gaiter along with walking devices including stick, elbow crutches and walker. Botulinum toxin is required to manage spasticity in early age child. Surgery is required only in spastic cerebral palsy where fix bony deformity, muscle contracture, joint deformity and bony torsion are interfering in ambulation. But usually we defer surgery till the age of 7 year.
What extra you should know about CP?
Beside all the direct symptom of cerebral palsy other factors are also very important. Severely affected children can also have lack of immunity, writing & learning problem, feeding problem, constipation, epilepsy. Most of the time cerebral palsy children are physical disable but with proper training they can do all the activities required for living good quality of life. They can joint main stream school. These children can have good singing. They can do lots of activities which are important for daily living but little assistance and training is required. They are slow worker but good in work once they learn and given sufficient time.
How our expert team can help you Children?
Multidisciplinary team of specialist is required to manage these children. It includes orthopaedic surgeon, neurologist, paediatrician, physical therapist, occupational therapist, speech therapist, special educator, social worker & orthotic specialist etc. Team of specialists work along with parents to plan treatment strategy. Involvement of parents and their understanding is very important for good outcome. Paediatrician deals with routine medical problem of child, neurologist deals with neurological problem in child, orthopaedic surgeon deal of orthopaedic issues. Physical and occupation therapist provide therapay along with guidance and training of parents in home based therapy and activities of daily life. Speech therapist provide speech and language therapy, special educator prepare the child for main stream school. Treatment of children with cerebral palsy is joint effort of team of specialist and parents. Psychologist assess the psychological status of parents and child along with IQ of child so that they can guide them for better future.
Important Facts About Cerebral Palsy