Cerebral Palsy in Children: What Parents Should Know About This Condition

Children with cerebral palsy can lead fulfilling lives if given the right support. Here are some things that parents should know about cerebral palsy (CP).

What is Cerebral Palsy?

A series of conditions known as cerebral palsy (CP) have an impact on a person’s mobility, balance, and posture. The most typical motor impairment in children is cerebral palsy. Cerebral refers to something involving the brain. Palsy refers to muscle weakness or functional issues.

During early childhood or preschool, signs and symptoms start to show up. Generally speaking, cerebral palsy results in movement impairment that is accompanied by heightened reflexes, floppiness or spasticity of the limbs and trunk, peculiar posture, involuntary motions, unsteady walking, or some combination of these.

Types of Cerebral Palsy

Cerebral Palsy is categorised by medical professionals based on the primary movement disorder that is present. Movement disorders can include one or more of the following, depending on which parts of the brain are impacted:

• Tense muscles (spasticity)
• Involuntary motions (dyskinesia)
• Poor coordination and balance (ataxia)

There are four types of Cerebral Palsy:

1. Spastic Cerebral Palsy

Spastic CP is the most typical kind of CP. About 80 per cent of CP sufferers have spastic CP.

The tone of their muscles is higher in people with spastic CP. As a result, their movements may be uncomfortable due to their rigid muscles. The bodily components affected by spastic CP are typically used to define the condition:

• Spastic diplegia/diparesis—Muscle stiffness affects the arms and legs mostly in this kind of cerebral palsy. People with spastic diplegia may find it challenging to walk since their legs tend to pull together, curve inward, and cross at the knees due to tight hip and leg muscles (also known as scissoring).
• Spastic hemiplegia/hemiparesis: This type of cerebral palsy (CP) only affects one side of the body, usually the arm more so than the leg.
• Spastic quadriplegia, also known as quadriparesis, is the most severe type of spastic CP and affects the face, trunk, and all four limbs. In addition to having additional developmental difficulties like intellectual incapacity, seizures, or issues with vision, hearing, or speech, people with spastic quadriparesis typically are unable to walk.

2. Dyskinetic Cerebral Palsy (also includes athetoid, choreoathetoid, and dystonic cerebral palsies)

Dyskinetic CP patients have difficulty regulating their hands, arms, feet, and legs, making it challenging for them to sit and walk. The unrestrained movements can be quick and fast or slow and writhing.

Sucking, swallowing, and speech become difficult when the face and tongue are involved. Muscle tone can fluctuate from too tight to too loose in a person with dyskinetic CP, not just from day to day but even within a single day.

3. Ataxic Cerebral Palsy

Ataxic CP patients experience balance and coordination issues. When they walk, they could be shaky. Quick movements or actions requiring a lot of control, like writing, may be difficult for them. When they grasp anything, they can find it difficult to keep their hands or arms under control.

4. Mixed Cerebral Palsy

Some people exhibit signs of multiple CP types. Spastic-dyskinetic CP is the kind of mixed CP that is most prevalent. 

What Causes Cerebral Palsy?

Damage to or abnormal development in the areas of the brain that control movement is what leads to cerebral palsy. These occurrences can take place in the first few years of life, when the brain is still developing, or just before, during, or right after birth. The precise cause of cerebral palsy is frequently unknown.

Congenital cerebral palsy is the term used to describe the majority of cerebral palsy cases in children.

Prenatal factors that contribute to cerebral palsy include:

• Damage to the white matter of the brain
• Abnormal brain development
• Bleeding in the brain
• Lack of oxygen in the brain

A small percentage of kids have cerebral palsy that has been acquired, meaning it started more than 28 days after birth. among the potential causes of acquired cerebral palsy are

• Brain injury that occurs in the early months or years of life
• Diseases like meningitis or encephalitis
• Issues with blood clotting, faulty blood arteries, a heart defect that was present at birth, or sickle cell disease that result in issues with blood flow to the brain.
• Head injuries from a fall, an automobile collision, or child abuse

Cerebral Palsy Baby

Due to the wide range of impairment types and severity levels, there are many different indications of CP. A delay in achieving motor or movement milestones is the primary indicator that a child may have CP (such as rolling over, sitting, standing, or walking).

Here are a few additional indications of potential CP. It’s crucial to remember that some kids without CP could also exhibit some of these symptoms.

For babies below 6 months of age:

• When you pick him up when he’s lying on his back, his head lags.
• He feels stiff.
• He is unsteady.
• He appears to overextend his neck and back when being held in your arms, acting as though he’s trying to push you away continually.
• When you bring him up, his legs get rigid and scissor or cross

For babies older than 6 months of age:

• Does not roll over either way.
• Is unable to clasp her hands.
• Has trouble putting her hands near her lips.
• Extends only one hand, keeping the other tightly fisted.

For babies older than 10 months of age:

• Moves lopsidedly when crawling, dragging one hand and one leg while pushing off with the other.
• Instead of crawling on all fours, he hops or moves around on his buttocks.

If you experience any of these symptoms, tell your doctor right away.

Cerebral Palsy Symptoms

Cerebral palsy signs and symptoms might differ widely from person to person. The entire body may be affected by cerebral palsy, or it may only largely affect one or two limbs or one side. Typically, indications and symptoms include issues with growth, speech and feeding, mobility and coordination, and other issues.

Movement and coordination

• Spasticity, the most prevalent movement disorder, is characterised by tight muscles and heightened reflexes.
• Muscle tone variations such as being either excessively stiff or too flabby
• Muscle stiffness with appropriate reflexes (rigidity)
• Impaired muscular coordination and balance (ataxia)
• Tremors or sudden, abrupt movements
• Writhing, slow movements
• Favouring one side of the body, such as while crawling by dragging a leg or using only one hand to reach.
• Difficulty walking, such as a broad gait or an asymmetrical gait; walking on your toes; a crouching posture; a scissors-like stride with crossed knees;
• Problems with fine motor skills, such as difficulty picking up objects or buttoning clothing

Speech and eating

• Speech development delays
• Speaking is challenging
• Problems eating, chewing, or sucking
• Excessive drooling or swallowing issues

Development

• Delayed achievement of motor skill milestones, such as crawling or sitting up
• Challenges with learning
• Intellectual handicaps
• Delayed growth that causes a smaller size than anticipated

Other problems

Brain damage may be a factor in the development of several neurological issues, including:

• Snimming (epilepsy)
• Trouble hearing
• Vision issues and strange eye motions
• Unusual pain or touch sensations
• Issues with the bladder and bowels, such as constipation and urine incontinence
• Mental illnesses, including emotional disorders and behavioural issues

Because the underlying brain condition that causes CP doesn’t alter with age, the symptoms often don’t become worse. However, some symptoms may become more or less obvious as the child ages. And if not aggressively addressed, muscular shortening and rigidity might worsen.

Cerebral Palsy Life Expectancy

Children with cerebral palsy can typically expect to live between 30 and 70 years. Most people who live the longest tend to be more mobile, have better medical treatment and adaptive equipment, and are more independent and autonomous. 

Treatment for Cerebral Palsy

Cerebral palsy may require lifelong care from a medical care team for both children and adults. The team may include a number of therapists and mental health professionals in addition to a paediatrician, physical medicine and rehabilitation expert (physiatrist), and maybe a paediatric neurologist to manage your child’s medical care.

These specialists can collaborate with your main care physician and pay particular attention to requirements and problems that are more prevalent among people with cerebral palsy. You can create a treatment strategy jointly.

This condition is incurable. However, there are numerous therapeutic choices that can help your child operate better on a regular basis. The type of care chosen will depend on the individual’s particular symptoms and needs, which may change over time. Results can be improved with early intervention.

Medications

To enhance functional abilities, reduce pain, and manage consequences connected to spasticity or other symptoms, medications that can ease muscle stiffness may be utilised.

• Nerve or muscle injections
• Muscle relaxants taken orally
• Medicines that lessen drooling

Discuss the advantages, disadvantages, and potential adverse effects of the prescription drug alternatives with your doctor.

Therapies

The following therapies are significant in the treatment of cerebral palsy:

• Physical therapy
• Occupational therapy
• Speech and language therapy
• Recreational therapy

Surgical procedures

Surgery might be required to treat bone abnormalities brought on by spasticity or to alleviate muscular tightness. These remedies consist of:

• Orthopaedic surgery
• Cutting nerve fibres (selective dorsal rhizotomy)

Other treatments

For epilepsy, pain, osteoporosis, mental health concerns, issues with sleep, oral health, food and nutrition, bladder incontinence, vision, or hearing, drugs and other therapies may be prescribed as needed.

Cerebral Palsy Alliance Singapore

Previously known as The Spastic Children’s Association of Singapore, Cerebral Palsy Alliance Singapore (CPAS) was founded in 1957. (SCAS).

Over 700 children and adults with cerebral palsy and other disabilities are currently served by CPAS. Their completely integrated programmes and services support the functional independence of people with the disease at every stage of life by meeting their developmental needs.

CPAS offers early intervention, special education, rehabilitation services, day activity centre programmes, as well as vocational training and meaningful employment in Singapore to people with cerebral palsy and various impairments.

CPAS’ vision is to empower all persons with cerebral palsy or multiple disabilities to realise their full potential and lead fulfilled, dignified lives.

If you suspect your child may have cerebral palsy, discuss this with your child’s paediatrician without delay. Meanwhile, if your child has been diagnosed with this condition, you can visit www.cpas.org.sg.