Causes of Cerebral Palsy
Many different types of injury to the brain can cause cerebral palsy, and often more than one cause is involved. Birth injuries and poor oxygen supply to the brain before, during, and immediately after birth cause 15 to 20% of cases. Prenatal infections, such as rubella, toxoplasmosis, or cytomegalovirus infection, sometimes result in cerebral palsy.
During the first years of life, severe illness, such as inflammation of the tissues covering the brain (meningitis), sepsis, trauma, and severe dehydration, can cause brain injury and result in cerebral palsy.
Symptoms of Cerebral Palsy
The symptoms of cerebral palsy can range from barely noticeable clumsiness to severe spasticity that contorts the child's arms and legs, requiring mobility aids, such as braces, crutches, and wheelchairs.
There are four main types of cerebral palsy: spastic, athetoid, ataxic, and mixed. In all forms of cerebral palsy, speech may be hard to understand because the child has difficulty controlling the muscles involved in speech. With non-motor parts of the brain sometimes being affected, many children with cerebral palsy may have other disabilities, such as mental retardation, behavioural problems, difficulty seeing or hearing properly, and seizure disorders.
In many children with cerebral palsy, the muscles are stiff and weak. The stiffness may affect both arms and both legs (quadriplegia), mainly the legs and lower part of the body (paraplegia or diplegia), or only the arm and leg on one side (hemiplegia). The affected arms and legs are poorly developed, stiff, and weak. Some children may walk in a criss-cross motion, where one leg swings over the other (scissors gait), and some may walk on their toes. Crossed, lazy, or wandering eyes (strabismus) and other vision problems may occur. Children with spastic quadriplegia are the most severely affected. They commonly have mental retardation (sometimes severe) along with seizures and trouble swallowing. Trouble with swallowing makes these children prone to choking on secretions from the mouth and stomach (aspiration). Aspiration injures the lungs, causing difficulty breathing. Repeated aspiration can permanently damage the lungs.
In the athetoid type, the muscles spontaneously move slowly and without normal control. Movements of the arms, legs, and body may be writhing, abrupt, and jerky. Strong emotion makes the movements worse; sleep makes them disappear. Children with the athetoid type usually have normal intelligence and rarely have seizures. Difficulty with articulating words clearly and normally is common and is often severe.
In the ataxic type, coordination is poor and movements are shaky. Children with the ataxic type also have muscle weakness and trembling. Children with this disorder have difficulty making rapid or fine movements and walk unsteadily, with their legs widely spaced.
Physical therapy, occupational therapy, and braces may improve muscle control and walking, particularly when rehabilitation is started as early as possible.
