Cerebral Palsy in infants
Cerebral simply means something that pertains to the brain or the cerebrum. The cerebrum is the biggest part of the brain.it mainly initiates and coordinates the body movement and also, temperature. It has two hemispheres which basically receive and give information meaning from the various sense organs in our body. Cerebral palsy (CP) is a group of disorders that affect a person' s ability to move and maintain balance and posture. Cerebral palsy is the most common motor disability in childhood (Wilson 17). Recent population-based studies from around the world report prevalence estimates of Cerebral Palsy ranging from 1 to nearly 4 per 1,000 live births or per 1,000 children. Being one of the many major milestones reached in medicine, cerebral palsy and its treatment techniques have been helping many people with the unfortunate conditions. First called "Little' s disease", it was discovered in the mid 1800s by Dr William John Little who battled a very long childhood full of illnesses, used his own disability and experience as his inspiration ("Treatment of Posttraumatic Deformities in Children And Adolescents By Taylor Spatial Frame& quot;).
Cerebral palsy is a combination of disorders that normally impact the movement, coordination of muscles, and also posture of a person. Cerebral palsy is a result of abnormal development or growth of the brain of an infant mostly (Van Naarden Braun et al.).This is normally due to neurological damage caused either before, during, or after the birth of an infant in its early stages. Cerebral palsy is caused by abnormality or disruption in brain development. Factors that can lead to problems with brain development include:
a) Gene mutations that cause varied gene disorders or clinical differences in infant brain development.
b) Maternal infections or other medical problems during pregnancy that negatively impact the developing fetus.
c) Infections that result in inflammation in and around the brain of the infant
d) birth-related asphyxia due to uterine raptures, placental damage
e) Fetal stroke leading to disruption of blood supply to foetus brain
f) Traumatic head injury to an infant leading to bleeding into its brains such as from accidents, tragic falls or physical abuse to the infant.
g) Inadequate supply of oxygen to the brain associated with difficulties during child delivery or labor.
Certain factors increase the risk of babies getting cerebral palsy. These include premature birth, low birth weight, multiple births such as twins and triplets, maternal exposure to toxic substances during pregnancy(Jain et al., 201), breech birth, and a low Apgar score and Rh incompatibility between the mother's and foetus' blood.
Types of cerebral palsy
There are four main types of cerebral palsies which are Ataxic, Spastic, Mixed, and Dyskinetic cerebral palsy. Some people have one specific type of cerebral palsy while others tend to have more than one type simultaneously.
a) Ataxic cerebral palsy is a more rare type of cerebral palsy. Its name is generated from the word ataxic which is a lack of coordination. Ataxic cerebral palsy is therefore caused by damage to the center of balance of the brain, the cerebellum. This results in poor muscle coordination and imbalance(Aliyu 42). Most Ataxic cerebral palsy patients walk with their feet wide apart in an attempt to regain impaired balance. They also tend to experience tremors of varying intensities. In some cases, the damage to the cerebrum causes hearing and vision impairment. Ataxic cerebral palsy is however not usually detected until an infant is past 3 months after a series of doctors' diagnostic tests
b) Spastic cerebral palsy is the most common type of cerebral palsy which affects about 80 of patients with cp. spasticity is defined as a condition where muscles stiffen interfering with normal fluid movement. Spastic cerebral palsy is caused by damage to the brain's motor cortex which is responsible for voluntary movement and the pyramidal tract which normally relays signals to the muscles. This often results in muscle tone and extremely jerky movements' .muscles normally appear stiff because messages are sent incorrectly to the cerebrum. When an individual has Spastic cerebral palsy and the injury to the brain does not change over some time, it can result in muscle atrophy, fibrosis, and short muscles that can lead to bone deformities such as spine scoliosis and hip dislocation. People with Spastic cerebral palsy have flexion at the knees, hips, elbow, wrist, and fingers
c) Dyskinetic cerebral palsy is caused by brain damage to the cerebellum which controls body balance and coordination. It is the second most common type of cerebral palsy. It is typified by abnormal motor activities of the hands and legs making it difficult to coordinate body movements. The various movement disorders observed include:
a) Dystonia - This is marked by twisting movements that are repetitive in either one part of the body or the entire body. This involuntary movement is usually stimulated by initiating a voluntary movement.
b) Athetosis- This type is attributed to slow, squirming movements with extreme fluctuations that make it hard to maintain posture.
c) Chorea - This is typified by sudden, restless unforeseeable movements that portray one as a clumsy person. These movement disorders interfere with motor skills such as walking and grasping. Individuals with Dyskinetic cerebral palsy exhibit slow or jerky movements. Their muscle tones loosen over time. Some may have difficulties in speech since they can't control the movement of their face and tongue.
d) Mixed cerebral palsy is where a patient is diagnosed with more than one cerebral palsy as a result of damage to different parts of the brain that control motor activities such as damage to the motor cortex, pyramidal tracts, basal ganglia, and cerebellum.
Symptoms
Common symptoms in cerebral palsy patients include; Variations in muscle tone (being too stiff or too floppy of limbs and trunk), Muscle rigidity, chronic shortening of the muscle, tight muscles, overactive reflexes, muscle weakness, muscle spasms, or paralysis of one side of the body. Lack of balance and muscle coordination, involuntary movements, Difficulty walking, Excess drooling or issues swallowing, seizures, Difficulty with fine motor skills, speech, and learning. Most people with cerebral have an imbalance of the eye muscle. Constipation, deformities, difficulty eating, foot drop, teeth grinding, hearing loss, paralysis, scissor gait, seizure, spastic gait, tremor, or urine incontinence are all common symptoms. Some have also the occurrence of epilepsy, blindness, or deafness.
Diagnosis
Its diagnosis is made by checking the medical history and performing a physical exam on the patient that includes a detailed neurological exam. The following additional testing is conducted;
Electroencephalogram (EEG) is a procedure that looks for disorders in your brain's electrical activity or brain waves. Electrodes, which are little metal discs with thin wires, are deposited onto your scalp during the operation. The electrodes detect minuscule electrical charges produced by your brain cells' activity. The charges are magnified and displayed on a computer screen as a graph or as a recording that can be printed out.
A Magnetic Resonance Imaging (MRI) scan is a medical imaging method used in radiology to produce images of the body's anatomical and physiological processes. Strong magnetic fields, magnetic field gradients, and radio waves are used in MRI scanners to create images of the body's organs. It's used to identify malformation and injury the brain Computed Tomography (CT) scan combines a sequence of X-ray images taken from various angles around your body with computer processing to create cross-sectional images (slices) of the bones, blood arteries, and soft tissues within your body. CT scan images contain more information than standard X-rays.
Cranial ultrasonography is a high-frequency sound wave technique for examining the brain. Because the fontanelle provides an & quot; acoustic window, " it is virtually exclusively utilized in newborns. Transcranial Doppler, a new type of ultrasound-based brain scanning, can be utilized on people of any age.
Treatment
The goal of treatment is to improve limitations and prevent complications. Treatment may include assistive aids, therapy, medications, or surgery.
a) Assistive aids include: eyeglasses, hearing aids, walking aids, body braces, and wheelchairs
b) Medications: Muscle relaxants are commonly used to treat the symptoms of spasticity. Relaxing the muscles helps reduce pain from muscle spasms. The doctor might prescribe baclofen, dantrolene (Dantrium), diazepam (Valium), and tizanidine (Zanaflex). Doctors might also suggest either local injections of botulinum toxin type A (Botox) or intrathecal baclofen therapy (Gablofen, Lioresal), where the drug is delivered through an implantable pump.
c) Therapy
i. Physical therapy is a type of treatment that involves the use of Strength, flexibility, equilibrium, motor development, and mobility can all profit from muscle training and exercises. Physical and occupational therapists concentrate on issues like head and trunk coordination, rolling, and gripping for the first 1 to 2 years after birth. The child may need braces, splints, or other therapeutic devices to help with functionality, also including enhanced walking and relieving stiff muscles.
ii. Speech and language therapy is a type of speech and language treatment. Therapists help your child improve his or her ability to communicate clearly or use sign language.
iii. Recreational therapy. Some children benefit from regular or adaptive recreational or competitive sports, such as therapeutic horseback riding or skiing. This type of therapy can help improve your child's motor skills, and speech and emotional well-being.
d) Surgical operations. To relieve muscular stiffness or rectify bone deformities caused by spasticity, surgery may be required. Orthopedic surgery is a type of surgery that deals with the bones and joints Children with severe contractures or abnormalities may require bone or joint surgery to rectify the position of their arms, spine, hips, or legs. Selective Dorsal Rhizotomy (SDR) is however recommended as a last resort to lessen chronic pain or spasticity by cutting the nerves near the base of the spinal column.
e) Other options for treatment. For convulsions, pain, osteoporosis, psychiatric issues, sleep, oral health, diet and health, bladder dysfunction, visual, or hearing problems, medicines, and other therapies may be prescribed as needed.
Prevention
Most cases of cerebral palsy can't be prevented, but one can lessen the risks. If one is pregnant these steps minimize pregnancy complications: vaccination against diseases such as rubella (prevent fetus brain infection), seeking early and regular prenatal care, avoiding alcohol, tobacco, and other illegal drugs, and practicing good child safety when they are born.
Recommendations
The health sector in collaboration with the government should educate the general public on the symptoms and causes of cerebral palsy as well as the prevention measures. Pregnant women should seek good prenatal care and attend their appointments with the doctor to minimize all complications that might arise during pregnancy. Vaccinations against diseases such as rubella which cause brain damage to the foetus should be done before pregnancy.
Conclusion
In conclusion, cerebral palsy is a group of maladies that affect the movement and coordination of muscles. Children are the most susceptible to cerebral palsy. Although it can't be cured nor fully prevented, there's a treatment that will help improve the lives of people with this condition.
Work cited
Weakness
Most of the information is scientific acts leaving little room for opinions and assumptions on the topic researched. Previous researched completed can not be entirely relied on since they were done in the early era of medical discovery which has gradually changed as a result medical technology advancement. Data used is acquired from research from specialist. Hospital policy does not allow access of raw medical data of patients by the general public
