October 6th celebrates World Cerebral Pasly Day!
Over 17 million people live with Cerebral Palsy (CP) worldwide – this day makes space to spread awareness and knowledge of CP and treatment options.
CP is a lifelong physical disability that describes a group of disorders that affect one’s movement and posture. CP can affect body movement, reflexes, posture balance, muscle control, coordination, and tone. These symptoms can improve or worsen over time.
Symptoms also vary in severity from person to person; One person may require mobility aids and lifelong care, while another person may only walk awkwardly and will not require external aid. Most children with cerebral palsy will walk; 60% are Independent ambulators; 10% walk with an aid, and 30% use a wheelchair.
People who have CP may also have related conditions, including vision, hearing, speech and intellectual impairments, epilepsy, changes in the spine (e.g., scoliosis),and joint problems (e.g., contractures).
CP has no singular cause; CP is caused by abnormal development of the brain or damage to the developing brain before, during, or after birth.
There are four main types of CP, classified by the type of movement disorder involved:
Spastic CP: 80%-90%
People with spastic CP have increased muscle tone which makes their muscles appear stiff, resulting in awkward movements. Spastic CP is further broken down into categories by the body part affected. In spastic diplegia, muscle stiffness mainly affects the legs, which may cause difficulty walking.
In spastic hemiplegia, only one side of a person’s body is affected. In spastic quadriplegia, all four limbs, the trunk, and the face are affected. People with spastic quadriparesis usually cannot walk and often have other developmental disabilities.
Dyskinetic CP (includes dystonia, athetosis, and chorea): 6%
Dyskinetic CP is characterized by involuntary movement (slow and writhing or rapid and jerky) of the hands, arms, feet, and legs, which causes difficulty sitting and walking. The face and tongue can also be affected, which causes difficulty sucking, swallowing, and talking. A person with dyskinetic CP has
muscle tone that can change between too tight and too loose from day to day and through a single day.
Ataxic CP: 5%
Ataxic CP is characterized by shaky movement, which causes difficulty with balance, coordination, and sense of positioning in space. People with ataxi CP may be unsteady when they walk have difficulty with quick or controlled
movement (e.g., writing), or have difficulty controlling their hands or arms when reaching for something.
Mixed Cerebral Palsy:
Some people have two motor types present. Spastic-dyskinetic CP is the most
common type of mixed CP.
Treatment for CP is determined on an individual basis. Common treatment options are surgeries, medicines, braces, and physical, occupational, and speech therapy. Pain, behavior, and sleep disorders in people with CP are under-recognized medication can help control muscle spasms, uncontrollable limb movements, and seizures. The most common medications prescribed are baclofen and diazepam(muscle relaxants), anticonvulsants, stool softeners, sleep aids, and Botox. Muscle or nerve injections of Botox can be used to treat the tightening of a specific muscle. Botox injections into the salivary glands can also reduce drooling.
Surgery can reduce muscle spasticity, increase flexibility, improve mobility, and reduce pain. Orthopedic surgeries can treat contractures (muscle tissue shortening) by operating on bones or joints to reposition arms, legs, spine, or hips, lengthening muscles, or lengthening or repositioning tendons. Selective dorsal rhizotomy can treat pain while walking or moving by cutting the nerve fibers serving specific spastic muscles. This relaxes the muscle and reduces pain, but it may cause numbness. To increase symptom relief, an intrathecal baclofen pump can be surgically placed in the abdominal wall to deliver medication directly into the spinal fluid.
Physical therapy can build strength, flexibility, balance, motor development, and mobility, alongside braces or splints. Occupational therapy can help children gain independence, aided by walkers, wide-based canes, standing and seating systems, or electric wheelchairs. Speech and language therapy can improve ability to speak, use sign language, or use communication devices, as well as address
difficulty eating and swallowing. Recreational therapy can improve motor skills, speech, and emotional well-being – regular physical activity and exercise are beneficial for both adults and children.
https://worldcpday.org/resources/
https://www.cdc.gov/ncbddd/cp/facts.html
https://www.mayoclinic.org/diseases-conditions/cerebral-palsy/diagnosis-