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World Cerebral Palsy Day 2020: Know About This Condition From A Doctor
Every year, on 6 October World Cerebral Palsy Day is observed to create awareness about cerebral palsy and how early detection of the condition can help improve a better quality of life for people with cerebral palsy. This day also brings people from all over the world to come together to recognise and celebrate the 17 million people who are living with cerebral palsy around the world.
The vision of Cerebral Palsy Day is to ensure that children and adults with cerebral palsy have the same equal rights and opportunities just like any person living in the society. The World Cerebral Palsy Day 2020 theme is 'Make Your Mark'.
Cerebral palsy (CP) is the most common physical disability in childhood. It is difficult to estimate exactly how many people have CP. However, with increasing improvements in the care of the newborns it is estimated that 3:1000 babies and 1:3 premature babies are affected. According to WHO, 15-20 per cent of the disabled and challenged children in India have CP [1].
On World Cerebral Palsy Day, we'll discuss what causes cerebral palsy, its symptoms and how it can be managed.
What Is Cerebral Palsy?
Cerebral palsy is a condition that affects muscle control and movement. It is a non progressive condition due to a one time injury to the developing brain, before, during or after birth. The condition will not get worse, although the effects of CP may change over time [2].
What Causes Cerebral Palsy?
The brain development starts in early pregnancy and continues until about three years of age. As a result, any injury to the brain interferes with messaging from and to the brain and the body.
During pregnancy any condition which tends to produce low birth weight will increase the likelihood of CP. During delivery and shortly thereafter, lack of oxygen or sugar to the brain, head injury, infections, bleeding or clotting in the brain may produce CP [3].
Image ref: raisingchildren.net.au
Types Of Cerebral Palsy
Depending on which part of the brain is injured, these children may have various difficulties. CP takes many forms, but there are three main types and usually children have a mixture of these. The effects may vary from person to person [4].
- Spastic CP
- Dyskinetic CP
- Ataxic CP
- Mixed CP
Spasticity means the muscle tone is tight and stiff, which will limit movement. As the muscles are tight, the spasticity can be painful. Spasticity can affect different parts of the body.Hemiplegia, diplegia and quadriplegia are different types of spastic CP.
Sometimes
called
athetoid,
choreo-athetoid
or
dystonic
cerebral
palsy.
Dyskinetic
CP
causes
uncontrolled,
involuntary,
sustained
or
intermittent
muscle
contractions.
It
may
be
difficult
to
maintain
an
upright
position.
It
may
be
difficult
to
control
the
tongue,
vocal
cords
and
breathing.
This
may
affect
speech.
Ataxia
is
an
inability
to
activate
the
correct
pattern
of
muscles
during
movement.
This
affects
balance
and
spatial
awareness.
Most
people
can
walk
but
will
be
unsteady
with
shaky
movements.
It
can
also
affect
the
speech.
Many
children
will
have
a
mix
of
types.
Symptoms Of Cerebral Palsy
- Lack of balance and muscle coordination
- Slow body movement
- Stiff muscles with normal reflexes
- Stiff muscles with exaggerated reflexes
- Tremors or involuntary movements
- Variations in muscle tone, like being too stiff or floppy
- Difficulty in walking
- Difficulty in speaking and delayed speech development
- Difficulty in eating or sucking
- Excessive drooling and difficulty in swallowing
- Delays in reaching motor skills milestones, such as sitting up alone, rolling over or crawling
- Favoring one side of the body, such as reaching with one hand
- Seizures [5]
Cerebral Palsy: Associated Conditions
The injury to the brain that caused CP can also cause a number of other associated conditions. Children may or may not have associated conditions [6].
- Epilepsy: affects up to a third of children with CP.
- Hearing impairment: in up to 8 per cent of children
- Visual impairment: in up to 60 per cent of children with CP
- Swallowing and eating difficulties.
- Sleep difficulties.
- Toilet problems.
- Learning and behavioral issues: affect one in four children with CP
Diagnosis Of Cerebral Palsy
A
child
with
CP
will
probably
be
delayed
in
reaching
milestones,
such
as
sitting,
walking
or
talking.
A
baby
may
feel
unusually
stiff
or
floppy.
A
diagnosis
of
CP
is
given
only
after
a
child's
progress
is
observed
over
a
period
of
time
and
other
conditions
are
ruled
out.
MRI
of
the
brain
is
usually
undertaken.
Blood
tests
to
rule
out
other
conditions
might
be
undertaken
[7].
Management And Support
CP is not a curable condition and the word management is used more often than treatment. There is much that can be done to lessen the effects of CP and help children with CP to lead independent lives. It is easy to be overwhelmed by the number of professionals involved and different management and therapy options [8].
- Therapy
- Orthotics, Casts and Splints:
- Medications
- Surgery
- Educational support
- Attitude
A
lifestyle
that
involves
regular
exercise
and
proper
nutrition
(high
fibre
and
protein
rich
diet)
is
very
important
including
those
with
disabilities.
Most
children
will
be
prescribed
orthotics,
casts
or
splints
to
supplement
their
therapy
programs.
These
should
be
custom
made
to
help
provide
stability,
keep
joints
in
position
and
help
stretch
muscles.
Medications
may
be
prescribed
for
conditions
associated
with
CP
such
as
seizures.
Sometimes
drugs
may
be
prescribed
for
severe
spasticity,
or
painful
spasms.
Botulinum
Toxin
(Botox)
can
be
injected
into
a
spastic
muscle
group.
This
can
reduce
tone
for
several
months,
during
which
time
physical
therapy
should
continue.
Orthopedic and soft tissue surgery can help to counter the effects of spasticity on the hips, legs and spine. Surgery can lengthen or transfer tendons, enabling the child to move more easily. When the child has finished growing, bone surgery may help reposition and stabilize bones.
Neurosurgery involves surgery on the nerve roots in the spine, which control muscle tone.
Many
children
with
CP
will
also
have
some
type
of
learning
difficulty.
Assessment
by
a
psychologist
and
the
support
of
special
educators
can
reduce
the
effects
of
a
learning
difficulty.
These
should
be
instituted
as
early
as
possible,
even
before
starting
school.
It is very hurtful to have someone pat you on the head if you are sitting in a wheel chair or walk away if they cannot understand what you are saying, Prejudice and teasing can be very damaging. Children who are overprotected may also be prevented from being independent.
People with CP often cite discriminatory attitudes and barriers as a greater challenge than any physical or cognitive difficulty they may have. The barriers that individuals with CP may face are often created by others. For instance, someone with CP may wish to enter a building that has no wheel chair entrance, the barrier in this case is the building itself, not the person using wheel chair.Public education and policy initiatives need to be developed to be more inclusive. It is difficult to lead an independent life if public buildings, washroom and transportation facilities are not accessible.Image ref:everydayhealth.com
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