The following document is an essay which I wrote about cerebral palsy as a part of my degree in Biomedical Sciences. I would put the references section at the end, but that was in a separate file and I have since lost the disk with it on. Any comments are welcome, there are also some cerebral palsy links which I have compiled, click on the button.
Cerebral Palsy - An Overview
Cerebral Palsy is a medical condition that affects control of the muscles, Cerebral means anything in the head and Palsy means a problem with the control of joints or muscles. Cerebral Palsy (CP) is not a disease or an illness, and therefore is not a contagious nor temporary condition. It is not a progressive relapsing/remitting type of disease such as Multiple Sclerosis and therefore does not get worse with time. Individuals with CP will have the condition throughout their lifetime and thus must learn to cope with the condition.
Causes of Cerebral Palsy
Cerebral Palsy is caused by injury to the brain before, during or shortly after birth, though the actual injury, or nature of the injury may remain unknown. The injury sustained is to the area of the brain which controls muscle tone and depending on the location and size of the injury, it may cause muscles to become too tight, too loose, or a combination of the two. It is changes in muscle tone that allow us to move our limbs in a smooth controlled manner. The injuries may occur before birth in the mother's womb, these such injuries can include infections, accidents in which the mother is hurt, or other medical problems, such as diabetes or high blood pressure. Injuries during birth include difficult delivery and if the child is starved of oxygen. Injuries which are caused after birth include problems associated with premature births when the baby is unable to function completely in the outside world, the difficulties arising from this are possible causes of CP. Babies born on time are also subject to infections, brain haemorrhages, both of which can cause brain injuries and hence can cause CP.
Types of Cerebral Palsy
There are four main types of cerebral palsy - Spastic, Ataxic, Athetoid and Mixed. Spastic cerebral palsy is a result of muscle tone being too tight, children with spastic cerebral palsy perform jerky movements and often find it difficult moving from one position to another or releasing their grip on an object. This is the most common form of cerebral palsy, with around half of all people with CP having the spastic form. The UK cerebral palsy charity Scope was formerly known as The Spastics Society but has changed its name in recent years to encompass the whole spectrum of cerebral palsy types. Ataxic cerebral palsy is when an individual has too loose muscle tone this gives rise to a lack of co-ordination of movements and typical movements appear unsteady and shaky. The shaky movements are similar to those shown in very old people and are most obvious when performing actions such as turning a page, writing or using a pair of scissors. Ataxic CP also causes problems with balance and may cause difficulties in walking. Athetoid cerebral palsy is when muscle tone varies and may be sometimes too tight and sometimes too loose. Children with athetoid CP often have problems walking, sitting and keeping upright and often show large involuntary movements of the face, arms and upper body. Individuals with athetoid CP often find it very difficult to move their hand directly to a certain position, i.e. to scratch their nose or other similar movements. Around a quarter of all people with CP have athetoid CP. The fourth type of CP is Mixed cerebral palsy, which affects around a quarter of individuals with CP and this is where the muscle tone is too tight in some muscles, but too loose in others.
Associated Medical Conditions
As well as the problems mentioned above, children with cerebral palsy may experience other problems, which are also possibly caused by the same brain injury which caused the CP. About half of all children with cerebral palsy have seizures. A seizure is a time when abnormal activity in the brain occurs and the individual is unable to continue in normal behaviour. Seizures can be shown in many ways, sometimes the individual will begin to stare and stop all movement or in some cases they may just simply lose all muscle control and collapse. At other times however, the seizures may be shown as shaking movements throughout the body. Seizures last between a few seconds and a few minutes and are generally not dangerous, some drug treatments are available to reduce the frequency and severity of seizures. Seizures are not just a characteristic of cerebral palsy and can be caused by many conditions and/or diseases.
Children with CP may also experience learning problems, either as a learning disability or a mental retardation. Learning disabilities are when a child may have problems in learning or understanding certain subjects/concepts but has no problems in other areas of education. On the other hand, children may have what is known as mental retardation where children learn everything at a slower rate, the severity of the retardation varies greatly. Children with either of these conditions need a great deal of special learning help in school to help them to learn effectively. As I mentioned above, these conditions are not caused by cerebral palsy, but are caused by the same brain injury which gave rise to the cerebral palsy in the first place.
Children with CP may also have difficulties with talking and eating, as both of these activities require the use and complex control of muscles in the face and mouth. When speaking, children with CP may be difficult to understand or may seem to put a lot of effort into pronouncing their words, this is because they are unable to move their lips, jaw and mouth at the normal speed. The speech problems usually associated with CP are known as dysarthria. Problems with eating are also common and there may be much difficulty involved in biting, chewing or using a straw.
Therapy for Cerebral Palsy
There are many different kinds of therapy for cerebral palsy to help with the various difficulties caused by cerebral palsy. Physical therapy is to help children with CP to be able to move more freely and to improve balance, this may also involve the teaching of skills such as walking, using a wheelchair free standing and the ability to go up and down stairs safely. Physical therapy also involves more fun exercises, such as running, kicking and throwing a ball and riding a bike. Physical therapy is usually abbreviated to PT. Another type of therapy is speech and language therapy, which as the name suggests concentrates on communication skills. This may mean talking, using sign language or using a communication aid. Speech therapy is centred on making distorted speech clearer and easier to understand, either in audible terms, or in relation to vocabulary and grammar. If speech is not possible, then the therapist may teach sign language or the use of a communication aid. Communication aids include books or posters showing things the child may want, or an alphabet board for the child to spell out messages. These different techniques are used on the basis of the child's abilities and the presence of learning difficulties as mentioned above. Computers can also be used to talk for an individual who cannot do so alone, one famous example of this technique in use (though not due to cerebral palsy) is Professor Stephen Hawking, who has Motor Neurone disease and uses computer synthesised speech.
Occupational therapy is aimed at improving the movement of the arms, hands and upper body. Occupational therapists may teach children easier ways to write, draw, cut with scissors, brush their teeth, dress, feed themselves and control their wheelchair. Occupational therapists also help find special equipment to help with everyday tasks and the basis of occupational therapy is to give the individual more independence and to improve personal abilities in everyday tasks. Recreational therapy is related to sports skills or other leisure activities, such as dance, swimming, horse riding, art and various other hobbies.
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