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CEREBRAL PALSY

CEREBRAL PALSY

The word cerebral means brain, palsy means damage. Cerebral palsy is a disorder of posture, and movements that results from damage to the developing brain before, during or just afterbirth, or in early childhood. Cerebral palsy is non progressive. The disorder varies in severity from slight clumsiness of hand movement and gait to complete mobility.

People with cerebral palsy may have difficulty in walking, writing and other medical conditions like seizures/ mental retardation.

Types of Cerebral Palsy:

  1. Spastic Cerebral Palsy – Stiffness of both upper and lower limbs.
  2. Athetoid Cerebral Palsy – It leads to involuntary and uncontrolled movements.
  3. Ataxic Cerebral Palsy – Balance disturbance, In co-ordination, Hypotonia, Tremor.
  4. Flaccid Cerebral Palsy – Floppy muscle tone and weakness.
  5. Mixed Cerebral Palsy – Stiffness, involuntary movement, Balance disturbance.
  6. Rigid Cerebral Palsy – Increased muscle tone.

Classification of Cerebral Palsy:

  • Hemiplegic Cerebral Palsy – Affects one side of the body.
  • Diplegic Cerebral Palsy – Affects both legs and at times can also affect one/both hand.
  • Quadriplegic Cerebral Palsy – Affects all four limbs equally including the trunk and can cause problems with head control.
  • Monoplegia – Affects only one limb.
  • Triplegia – Affects both legs and one upper limb is affected.

Causes:

  • Prematurity
  • Asphyxia (Not getting enough oxygen, blood before/during birth)
  • Trauma during pregnancy/ Head Injury
  • Severe jaundice
  • Hypoglycaemia – Low blood sugar for long period can cause severe brain damage and epilepsy
  • Infections – Rubella virus, cytomegalo virus
  • Neonatal meningitis
  • Genetic causes
  • Vascular causes

Symptoms:

  • Rigidity
  • Abnormal muscle tone
  • Difficult to feed/sucking/swallowing
  • Delay in sitting up without support
  • Awkward sleeping position
  • Bad co-ordination and balance
  • Writing problems
  • Eye problem
  • Hearing problem
  • Epileptic seizures
  • Poor bowel/ Bladder control
  • Delay in reaching motor milestones such as creeping, crawling, sitting, standing and walking
  • Walking on toes, a crunched gait, a wide gait, knee crossed gait.

Diagnosis:

  • MRI Scan
  • CT Scan

Treatment:

Physiotherapy is an important part of managing cerebral palsy. It usually starts soon after diagnosis. It may begin earlier depending on the symptoms, some people with cerebral palsy continue physiotherapy throughout their lives, especially those with severe physical disabilities.

Treatment done:

  • To normalize the tone
  • To achieve the normal milestones
  • Prevent joints from becoming tight/ permanently bent
  • To correct postures
  • Stretching
  • To develop grasp
  • Balance – sitting, kneeling, crawling, standing and walking
  • Mobilization activities
  • Strengthening exercises
  • Weight bearing exercises
  • Gait training

Orthotics:

  • Braces
  • Ankle Foot Orthotics (AFO)
  • Seating
  • Standing frame
  • Walking aids
  • Splints
  • Specially designed shoes (medical arch/ lateral wedge)

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