Cerebral Palsy
...nvoluntary, slow, purposeless movements especially in the face, arms, and trunk, and can interfere with speaking, feeding, reaching, and other movements involving of requiring coordination. The part of the brain that is damaged is the cerebellum or basal ganglia. These areas normally process signals from motor cortex which enable smooth coordinated movements and maintain posture (Children with Cerebral Palsy p.8). Ataxic CP occurs in 10% of cases (Merch Manual p.1312). The child=s movement is shaky and coordination is poor. These children have trouble making rapid or fine movement and walk unsteady (p.1312). Finally, mixed type cerebral palsy occurs in about 25% of cases. This happens when a child is affected by both spastic cerebral palsy and choreoathoid cerebral palsy because both areas of the brain were affected (Children with Cerebral Palsy p.9, Merch Manual p.1312). When referring to spastic cerebral palsy, there are four regions or locations that describe the areas that are affected in that child=s body. These include monoplegia (one extremity), hemiplegia (two hemolateral extremities, same side), paraplegia (three extremities) and quadriplegia (whole body), also there are degrees of severity such as mild, moderate, severe and profound (Cerebral Palsy p.2). My daughter=s complete diagnosis is a mild 4 right side spastic hemiplegia. Isn=t that a mouthful for a child to swallow! There are a verity of symptoms of cerebral palsy. Some of these symptoms include poor motor development, weakness, spasticity, abnormal primitive reflexes, asymmetric body movements, low muscle tone and seizures (Children with Cerebral Palsy p.19, Merch Manual p.1312). When these children have poor motor development, they are usually delayed in developmental motor movements such as learning to sit-up, crawl, walk, etc.. Weakness can include limp or slower muscle movements. Spasticity is when the child has increased muscle tone which results in difficult movements (Children with Cerebral Palsy p.364). Abnormal primitive reflexes are involuntary response to certain kinds of stimulation (p.19). Asymmetric body movements, are when the child is able to move one side of their body more freely and easily than the other side of their body (p.19). Low muscle tone is a lower amount of tension or resistance to movement in the muscle (p.359-360). Finally, seizures occur in about 50% of cases of cerebral palsy, mostly in children with quadriplegia or hemiplegia. These are common to children with cerebral palsy simply because brain injury provides a focus for abnormal nerve impulses to occur (p.15). Diagnosis of cerebral palsy is very difficult and usually cannot be distinctly diagnosed until the child is 12 to 18 months 5 of age. This problem occurs because laboratory tests cannot identify cerebral palsy. First of all, doctors must monitor this child to see if the child=s symptoms are progressive (Merch Manual p.1312). Secondly, the answer or question lies in the plasticity (the ability to recover completely or partially after injury) of the child=s central nervous system (Children w/CP p.21&22). This is because a child=s brain is producing so many brain cells and sometimes an undamaged area can take over the functions of the damaged areas (p. 21&22). Because of this fact, doctors often hesitate to make a firm diagnosis until the child=s nervous system has fully matured since a change of at least partial recovery can occur (p.16). Once the child has been diagnosed, these are some effects of the brain damage that can further affect a child with cerebral palsy. These children may have mental as well as physical affects. Some mental effects can be highly severe such as mental retardation or milder, yet troublesome, such as attention deficit hyperactivity disorder(ADHD) and learning problems. Some examples of physical effects range from completely wheelchair bound, speech impairments, visual problems, hearing problems to contractures, and sensory impairments. The mental and physical effects can and will determine the child=s prognosis because the more severe the effects are, the harder it will be for that child to become an independent adult, and even affect their life 6 expectancy in the most severe case. Children with mental retardation can learn new skills but at a much slower rate than other children and find it harder to learn advanced skill such as reading, math, etc... (Children with Cerebral Palsy p.16). Children with ADHD and learning problems may have a high level of distractability or find it hard to concentrate on a certain activity at one time. Also with certain learning problems there are visual perceptual skills and developmental language skills are that are affected(p.20). Physically in the most severe of cases a child becomes completely wheelchair bound and is considered quadriplegic. These children have their whole body effected and may also have significant impairment in facial muscles used in feeding and speaking. These children have difficulty in most daily living activities (p.10). Speech, hearing, and vision can all be affected. Speech, as said before, can be effected because of the muscle groups that are affected which are needed for speech. Sight and hearing problems stem from actual brain damage to these parts of the brain needed for 20/20 vision and normal hearing. Contractures are a shortening of muscles and other tissues, with or with out joint misalignment. These are caused by a constant pull of a child=s tight muscles. If certain muscles around a joint pulls harder then others, over time this muscle imbalance can lead to contractures and misalignment of the joints (p.73). Sensory 7 impairments are when the child=s brain has problems interpreting and using information from the senses. This is due to damage of the parietal lobe of the brain. The most common sensory impairments in a child with cerebral palsy are touch, position movement, and balance (Children with Cerebral Palsy p.18). All of these effects can become more tolerable or decreased with some type of treatment. Some treatments include: speech therapy, special education and resource rooms. Also, for physical treatment options, there are a variety of treatments available. Some of these include Botox in conjunction ...