Cerebral Palsy - Overview
Cerebral palsy is an umbrella term for describing a group of persistent disorders that damage a person’s ability to control body movement and posture. These disorders result from injury to the motor areas of the brain. Cerebral palsy affects two to six infants out of every 1,000 births, and is the most common disability among children in the U.S. The problem causing cerebral palsy may occur while the infant is still in the womb or after birth, and the problem is not always detectable during a child’s first year of life.
Cerebral palsy may affect one arm or leg, an arm and leg on the same side, only the legs, all four limbs, or any combination of arms and legs. Whatever the affected areas may be, the muscle types involved are often the same. Muscles that enable people to bend their arms and legs are called flexor muscles. Extensors muscles are the opposite of flexors and enable a person to straighten these limbs back out. It is the inability to control these and other muscles that defines the most common cerebral palsy syndromes
Patients with cerebral palsy can have a range of symptoms. These symptoms usually do not worsen over time and include:
- 1) Difficulty with fine motor skills
- 2)_ Instinctive muscle movements
- 3) Difficulty maintaining balance and walking
- 4) Learning problems
- 5) Vision defects
- 6) Speech difficulty
- 7) Sucking and swallowing problems
Spastic cerebral palsy is the most common form and is the type seen in close 80 percent of cases. Patients with this form are unable to relax their muscles, which respond by contracting further if the patient or someone else tries to stretch them. This spasticity affects the function of individual muscles, especially flexor muscles.
When spasticity occurs in the arms, the flexors tighten, pulling the elbows toward the body, and hands and wrists toward the chin. The hands themselves form tight fists. This constant tightened state may in turn weaken the extensor muscles, stretching them to the point where some of their functionality is lost. When spasticity occurs in the legs, the flexor muscles in the calves are affected. When this happens, the heels become raised, pushing the toes downward and often causing a child to walk on their toes.
Spasticity in the legs also affects the adductor muscles (the inner thigh muscles). Adductor muscles pull a body part toward its midline, such as those that pull the arms to a person’s side or close a person’s legs. In patients with cerebral palsy, the inward pull of the adductor muscles is so strong that the legs cross over each other or scissor. This motion also rotates the legs inward at the hips, pulling them away from the hip sockets, which can lead to abnormal socket development and hip dislocation.
Other conditions associated with spastic cerebral palsy may include an overstated response to startle stimulation, a degree of mental impairment, and weak respiration. Some children with spastic cerebral palsy develop a curvature of the spine. This results from remaining in a constant upright position, which prevents the trunk muscles needed for supporting the spine from developing properly.
Children with mild cerebral palsy may only have a minor limp or an awkward walk, while patients with severe cases will require care and supervision throughout their lives. Many of the infants born with cerebral palsy also experience some degree of mental retardation and/or have seizures.