Cerebral Palsy in Babies & Children

Cerebral Palsy is used to describe certain neurological conditions affect movement in kids. The effects of Cerebral Palsy may differ from one baby to another. In severe cases, the signs and symptoms may show up as early as one month of age and in some children, it may be diagnosed late. Children diagnosed with it face problems with movement, posture and balance but in some, there may be intellectual and developmental disabilities too.

What is Cerebral Palsy?

Cerebral Palsy is a condition in which the brain of the baby gets damaged before birth, during delivery or labour or when a child is in between 3 to 5 years of age, due to various reasons. It permanently affects body movement and muscle coordination but it does not get worse over time.

Types of Cerebral Palsy

The effects of Cerebral Palsy may vary in degree from one child to another. In some, it may be severe and may restrict the child from walking or has to walk around with the help of some special equipment and in some, it may be mild and the child may walk in an awkward manner but may not require any help.

There are chiefly four main types of Cerebral Palsy:

1. Spastic Cerebral Palsy

This is the commonest of all and comprises 80% of people who suffer from Cerebral Palsy. In this, the muscles of the person are stiff and thus movements are awkward. This is further divided into three types

a. Spastic Diplegia/Diparesis

People suffering from this suffers muscle stiffness in the leg but the arms are not affected at all or less affected. As a result, the individual affected by this condition may find it difficult to walk.

b. Spastic Hemiplegia/Hemiparesis

It affects only one part of the body and usually the arm is more affected than the leg.

c. Spastic Quadriplegia/Quadriparesis

This condition is the most severe of the lot. It affects all the four limbs, the face and the trunk. Individuals affected with this cannot walk and often have a developmental and learning disability along with hearing and vision impairment.

2. Dyskinetic Cerebral Palsy

This is a condition where individuals have no control over the movement of their hands, arms, feet and legs thus making it difficult for them to sit and walk. The movements can vary from being slow or being very fast and jerky. In some individuals, even the face and tongue are affected making it difficult for them to suck, swallow and talk.

3. Ataxic Cerebral Palsy

This is a condition where the individual has problems with coordination and balance. Such individuals may have unsteady walks and may have problems with quick movements or movements that require lot of control.

4. Mixed Cerebral Palsy

This is a condition in which an individual shows symptoms of more than one Cerebral Palsy. The most common being a combination of Spastic and Dyskinetic Cerebral Palsy.

Causes of Cerebral Palsy in Children

Usually, 80% to 90% of babies with Cerebral Palsy get afflicted with it from their mother’s womb due to various reasons ranging from maternal health condition during pregnancy to genetic disorders. However, illness of the baby after birth or complications during birth also attribute to it. Some reasons are given as below.

• Severe Jaundice: This poses a risk to the baby’s brain thereby increasing his chances of being affected by Cerebral Palsy. 
• Acquired Cerebral Palsy: Some babies get it within the first two years of their birth after having suffered some head injury due to an accident or a disease that affects the brain (like Meningitis).
• Birth Defects: Babies born with genetic disorders or brain malformations run a risk of getting Cerebral Palsy.
• Breech Birth: Babies positioned with their feet downwards and their head upwards in the womb during birth, are more likely to be affected by Cerebral Palsy.
• Multiple Babies: Mothers having multiple babies also run a risk of giving birth to one or more babies having Cerebral Palsy.
• Low Birth Weight: Babies weighing less than 2.5 kgs or 5.5 pounds may also get afflicted by this condition. This is one of the reasons why pre-term babies have a higher chance of getting affected by Cerebral Palsy.

What are the Risk Factors Before Birth?

In most cases, Cerebral Palsy in a baby develops when he is in his mother’s womb. Certain factors attribute to it.

• Bacterial and viral infections in the mother during pregnancy.
• Mother suffering from blood clotting disorders like Thrombophilias.
• Mother exposed to various toxins during pregnancy like cat’s faeces, eating sea fish containing mercury or eating raw or uncooked meat.                                                              
• Mother suffering from Thyroid problems during pregnancy.
• Incompatible blood group of the mother and the baby.
• Mother getting seizures during pregnancy.

Cerebral Palsy – Signs & Symptoms in a Child

The tell-tale signs and symptoms of Cerebral Palsy appear from infancy to pre-school years. During this period, parents or doctor can make out whether a child has the condition by observing him.

1. If Your Baby is Below Six Months

• The baby’s legs make a cross or scissor or his legs get stiff when he is picked.
• The baby has a problem with swallowing or sucking and sleeping or vomits often.
• The baby has poor visual attention.
• The baby does not smile within 3 months of age.
• The child cannot hold his head steady within 6 months of age.
• The body is either very stiff or very limp.                                 

2. If Your Baby is Over Six Months

• The baby cannot roll onto any side.
• The baby reaches out with one hand and keeps the other one fisted.
• Unable to bring both the hands together.
• Unable to bring the hand to the mouth.
• Either the muscles are too stiff or too loose.
• The head is still not steady.

  

3. If Your Baby is Over Ten Months

• The baby cannot crawl normally like other babies. Rather, he pushes one hand and leg and drags the other.
• Cannot sit or stand without any support.

How Can Cerebral Palsy Affect your Baby?

When a baby is affected by Cerebral Palsy, he may not be able to make movements normally as other children of his age do. In severe cases, the child may have a hearing or speech impairment. He may suffer from seizures which may affect his everyday life like being able to go to school or play like other children. The child may also suffer breathing, swallowing or chewing difficulties. Throughout his life, he may have to depend on someone or some equipment to do simple everyday tasks.

Diagnosis and Tests

Diagnosing Cerebral Palsy is best if done early. There are many ways to diagnose it but the three main ways are :

1. Careful Monitoring of the Child’s Development

A point to be noted is that the first observation should be that of the parents. If in case the parents realize that their child is not meeting certain milestones, they should immediately consult a doctor to ascertain the chances of their child having it.

2. Developmental Screening

In case the doctor, too, sounds an alarm, then a screening test of the child’s developments should be carried out immediately. In these tests, questionnaires are answered or interviews are taken of the parents. However, since the signs and symptoms of the condition come with age, it is only till later as much as 30 months that some children with milder versions are diagnosed with it since till then most developmental delays don’t come to the forefront.

3. Developmental And Medical Evaluation

Once the doctor suspects some kind of anomaly in the child, he will ask for certain tests to detect the specific type and the degree to which the child is affected. He will evaluate the child through his motor skills, muscle tone, reflexes, posture and medical history.

Other than these, the doctor will carry out a series of tests like CT Scan of the brain, Magnetic Resonance Imaging (MRI) followed by an Electroencephalogram (EEG), genetic testing or metabolic testing or a combination of all of these.

Complications Associated With Cerebral Palsy

Complications and problems are a part and parcel of Cerebral Palsy. Children with the condition have associated disorders along with it. Some of them are listed below.

1. Hearing impairment
2. Speech impairment
3. Vision problems
4. Seizures or Epileptic fits
5. Bladder dysfunction
6. Gastrointestinal problems
7. Drooling
8. Problems in chewing and swallowing leading to nutritional problems
9. Constipation
10. Respiratory problems
11. Sleeping disorders like Hypoventilation (not breathing adequately while sleeping), Sleep Apnea (changes in breathing pattern during sleep) or Sleep Obstructive Apnea (having an obstruction in the airway during sleep).
12. Body pain, especially in the hip area, is a common thing in Cerebral Palsy.

Treatment

People with Cerebral Palsy require lifelong care and medical attention. As per the severity of the condition, the individuals have to consult specialists. In case of any disorder, they have to consult the respective consultants like an Orthopaediatrician for bone disorder or a Cardiologist for heart problems. A Physiotherapist further helps the individual to try and overcome his movement disability, in case there is any scope for improvement. As for speech problems, a speech/language therapist can help the child to work on it. A child with Cerebral Palsy can take the help of special educators who educate the child in a way that is appropriate for him.

Medication Choices

Medication should be given according to the severity of the condition and whether it is isolated Spasticity (certain muscles) or generalised Spasticity (whole body). Certain medicines are given to relieve several of the symptoms of Cerebral Palsy, like muscle stiffness, to relax the muscles, seizures, constipation, drooling and body pain.

Surgery

Some people with Cerebral Palsy have difficulty with their movements. Such people may need surgery to restore movement to that part of the body. At times, a hip joint repair surgery or a surgery to correct the curvature of the spine is required. In some cases, an operation is done to reduce stiffness in the legs in order to make walking easier or to combat urinary incontinence.

Home Remedies

There are many home remedies which may prove to be useful in some of the problems that people with Cerebral Palsy face on a daily basis.

• Ginger is considered to be a boon when it comes to reducing inflammation and pain. Whether taken raw or in tea, it helps in relaxing the muscles.
• Acupuncture has been successful in reducing the pain and in improving flexibility and muscle control of Cerebral Palsy patients by focusing on key nerve centres and pressure points.
• Peppermint Oil acts as a reliever of pain and inflammation.
• Apple Cider Vinegar acts as a digestive stimulant and also helps to reduce muscle spasticity.

Prevention

Some causes of childhood Cerebral Palsy have been identified and thus if these causes are taken care of, it can be prevented.

• Pregnant mothers smoking/passive smoking and drinking alcohol can result in the baby acquiring Cerebral Palsy so these practices should be avoided.
• Infection in mothers, while they are pregnant, can be risky for the baby since he too may acquire it. Therefore mothers should wash their hands frequently and maintain proper hygiene.
• Mothers should be vaccinated so that they do not get any infection or any disease during pregnancy.
• The child should be properly vaccinated so as to rule out any kind of damage to the brain which could lead to Infantile Cerebral Palsy.
• Injury to the brain should be avoided.
• If in case of any signs of Jaundice like skin colour turns yellow including the whites of the eye, the child refuses to eat or the child is not passing urine as often as required, a doctor must be consulted immediately. Jaundice, if not treated in time, can lead to brain damage resulting in Cerebral Palsy in the baby.

Although a lot of new research and development is taking place to combat Cerebral Palsy in babies and children, it is still on the rise. As studies show, it is not 100% preventable and neither can it be fully cured. However, people should be aware of the known causes through which individuals may acquire it and try to prevent it to ensure a better quality of life for their children.