CEREBRAL PALSY

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Definition

Cerebral palsy is a group of disorders involving movement, learning, hearing, seeing, and thinking that occur due to problems with brain development.

Alternative Names

Spastic paralysis; Paralysis - spastic

Causes, incidence, and risk factors

Cerebral palsy is caused by injuries or abnormalities of the brain. Most of these problems occur as the baby grows in the womb, but they can happen at any time during the first 2 years of life, while the baby's brain is still developing.

In some people with cerebral palsy, parts of the brain are injured due to low levels of oxygen (hypoxia) in the area. It is not known why this occurs.

Trauma and low oxygen levels during birth (birth asphyxia) is an uncommon cause of cerebral palsy.

Premature infants have a slightly higher risk of developing cerebral palsy. Cerebral palsy may also occur during early infancy as a result of several conditions, including:

• Bleeding in the brain
• Brain infections (encephalitis, meningitis, herpes simplex infections)
• Head injury
• Infections in the mother during pregnancy (rubella)
• Severe jaundice

Types of cerebral palsy include:

• Spastic cerebral palsy is the most common type.
• Dyskinetic (athetoid) cerebral palsy involves abnormal movements (twisting, jerking, or other movements).
• Ataxic cerebral palsy involves tremors, unsteady gait, loss of coordination, and abnormal movements.
• Hypotonic cerebral palsy involves floppy muscles, especially at rest, and increased range of motion in the joints.
• Mixed cerebral palsy involves any combination of symptoms.

Symptoms

Injury to the largest part of the brain (cerebrum) can lead to the loss of nerve functions in different areas. Many children with this condition have increased muscle tone (spasticity). Spasticity may affect:

• One arm or leg
• One side of the body (spastic hemiplegia)
• Both legs (spastic diplegia)
• Both arms and legs (spastic quadriplegia)

Symptoms are usually seen before age 2. In severe cases, they may appear as early as 3 months.

Symptoms may include:

• Abnormal movements
• Abnormal sensations
• Abnormal muscle tone
• Decreased intelligence
• Difficulty sucking or feeding in infants
• Hearing problems
• Increased drooling
• Irregular breathing
• Learning disabilities
• Limited range of motion
• Pain
• Partial or full loss of movement (paralysis)
• Peg teeth
• Problems swallowing (at all ages)
• Seizures
• Speech problems (dysarthria)
• Urinary incontinence
• Vision problems
• Vomiting or constipation

Reviewer Info: Jennifer K. Mannheim, CRNP, private practice in Autism Treatment and Research, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., 09/21/2008