"Cerebral" is medical terminology for the brain. "Palsy" means a disorder of movement or posture. So in simple terms, Cerebral Palsy (CP) describes a group of conditions where movement and posture are affected as a result of damage to one or more areas of the brain. Cerebral palsy is characterized by an inability to fully control motor function, particularly muscle control and coordination.
Depending on which areas of the brain have been damaged, one or more of the following may also be present although every person with CP is affected in a different way:
Balance and coordination problems
Difficulty controlling and maintaining posture (help required to sit upright)
Epilepsy - Up to one in three children with CP also have epilepsy.
Difficulty eating and drinking (swallowing) and talking
Learning difficulties
Cerebral Palsy is the most common childhood physical disability. Around one in every 400 children born in developed countries has CP. In the United States, it is estimated that some 764,000 children and adults exhibit one or more of the symptoms of Cerebral Palsy. Around 8,000 babies and infants are newly diagnosed with the condition each year. Despite medical advances, incidence has not declined over the last 60 years.
Often the exact cause of a child developing Cerebral Palsy is not known, but contributing factors can include infections such as meningitis, bleeding into the brain, pressure or blows to the head and lack of oxygen. These may have occurred before, during or after birth and the severity of the cause will affect the severity of the damage caused to the brain. For example, each minute that a baby is deprived of oxygen during a difficult delivery will increase the extent of brain damage caused.
Cerebral Palsy is classified into three main types; Spastic, Athetoid and Ataxic. Those with Spastic CP have muscles that are weak, tight or stiff making it difficult for the person to make controlled movements. Those with stiff or tight muscles will find it difficult to fully extend arms and legs, while those with weak muscles may be unable to stand unaided. Spastic Cerebral Palsy is the most common type of cerebral palsy, accounting for nearly 80 percent of all cerebral palsy cases.
Athetoid Cerebral Palsy is caused by damage to the cerebellum or basal ganglia. These two areas of the brain work in opposition to create smooth, coordinated movements as well as maintaining body posture. Damage to one or both of these areas creates an imbalance that may cause a child to develop involuntary, uncoordinated movements, especially in the face, arms, and trunk. Secondary problems with eating, speaking, picking up objects may also result from the imbalance. Approximately 10% of those with Cerebral Palsy are Athetoid.
Ataxic Cerebral Palsy is characterised by low muscle tone and poor coordination of movements. Ataxic children look very unsteady and shaky and have a disturbed sense of balance and depth perception. This is particularly apparent when walking which is unsteady and can resemble an intoxicated adult. Ataxic children can also suffer from shaky hands which make it difficult to hold a pencil and write.
Although Cerebral Palsy is not progressive (the brain damage does not get worse) and there is no cure (brain damage can not be repaired), tight, stiff or weak muscles will become increasingly so as the child gets older without therapy or treatment and in severe cases surgery. As a result, the child will inevitably become more dependant on their parent or carer and less able to lead any sort of independent life. Appropriate and regular therapy provided from an early age can significantly improve mobility and coordination abilities, independence and quality of life.
Sally Aspinall is founder and director of the Cerebral Palsy Physiotherapy Centre, the only centre of its kind in the UK providing therapy and treatment to cerebral palsy and brain injured children and adults from around the world. Sally can be contacted via the CPPC website or email sallyaspinall@cppcltd.co.uk
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