Cerebral Palsy – Signs & Treatment

Cerebral  Palsy is a disorder of movement, muscle tone or posture that is caused by damage of the developing brain before birth, during birth or after birth of the child. It is a non progressive disorder. In India every 3^rd baby in 1000 births is associated with the disease. This is a neurological disorder that needs neurological management, rehabilitation and psychological support.

Signs and Symptoms associated with Cerebral Palsy :

• The baby may be floppy or flaccid to begin with or may have peculiar postures, involuntary movements , walking difficulties or a combination of these, resulting in delayed milestones.
• Children with cerebral palsy are most commonly stiff or spastic. Their motor milestones like neck holding, sitting, standing and walking are grossly delayed.
• May also have problems in the development of speech, swallowing difficulties, hand eye coordination and bladder bowel control.
• Significant number of such children may also be mentally challenged and may have recurrent seizures.
• Some children may be ataxic or have involuntary movements.

Risk factors associated with Cerebral Palsy:

• Certain infections during pregnancy may increase the risk of cerebral palsy in the offspring- rubella, cytomegalo virus, Zika Virus, toxoplasmosis, herpes etc.
• Exposure to certain toxins may also increase the risk of Cerebral Palsy.
• Thyroid disorders and various medications during pregnancy may also increase the risk of cerebral palsy
• During delivery: Complicated labour, breech delivery, delayed cry of the baby
• After birth: Electrolyte imbalance, Infections, recurrent seizures, injuries etc.

Important notes on Cerebral Palsy :

• Behavior: Cerebral palsy is a non progressive disorder. If there is further regression of milestones then one has to rule out other disorders that may require specific treatment.
• Diagnosis: Diagnosis is made by a detailed history and neurological assessment along with MRI brain to find out the cause of cerebral palsy. if there are seizures then an EEG is also needed.
• Treatment & Management: Treatment by a multi disciplinary team- pediatrician, neurologist , psychologist, physiotherapist , occupational therapist , speech therapist etc.

Medication associated with Cerebral Palsy:

• Symptomatic : To reduce spasticity muscle relaxants- oral or injectable. Botulinum toxin injection in spastic limbs with rigorous physiotherapy is quite beneficial. Inf Botulinum toxin is also helpful for drooling of saliva.
• There are oral drugs and botulinum toxin injection in the salivary gland.
• Control of seizures by anti epileptic drugs, surgery can be performed for contractures due to spasticity and fixed postures.
• With the help of splints and braces the child may be able to walk better.

Please note that raising a child with Cerebral Palsy needs a lot of effort and commitment. India currently lacks in having specialized schools and environments that ensure that children get ample opportunities and don’t get discriminated due to their disorder. However every black cloud has a silver lining. Discuss your concerns and apprehensions with your neurologist. He or she shall have a detailed list of schools, rehabilitation support and even work opportunities for your children. Be free to share your feelings and let your guard down for your child’s benefit. Paras Hospitals, Gurgaon specializes in providing the right support to children with Cerebral Palsy.