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The term cerebral palsy came into use in the late 1800s. Sir William Osler, a British medical doctor, is believed to have coined the term. Dr. Sigmund Freud, the Austrian neurologist better known for his work in psychiatry, published some of the earliest medical papers on cerebral palsy. In the early years, Dr. Little believed most cases of cerebral palsy were caused by obstetrical complications at birth. He suggested that children born with cerebral palsy were born following complicated deliveries, and that their condition was a result of lack of oxygen to the brain. He said this oxygen shortage damaged sensitive brain tissues controlling movement. But in the late 1800s, Freud disagreed. Noting that children with cerebral palsy often had other problems such as mental retardation, visual disturbances, and seizures, Freud suggested that the disorder might be caused earlier in life, during the brains development in the womb. Despite Freuds research on cerebral palsy, the belief that birth complications accounted for most cases was widespread among doctors, families, and even medical researchers. In the 1980s, scientists analyzed extensive data from a government study of more than 35,000 births. While they found that birth trauma was the cause of thousands of cerebral palsy cases, no cause could be found in the majority of cases. This has influenced researchers to explore other causes, and look at medical theories about cerebral palsy more closely. Fortunately, in the past few decades, information on the many facets of cerebral palsy has significantly increased. Today, the medical community has great interest in studying cerebral palsy to determine its causes and the most effective ways to treat it. As knowledge and treatment techniques have expanded and improved, so too have the prospects of all children with cerebral palsy. Cerebral Palsy Definition - Cerebral Palsy A-Z What is the Definition of Cerebral Palsy? Cerebral palsy is a term used to describe a group of chronic conditions affecting body movements and muscle coordination. It is caused by damage to one or more specific areas of the brain, usually occurring during fetal development, or during infancy. It can also occur before, during or shortly following birth. Cerebral refers to the brain and Palsy to a disorder of movement or posture. If someone has cerebral palsy it means that because of an injury to their brain (cerebral) they are not able to use some of the muscles in their body in the normal way (palsy). Children with cerebral palsy may not be able to walk, talk, eat or play in the same ways as most other children. Cerebral palsy is neither progressive nor communicable. It is also not curable in the accepted sense, although education, therapy and applied technology can help persons with cerebral palsy lead productive lives. It is important to know that cerebral palsy is not a disease or illness. It isnt contagious and it doesnt get worse. Children who have cerebral palsy will have it all their lives. 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 occur: * muscle tightness or spasm * involuntary movement * disturbance in gait and mobility * abnormal sensation and perception * impairment of sight, hearing or speech * seizures Types of Cerebral Palsy Cerebral palsy is a broad term which encompasses many different disorders of movement and posture. To describe particular types of movement disorders covered by the term, pediatricians, neurologists, and therapists use several classification systems and many labels. To understand different types of cerebral palsy more clearly, you must first understand what professionals mean by muscle tone. All children with cerebral palsy have damage to the area of the brain that controls muscle tone. As a result, they may have increased muscle tone, reduced muscle tone, or a combination of the two (fluctuating tone). Which parts of their bodies are affected by the abnormal muscle tone depends upon where the brain damage occurs. There are three main types of cerebral palsy: * Spastic Cerebral Palsy (stiff and difficult movement) * Athetoid Cerebral Palsy (involuntary and uncontrolled movement) * Ataxic Cerebral Palsy (disturbed sense of balance and depth perception) * Mixed Cerebral Palsy There may be a combination of these types for any one person. Cerebral Palsy Statistics Because cerebral palsy influences the way children develop, it is known as a developmental disability. In the United States today, more people have cerebral palsy than any other developmental disability, including Down syndrome, epilepsy, and autism. About two children out of every thousand born in this country have some type of cerebral palsy. Studies have shown that at least 5000 infants and toddlers and 1,200 - 1,500 preschoolers are diagnosed with cerebral palsy each year. In all, approximately 500,000 people in this country have some degree of cerebral palsy. There is not an American system for monitoring cerebral palsys occurrence. Therefore it is not known whether the incidence of cerebral palsy is increasing, declining, or staying the same. However, studies have shown that the use of the electronic fetal heart rate monitor during labor and delivery has not decreased the rate of cerebral palsy primarily because of the mistakes made by doctors and nurses during the birthing process. Although children with very mild cerebral palsy occasionally recover by the time they are school-aged, cerebral palsy is usually a lifelong disability. In most cases, the movement and other problems associated with cerebral palsy affect what a child is able to learn and do to varying degrees throughout their life. Key Terms Developmental Disabilities Down Syndrome Epilepsy Autism Fetal Heart Rate Monitor Cerebral Palsy Diagnosis How is the Diagnosis of Cerebral Palsy Made? When an infant or child has brain damage, a variety of symptoms can lead doctors and parents to suspect that something is wrong. In the first few months of life, an infant with brain damage may demonstrate some or all of the following symptoms: * Lethargy, or lack of alertness * Irritability or fussiness * Abnormal, high-pitched cry * Trembling of the arms and legs * Poor feeding abilities secondary to problems sucking and swallowing * Low muscle tone * Abnormal posture, such as the child favoring one side of their body * Seizures, staring spells, eye fluttering, body twitching * Abnormal reflexes. During the first six months of life, other signs of brain injury may also appear in an infants muscle tone and posture. These signs include: * Muscle tone may change gradually from low tone to high tone; a baby may go from floppy to very stiff. * The child may hold his or her hand in tight fists. * There may be asymmetries of movement, that is, one side of the body may move more easily and freely than the other side. * The infant may feed poorly, with their tongue pushing food out of their mouth forcefully. Once a baby with brain damage reaches six months of age, it usually becomes quite apparent that he or she is picking up movement skills slower than normal. Infants with cerebral palsy are more often slow to reach certain developmental milestones, such as rolling over, sitting up, crawling, walking and talking. Parents are more likely to notice these developmental delays and abnormal behaviors, especially if this is not their first child. Sometimes when they express their concerns to their physicians, their child is immediately diagnosed as having cerebral palsy. More often, however, medical professionals hesitate to use the term cerebral palsyat first. Instead, they may use broader terms such as: * Developmental delay, which means that a child is slower than normal to develop movement skills such as rolling over and sitting up * Neuromotor dysfunction, or delay in the maturation of the nervous system * Motor disability, indicating a long term movement problem * Central nervous system dysfunction, which is a general term to indicate the brains improper functioning * Static encephalopathy, meaning abnormal brain function that is not getting worse. So why do doctors frequently delay making a final diagnosis and prognosis when a child may have cerebral palsy? Part of the answer lies in the plasticity of a childs central nervous system, or its ability to recover completely or partially after an injury occurs. The brains of very young children have a much greater capacity to repair themselves than do adult brains. If a brain injury occurs early, the undamaged areas of a childs brain can sometimes take over some of the functions of the damaged areas. Although the child may have some motor impairment, he or she can often make great progress in other motor skills. Another reason doctors may delay a diagnosis of cerebral palsy is that a childs nervous system organizes over time. Damage to the brain may affect your childs motor abilities differently. For example, tone can go from low to high or vise versa, or involuntary movements can become more obvious. Generally, however, a childs motor symptoms stabilize by two to three years of age. After this age, tone is probably not going to change dramatically. So what does all of this mean? It means that a cerebral palsy diagnosis is not made over night. Since the extent of your childs problems will probably not be clear for some time, his or her symptoms need to be monitored by an interdisciplinary team. This is a group of professionals with specialties in different areas. These health care professionals gather information on the childs accomplishments and make comparisons over the months and years of the childs life. They will keep you up to date on your childs current needs and problems, as well as the medical reasons for these problems, if known. When diagnosing cerebral palsy, the interdisciplinary team must first conduct an assessment, or evaluation of the childs strengths and needs in all areas. As your child grows older, additional assessments may be necessary. In conclusion, cerebral palsy is diagnosed by a complete examination of your childs current health status. Doctors will test your childs motor skills and look carefully at his or her medical history. They will also look for slow development, abnormal muscle tone, and unusual posture. When diagnosing cerebral palsy, doctors must rule out other disorders that can cause abnormal movements. Cerebral palsy does not get worse, in other words, it is not progressive. Based on this fact, doctors must make the determination that your childs condition is not progressively getting worse. Doctors will also use a number of different specialized tests in diagnosing cerebral palsy. For example, the doctor may order a CT (computed tomography). This is an imaging of the brain that can determine underdeveloped areas of brain tissue. The doctor may also order an MRI (magnetic resonance imaging). This test also generates a picture of the brain to determine areas that may be damaged. In addition to these imaging tests, intelligence testing is also used. This helps to determine if a child is behind from a mental standpoint. In addition to diagnosing cerebral palsy through a complete and thorough examination of the childs abnormalities and behaviors, a review of the mothers pregnancy, labor and delivery and care received is also conducted. |
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