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Cerebral Palsy Cerebral palsy, also
referred to as CP, is a term used to describe a group of chronic
conditions affecting body movement and muscle coordination. It is
caused by damage to one or more specific areas of the brain, usually
occurring during fetal development; before, during or shortly after
birth; or during infancy. “Cerebral” refers to the brain and “palsy”
to muscle weakness/poor control. Cerebral palsy itself is not
progressive (i.e., brain damage does not get worse); however,
secondary conditions, such as muscle spasticity, can develop which
may get better, get worse, or remain the same. Cerebral palsy is not
communicable. It is not a disease and should not be referred to as
such. Although cerebral palsy is not “curable” in the accepted
sense, training and therapy can help improve function. What are
the effects?
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 spasticity;
involuntary movement; disturbance in gait or mobility, difficulty in
swallowing and problems with speech. In addition, the following may
occur: abnormal sensation and perception; impairment of sight,
hearing or speech; seizures; and/or mental retardation. Other
problems that may arise are difficulties in feeding, bladder and
bowel control, problems with breathing because of postural
difficulties, skin disorders because of pressure sores, and learning
disabilities.
What are the causes?
Cerebral palsy is not a disorder with a single cause, like chicken
pox or measles. It is a group of disorders with similar problems in
control of movement, but probably with a variety of causes.
Congenital cerebral palsy, results from brain injury during
intra-uterine life. It is present at birth, although it may not be
detected for months. It is responsible for about 70% of children who
have cerebral palsy. An additional 20 % are diagnosed with
congenital cerebral palsy due to a brain injury during the birthing
process. In most cases, the cause of congenital cerebral palsy is
unknown.
On the other hand, in the United States, about 10 percent of
children who have cerebral palsy acquire the disorder after birth.
(The figures are higher in underdeveloped countries.) Acquired
cerebral palsy results from brain damage in the first few months or
years of life and can follow brain infections, such as bacterial
meningitis or viral encephalitis, or the results of head injury --
most often from a motor vehicle accident, a fall, or child abuse.
Risk factors for cerebral palsy include the following: premature
birth; low birth weight; inability of the placenta to provide the
developing fetus with oxygen and nutrients; lack of growth factors
during intra-uterine life; RH or A-B-O blood type incompatibility
between mother and infant; infection of the mother with German
measles or other viral diseases in early pregnancy; bacterial
infection of the mother, fetus or infant that directly or indirectly
attack the infant's central nervous system; prolonged loss of oxygen
during the birthing process and severe jaundice shortly after birth.
Are there different types of cerebral palsy?
There are three main types: spastic – characterized by stiff and
difficult movement; athetoid – characterized by involuntary and
uncontrolled movement; and ataxic – characterized by a disturbed
sense of balance and depth perception. It is not unusual for
patients to have symptoms of more than one of the previous three
forms. The most common mixed form includes spasticity and athetoid
movements, but other combinations are also possible.
How many people have cerebral palsy?
It is estimated that some 764,000 children and adults in the United
States manifest one or more of the symptoms of cerebral palsy.
Currently, about 8,000 babies and infants are diagnosed with the
condition each year. In addition, some 1,200 - 1,500 preschool age
children are recognized each year to have cerebral palsy.
Can it be prevented?
Yes. Measures of prevention are increasingly possible today.
Pregnant women are tested routinely for the Rh factor and, if Rh
negative, they can be immunized within 72 hours after the birth (or
after the pregnancy terminates) and thereby prevent adverse
consequences of blood incompatibility in a subsequent pregnancy. If
the woman has not been immunized, the consequences of blood
incompatibility in the newborn can be prevented by exchange
transfusion in the baby. If a newborn baby has jaundice, this can be
treated with phototherapy (light therapy) in the hospital nursery.
Immunization against measles for all women who have not had measles
and are susceptible to becoming pregnant is an essential preventive
measure. Other preventive programs are directed towards the
prevention of prematurity; reducing exposure of pregnant women to
virus and other infections; recognition and treatment of bacterial
infection of the maternal reproductive and urinary tracts; avoiding
unnecessary exposure to X-rays, drugs and medications; and the
control of diabetes, anemia and nutritional deficiencies. Of great
importance are optimal well being prior to conception, adequate
prenatal care, and protecting infants from accidents or injury.
Can cerebral palsy be treated?
"Management" is a better word than "treatment." Management consists
of helping the child achieve maximum potential in growth and
development. This should be started as early as possible with
identification of the very young child who may have a developmental
brain disorder. A management program can then be started promptly
wherein programs, physicians, therapists, educators, nurses, social
workers, and other professionals assist the family as well as the
child. Certain medications, surgery, and braces may be used to
improve nerve and muscle coordination and prevent or minimize
dysfunction.
As individuals mature, they may require support services such as
personal assistance services, continuing therapy, educational and
vocational training, independent living services, counseling,
transportation, recreation/leisure programs, and employment
opportunities, all essential to the developing adult. People with
cerebral palsy can go to school, have jobs, get married, raise
families, and live in homes of their own. Most of all people with
cerebral palsy need the opportunity for independence and full
inclusion in our society.
Is research being done on cerebral palsy?
Yes. Active national programs of research are being vigorously
pursued to prevent cerebral palsy and improve the quality of life
for persons with cerebral palsy. The four organizations with major
research programs are the United Cerebral Palsy Research and
Educational Foundation in the private sector, and the National
Institutes of Health, the Centers for Disease Control and Prevention
and the National Institute of Disability and Rehabilitation Research
in the government sector. The research questions being addressed
include:
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What are the factors that predispose the developing fetal
brain to injury? Can these factors be eliminated or minimized?
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What are the causes of injury to the developing fetal brain?
Can the developing fetal and newborn brain be protected? What
are the causes of developmental delays and failure to thrive?
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Why are low birth weight in the full-term and the premature
infant important risk factors for cerebral palsy?
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Can cerebral palsy be diagnosed before birth and better
diagnosed shortly after birth?
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Which available treatments are most effective for specific
disabilities of persons with cerebral palsy?
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Based on new knowledge now available in the medical,
surgical, behavioral and bioengineering sciences, what
improvements can be made in the quality of life of people with
cerebral palsy?
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What are the effects of aging on a person with disabilities
due to cerebral palsy?
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Can the damaged brain be "repaired"?
What is UCP?
Founded in 1949, UCP is a nationwide network consisting of a
central national organization, located in Washington, D.C. and
over 100 independent, state and local non-profit affiliates. UCP
is the leading source of information on cerebral palsy and is a
pivotal advocate for the rights of all people with disabilities.
In fact, 65% of the people UCP serves have a disability other
than cerebral palsy. UCP is one of the nation’s most efficient
charities, with a system wide average of 85% of all revenues
going to programs.
UCP affiliates serve more than 170,000 children and adults with
disabilities and their families every day. Together, with over
100,000 volunteers and an even larger number of professional
staff, UCP serves people with disabilities and others, through
the development of state-of-the-art programs, information and
referral services, legislative advocacy, technology initiatives
and research, and the delivery of a range of direct services
tailored to local communities through programs such as assistive
technology training, early intervention services, individual and
family support services, and social and recreation programs. In
addition, UCP provides supported living services, employment
assistance and other supports as needed.
© October 2001 United Cerebral Palsy
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