Cerebral palsy: types, causes, symptoms, and treatment
The development of the human brain is a long and very complex process that begins during fetal development and continues throughout life. This organ and the whole of the nervous system are the bases from which all the functions of our organism are regulated, both at the level of basic functions of our organs and for example when allowing actions such as voluntary movement.
However, sometimes various problems occur during fetal development, during birth or during the first few years of life when brain development does not occur properly and ends up preventing different skills from being displayed or various functions from being performed. When these problems of cerebral origin generate the inability to carry out voluntary movement, we are talking about cerebral palsy .
What is cerebral palsy?
Cerebral palsy is understood as a medical condition in which the presence of alterations or injuries to the brain during brain development causes the development of movement and psychomotor skills to be greatly limited. These limitations are usually congenital and involve a permanent alteration that disrupts processes such as learning.
Movement problems, muscle stiffness, lack of coordination, tremors, hypotonia and hyperkinesia in the joints are common. These types of symptoms may be generalized or seen to a greater extent in extremities or in a specific hemicorpse. In addition to this the lack or difficulties of motor control caused by cerebral palsy can generate difficulties in feeding, breathing and excretion. Sometimes sensory perception is also affected.
It is frequent that delays appear in the development of the subject and that either it is delayed or various milestones typical of individuals without this problem are not overcome, given the existence of a problem in the central nervous system that hinders its correct maturation. It may be accompanied by intellectual disability , although it is not a symptom of this condition.
The severity of this paralysis can be enormously variable, ranging from barely noticeable to severe disability for the subject who suffers it, requiring constant support and care in the most serious cases.
Types of cerebral palsy
There is no single type of cerebral palsy, but this term encompasses different subtypes of problems. Some of the more common ones are as follows.
1. spastic cerebral palsy
One of the best known and most frequent forms, this is a type of cerebral palsy in which the subjects suffer a high level of muscular rigidity and great problems in mobilizing muscle groups.
There may be tetraplegia (although also diplegia, paraplegia, or hemiplegia), seizures, apraxia, high level of arousal and activation, and spasticity. Abnormal postures and contractions, hypertonia and hyperflexibility are often observed.
2. Ataxic cerebral palsy
Of the less frequent forms, it usually takes the form of lack of muscle tone, lack of coordination and lack of balance. Walking, in the case of those who have it, is difficult and presents a risk of falling. Oculomanual coordination also becomes complex , as well as orientation.
3. Dyskinetic cerebral palsy
In this subtype of cerebral palsy, hypotonia and the presence of involuntary dystonic or choreic movements are frequent, often in the form of contraction. They are especially visible in the muscles of the face, which together with the hearing problems they also tend to have can generate great difficulties in the area of communication.
The causes of cerebral palsy can be very varied, but generally they are due to the presence of alterations or injuries during fetal development , during birth or in the first years after birth.
These alterations and injuries are usually congenital, but they can also be acquired during development. Some of the acquired disorders can be meningitis, encephalitis and intrauterine infections. Also cardiovascular accidents, trauma, or anoxia may occur during development or delivery. On some occasions, there have been cases of cerebral palsy resulting from abuse in the form of blows or shaking in babies.
Although it is a condition that has no cure since it is produced by a chronic and irreversible lesion, it is possible to carry out various treatments from a multidisciplinary perspective that allows the individual to reinforce and optimize his or her capacities, create and improve communication and ultimately ensure that he or she reaches the maximum level of development and well-being possible.
At the medical level, a wide range of interventions may be required depending on the difficulties encountered, from the application of relaxing and anticonvulsant drugs to the use of surgery to treat joint deformations or the placement of gastric tubes. At the level of prevention, it is necessary to take care of nutrition during pregnancy (especially in the face of conditions such as hypertension or diabetes) and avoid the consumption of substances such as alcohol or drugs.
One of the strategies to employ is occupational therapy, which allows for adequate stimulation of the child. The use of physical and speech therapy is also required, so that movement and communication skills are strengthened as much as possible.
Another aspect to take into account, and one of the ones that requires more attention, is education, since the symptoms make normative learning very difficult. It is necessary to establish individualized plans for these children and provide them with the necessary support. It is necessary to stimulate these subjects and to reinforce the basic functions and tasks of daily life, or to educate the environment or caregivers in case they do not manage on their own.
Psychoeducation is fundamental not only for the child, but also for his or her family members. It is also advisable to attend support groups in which the child and family can meet and share experiences, thoughts, doubts and feelings.
- Colver, A.; Fairhurst, C. and Pharoah, P.O.D. (2014). Cerebral palsy. Lancet, 583(9924):1240 – 1249.
- Rosenbaum, P.; Paneth, N.; Leviton, A.; Goldstein, M. & Bax, M. (April, 2006). A report: The definition and classification of Cerebral Palsy. Developmental Medicine & Child Neurology, 49: 1 – 44.