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CEREBRAL PALSY Cerebral palsy is a condition that affects the brain. The word palsy means a weakness or problem in the way a person moves or positions his or her body. Cerebral palsy is a medical condition caused by permanent brain damage that occurs before, during, or shortly after birth. The effect of cerebral palsy, or CP, is characterized by a lack of muscle control and abnormal body movement. While it is not a progressive disease of the brain, the effects of cerebral palsy may change gradually over the years. Cerebral palsy is caused by an injury to the brain during pregnancy, around the time of birth, or shortly after birth. This brain damage may be the result of several factors depending on the type, the onset, and the health history of mother and child. The cause of cerebral palsy has not been definitively identified, but it has been linked to the health history of both the mother and child, as well as to accidents that result in brain damage. The three types of cerebral palsy are spastic, ataxic and athetoid. The most common type of cerebral palsy, spastic cerebral palsy is characterized by stiff, contracted muscles. Affected people will have stiff, jerky movements and will often have difficulty letting go of something in their hand. Diplegia : affects both arms or both legs Hemiplegia : affects limbs on one side of the body Quadriplegia : affects all limbs Monoplegia : affects only one limb (rare) Triplegia : affects three limbs (rare) Ataxic cerebral palsy occurs when the muscles are too weak making the limbs shaky and unsteady. Ataxic cerebral palsy affects balance, coordination, and depth perception. Victims typically walk unsteadily, have poor coordination, and have difficulty honing fine motor skills. Athetoid cerebral palsy occurs when the muscles fluctuate between being too tight and too weak. There is involuntary movement in the face and arms, and will have difficulty holding them in an upright position. Some children also experience speech problems, drooling, and other difficulty in controlling their facial muscles. Diagnosing cerebral palsy early in an individual’s life allows parents to learn how to best care for their child. A diagnosis of cerebral palsy is usually made within the first three years of a child’s life. Parents are usually the first to notice that their child is developing slower than normal. There are a range of tell-tale signs and symptoms of cerebral palsy that affect physical movement, speech, and brain function. The severity of cerebral palsy can vary as can their effects on the individual. The early symptoms of cerebral palsy are usually evident by the time the child reaches 18 months of age. The first signs of cerebral palsy include: Slow to reach developmental milestones: these include rolling over, sitting, crawling, and walking Abnormal muscle tone: the infant’s body may seem limp or abnormally stiff Unusual posture There are a number of developmental benchmarks in the first year of an infant’s life, including the ability to roll over, crawl, and walk. Other developmental problems include difficulty sucking and swallowing. Babies who suffer from cerebral palsy are typically slower to reach these milestones due to the effects of the condition. Some important developmental achievements include: Ability to roll over: three to six months Ability to babble: six to eight months Ability to sit with support: eight to ten months Ability to crawl: nine to 12 months Ability to walk alone: 12 to 15 months Ability to say a couple words other than dada and mama: 12 to 15 months Ability to eat with fingers; hold bottle: 12 to 18 months Ability to turn pages in books; remove shoes and socks: 24 to 30 months Ability to walk up and down steps: 24 to 36 months Some children who have been diagnosed with cerebral palsy display abnormal muscle tone. Decreased muscle tone can cause the baby to seem relaxed, or floppy, while increased muscle tone can make the baby appear rigid. Abnormal muscle tone can also include unusual posture and the tendency to favor one side of the body. There are a number of other signs of cerebral palsy. The magnitude of these effects depends on the severity of the brain damage associated with the condition. Learning Disabilities: Some individuals with cerebral palsy experience difficulty learning how to do certain activities such as mathematics, drawing, and reading. Speech Problems: Some individuals with cerebral palsy have difficulty controlling the muscles of the mouth, tongue, voice box, and palate. This can affect speech, as well as the ability to swallow. Seizures: Seizures can be one of the more dangerous conditions associated with cerebral palsy. The seizures can appear early in life or years after the brain damage occurred. Hearing Problems: A number of individuals with cerebral palsy suffer from partial hearing loss. To test for these effects, all individuals with cerebral palsy should undergo a hearing exam. Vision Problems: A number of individuals with cerebral palsy exhibit visual problems which need to be corrected. The cerebral palsy treatment team should be composed of professionals from various backgrounds. Members should include the following health care professionals: A physician trained in helping developmentally challenged youth. An orthopedist with expertise in dealing with bone-muscle-tendon issues is critical. A special educator to deal with issues related to learning. A psychologist can help individuals and their families deal with the unique stresses of cerebral palsy. Psychologists can help adjust the parent’s attitudes as well. A physical therapist can create a regimen of exercises designed to improve strength and movement. An occupational therapistcan help the patient to function better in everyday life at school or work. A speech-language therapist can help the patient work out communication problems. A social worker can help the family gain access to community resources available to the disabled.
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Cerebralna paraliza (moždana kljenut) je stanje koje se odlikuje lošom kontrolom mišića, ukočenošću (spazmom), paralizom i drugim neurološkim manjkavostima koje nastaju uslijed oštećenja mozga tijekom trudnoće, za vrijeme i poslije poroda, odnosno prije pete godine života. Brojne vrste oštećenja mogu biti uzrokom cerebralne paralize, ali je najčešće uzrok nepoznat. Porođajne ozljede i nedostatak kisika prije, za vrijeme i neposredno poslije poroda uzroci su cerebralne paralize u 10% do 15% svih slučajeva. Nezrela su djeca osobito sklona cerebralnoj paralizi, djelomično zato što su krvne žile njihovog mozga loše razvijene i lako prokrvare ili nisu u stanju dopremiti dostatnu količinu kisika u mozak. Simptomi cerebralne paralize mogu se kretati od jedva primjetljive nezgrapnosti do teške spastičnosti (mišićna ukočenost) koja iskrivljuje ruke i noge i veže dijete za invalidska kolica. Postoje četiri osnovna tipa cerebralne paralize: Kod spastične cerebralne paralize ukočenost može zahvatiti obje ruke i noge (kvadriplegija), uglavnom noge (diplegija), ili samo ruku i nogu na jednoj strani (hemiplegija). Pogođeni udovi su loše razvijeni, ukočeni i slabi. Kod koreoatetotične cerebralne paralize pokreti ruku nogu i tijela su usporeni, izvijajući i nekontrolirani, ali mogu biti i izbijajući (abruptni) i crvoliki. Jake emocije pokrete mogu pogoršati; u snu pokreti mogu nestati. Kod ataksičnog oblika cerebralne paralize postoji loša koordinacija mišićnih pokreta, a razvija se i njihova slabost i drhtanje. Djeca s ovim poremećajem imaju poteškoća s izvođenjem brzih ili finih kretnji, nestabilni su pri hodu jer su im spastične noge jako raširene. Kod svih oblika cerebralne paralize postoje govorne poteškoće jer nema potpune kontrole svih mišića koji sudjeluju u govornoj funkciji. Većina djece s cerebralnom paralizom ima i druge poteškoće, npr. graničnonormalna inteligencija, a neki imaju tešku mentalnu retardaciju.