Cerebral palsy is a group of neurological diseases occurring in early childhood and presenting with a delay in the acquisition of milestones. Early treatment of cerebral palsy prevents the emergence of complications and helps in the integration of the child into mainstream schooling.
Cerebral palsy can give rise to numerous physical and neurological symptoms in children. These symptoms vary from one child to another and depend on the location and severity of brain damage.
The physical symptoms of cerebral palsy include contractures, exaggerated or jerky reflexes, drooling, gastrointestinal problems, floppy muscle tone, involuntary movements or tremors, incontinence, lack of balance and coordination, problems sucking or swallowing, stiff muscles, and problems with movements on one side of the body.
The neurological symptoms of cerebral palsy include behavioural problems, a buildup of cranial pressure due to fluid balance, difficulty with language and speech, delayed motor skill development, hearing or visual impairments, and sensory impairments.
Babies with cerebral palsy may suffer from developmental delays that are difficult to notice. Therefore, parents and caregivers should monitor the timeline of the developmental milestones of their children.
The signs and symptoms of cerebral palsy are progressive and become more apparent over time. Therefore, the diagnosis may not be made until the child is a few months of age, sometimes even a year. If the signs and symptoms are mild, the diagnosis can be further delayed.
If your paediatrician or family doctor suspects that your child has cerebral palsy, they will evaluate your child’s condition, monitor his growth and development, assess his medical history, and perform a complete physical examination. You might also be referred to a specialist trained in dealing with neurological disorders in children, such as a pediatric physical medicine specialist, pediatric neurologist, child developmental specialist, and rehabilitation specialist.
Imaging the brain can reveal any areas of abnormal development or damage in the brain. Following are some of the brain imaging techniques used in patients with cerebral palsy:
MRI: An MRI employs a magnetic field and radio waves to create detailed cross-sectional or 3D images of the brain. It can often identify abnormalities or lesions in your child’s brain. It is a painless test but may take up to an hour to complete. The child is usually given a sedative for the procedure.
Cranial ultrasound: It is a brain imaging technique that can be performed during infancy. High-frequency ultrasound waves are used to produce images of the brain. Even though the image is not as detailed as an MRI image, an ultrasound is sometimes used because it is quick and provides a valuable preliminary evaluation of the brain.
Electroencephalogram (EEG): If your child has seizures, an EEG will be done to evaluate the condition further. During the procedure, a series of electrodes are attached to the scalp to record the electrical activity of the brain. In epilepsy or repeated seizures, there are changes in the normal brain wave patterns.
Laboratory tests like urine tests, blood tests, or skin tests are used to screen for metabolic or genetic problems.
If your child is found to have cerebral palsy, you will be referred to a specialist who will test your child for other conditions that these patients often present with. These tests are performed to identify problems with hearing, vision, intellect, speech, development, and movement.
The type of cerebral palsy depends on the main movement disorder exhibited by the patient, but several movement disorders may be present together. Spastic cerebral palsy is the commonest type of cerebral palsy. It involves exaggerated reflexes and stiff muscles. Other cerebral palsy types include movement disorders involving poor coordination and balance and difficulty controlling voluntary movements.
After establishing a diagnosis of cerebral palsy, a rating system such as the Gross Motor Function Classification System may be used by the doctor to determine the function and severity of posture, mobility, and balance. This helps to determine the treatment plan.
The goal of Cerebral Palsy treatment is to make the child functionally independent. Different treatment modalities, including therapy, medicines, and surgery, are used. The therapy comprises occupational therapy, physiotherapy, and speech therapy. Medicines are given to relax muscle spasms, control seizures, and alleviate pain. For severe and refractory spasticity, intrathecal baclofen pumps or intramuscular botulinum toxin injections are necessary. Surgery may be required to release tight muscles or correct anatomical abnormalities. Generally, patients require orthotic devices like splints, braces, communication aids, and wheelchairs.
Therapy plays a crucial role in the treatment of cerebral palsy. Following are some of the therapies recommended:
We at the Cerebral Palsy Clinic at Kokilaben Dhirubhai Ambani Hospital, Indore, have a devoted team of medical professionals who offer comprehensive treatment and care to patients with cerebral palsy. Our rehabilitation team consists of pediatric speech and language therapists, clinical psychologists, and pediatric occupational therapists. We also house an advanced Gait Analysis laboratory. We provide support and guidance to the patient and their families to cope with this chronic condition at every step of the disease, ranging from diagnosis to treatment.