What is Cerebral Palsy (CP)? What are the Symptoms?

Treatment of Cerebral Palsy (CP) 

Cerebral palsy, or CP for short, is a non-progressive, permanent movement and posture disorder due to damage to the developing brain. The prevalence of CP is 2-3 per 1000 live births.

What are the causes of Cerebral Palsy (CP)?

CP can be caused by prenatal (low or advanced maternal age, multiple pregnancies, genetic diseases, trauma, maternal diseases), intrapartum (preterm birth, low birth weight, prolonged labor, abnormal presentation and infections) and postnatal (jaundice, infections, trauma, intracranial hemorrhages) causes.

What are the types of Cerebral Palsy (CP)?

Depending on the location and severity of the damage, CP pictures are formed in various degrees and appearances

• Spastic type: Spastic type is the most common type of CP. Spasticity, in the most general sense, can be defined as muscle stiffness or resistance to passive movement. Changes in the normal structure of the muscles and stiffness cause movements to be affected and difficult to perform. Excessive spasticity leads to deterioration of skeletal structure and posture over time. It also negatively affects functional activities such as sitting, using hands and walking.

A spastic child is defined according to the part of the body affected under the diagnosis of Cerebral Palsy:

• Hemiplegia: In this type, the arm, trunk and leg on one side of the body are affected. Crawling in hemiparesis children is asymmetric or absent. With rehabilitation, most patients become independent in activities of daily living and ambulatory.
• Diplegia: In this type, both legs have more spasticity than the arms. Diplegic patients become spastic after a limp period. Standing and walking are delayed. Children who gain sitting balance by the age of two may be able to walk. Stepping on toes is common.
• Tetraplegia: In this type, the whole body is affected. Inadequate head control, hands in fists and legs crossed in a crossed position are common features. In 1/4 of children with tetraplegic CP, the disease progresses mildly and these patients become ambulatory and can perform activities of daily living with mild limitations. In half of them, the disease progresses moderately and these children cannot be fully independent but can reach adequate functional capacity. In the remaining 1/4, the disease is severe and these children need lifelong care.
• Athetoid Type: It can be defined as uncontrolled movement. Involuntary movements occur in the child's legs, arms, hands or face. In this type, sudden changes occur in the muscles. Muscles can change from a very loose state to a very stiff state. This prevents coordinated movements.
• Ataxic Type: There is impairment in maintaining balance. Due to poor head control and lack of trunk balance, development is slow and walking is achieved very late.
• Mixed Type: CP is called mixed when muscle tone is extremely low in some muscles and extremely high in others.

What are the signs and symptoms of Cerebral Palsy (CP)?

• Problems with movement on one side of the body
• Hard muscles
• Excessive or loose reflexes
• Involuntary movements or tremors
• Lack of coordination and balance
• Saliva
• Swallowing or sucking problems
• Difficulty with speech (dysarthria)
• Seizures
• Delayed motor skills
• Incontinence
• Gastrointestinal problems

Damage to a developing brain can cause problems other than the movement problems associated with cerebral palsy. Other conditions that may be present alongside cerebral palsy include

• Visual or hearing impairment
• Learning disorders
• Attention deficit hyperactivity disorder (ADHD)
• Inability to communicate through speech

What are the Complications of Cerebral Palsy?

Cerebral palsy is a disorder that occurs as a result of brain damage in infancy, causing permanent impairment of motor skills. Complications that can occur with cerebral palsy may vary depending on the location and degree of damage.

The most common complications are:

• Motor skill problems
• Speech and communication problems
• Educational challenges
• Social and emotional difficulties

Other possible complications include

• Joint deformities
• Respiratory problems
• Vision and hearing problems
• Other health problems
  Early intervention and regular care are important to prevent or reduce complications that can occur with cerebral palsy. Physical therapy, speech therapy, special education and other support services can help improve the quality of life for people with cerebral palsy.

Causes of Cerebral Palsy Near and During Childbirth

Causes of cerebral palsy that occur close to and during childbirth include

Insufficient blood flow or oxygen to the brain: Insufficient blood flow or oxygen to the baby's brain during birth can cause brain damage. This can occur due to complications during labor, abnormalities in intrauterine development or a breech baby.

Brain trauma Excessive trauma to the baby's head during birth can cause brain damage. This can occur as a result of a long or difficult birth, compression of the baby's head, or excessive turning of the baby's head during the passage of the baby through the birth canal.

Infections Infections that can be transmitted to the baby in the womb can increase the risk of CP. Infections that occur close to or during labor can cause brain damage.

Causes of Cerebral Palsy in the Postnatal Period

Causes of cerebral palsy that occur in the postnatal period include the following:

• Brain trauma
• Infections
• Bleeding
• Metabolic disorders
• Brain tumors

How to Prevent Cerebral Palsy?

This is a disease caused by brain damage during infancy. This damage can develop during pregnancy, during or after birth. Here are some measures that can be taken to reduce the risk of CP:

Having a healthy pregnancy: During pregnancy it is important to eat a healthy diet, exercise regularly and avoid smoking, alcohol and drugs.
Having a safe delivery: To reduce the risks during childbirth, it is important that the pregnancy is monitored regularly and the delivery is performed by an experienced doctor.
Protecting the baby's health: It is important that the baby is protected from infections and has a healthy diet after birth.

Cerebral Palsy (CP)

There is no complete cure for CP. However, treatment usually improves the child's abilities.

Early diagnosis and starting an early rehabilitation program are very important in CP. Treatment is not a definitive and single solution and is a long-term process. In this process, the teamwork of the physical therapist, physiotherapist, occupational therapist, child development specialist, speech therapist and family is an indisputable issue. All these approaches should be applied together to an individual with CP. Exercise, robotic therapies, hydrotherapy and occupational therapy are the main building blocks of physiotherapy applications, which are the most important pillars of rehabilitation.

Exercise applications are applied by physiotherapists according to the functional status of the child, using various techniques to support holding the head, sitting, standing and walking. This long and patient treatment process has been more easily accepted by both children and families with the development of robotic therapies. Thanks to arm and walking robots, repetitive, accurate walking patterns are created and these signals are transmitted to the brain.

In addition, applications enriched with a number of games ensure that the treatment is continued with interest by children. Hydrotherapy not only increases the child's compliance with the treatment, but also facilitates exercise by using the buoyancy of water and increases active participation. Occupational therapy, one of the main branches supporting rehabilitation, includes studies to increase the child's participation in daily life activities. In addition, Sensory-Integration therapy, which enables the child to receive sensory information from his/her body and environment, organize this information and use it in daily life activities, is among the new applications.

All these applications are included in the rehabilitation process by adjusting their doses according to the type and severity of CP. In addition, this process can be supported by various muscle relaxant applications (such as Botulinum toxin applications) and surgical treatments.

The most important thing is that the individual with CP takes his/her place in society and is included in life. For this reason, all these applications should be within a plan and with continuous rehabilitation support without disrupting the child's education process.

Physical Therapy Methods in Cerebral Palsy

Cerebral palsy is a disorder that occurs as a result of brain damage in infancy, causing permanent damage to motor skills. In people with CP, motor skills such as muscle tone, coordination and balance can be affected. This can make daily activities such as walking, running, climbing stairs, dressing and eating difficult.

Physical therapy is a treatment method that helps people with cerebral palsy to improve their motor skills. Physical therapists prepare a treatment program customized to the needs of people with CP. This program may include muscle strengthening exercises, balance and coordination exercises, exercises to increase range of motion, and exercises to develop skills to help perform daily activities independently.

Physical therapy methods for cerebral palsy are as follows:

• Muscle strengthening exercises
• Balance and coordination exercises
• Exercises to increase joint range of motion
  Exercises to develop skills to help perform daily activities independently

Frequently Asked Questions About Cerebral Palsy