Celebral palsy

Illness

There is a great amount of resources on the internet providing basic information about Cerebral Palsy (CP). We are therefore only offering the most fundamental information regarding this incurable disease based on Wikipedia (for Wikipedia click here, please) and others.

Cerebral palsy (CP) is a general term for a group of permanent, non-progressive movement disorders of the development in the motor areas of the brain that cause physical disability, mainly in the areas of body movement. This term does not describe movement disorders caused by diseases of the muscle or the peripheral nervous system.

Cerebral palsy is not neither an infectious nor a heritable disease. Parents often notice this disorder only when the motor the development of their child is delayed. This is often after the first half a year of life. This disorder is the result of damage on the brain, especially due to hypoxia. This can develop during one of these three periods:

–in pregnancy (prenatal aetiology)

–during delivery (perinatal aetiology)

–during the first months of life (postnatal aetiology).

The affected child is delayed not only in his motor development; hismind may also be affected. Frequently CP may be accompanied by other disorders such as low intelligence, disorders of the senses and in many cases epilepsy. Deformities of the legs and feet are common. The most common leg deformity is the so called club foot or Congenital Talipes Equinovarus where the heel is drawn up and the foot is pointed.

In summary these are the disorders accompanying CP:

–movement disorders

–learning disabilities

–epilepsy

–hearning loss and sight problem

–abnormal emotional development

–and others.

Treatment

CP is a disease that cannot be cured. However thanks to treatment the conditions and life opportunities of the child can be improved which usually benefits her quality of life. Medical advances in the past few years and especially advances made in the treatment of people affected by CP have led to a situation where those who are treated in a timely fashion can lead an almost normal life.

Even nowadays there is no such thing as standard treatment which would be effective enough for all patients. The doctor looking a CP patient is more or less reliant on a number of specialists whose help he employs into determining individual disorders and then the whole therapeutic programme is adapted accordingly. There is currently also research being conducted on the application of stem cells from umbilical cord blood.

General rule of thumb is the sooner complex treatment is initiated the more likely is the child to learn to overcome her developmental disorder. There is a number of rehabiliation methods. The best results are achieved if treatment is initiated by the age of 6 months. The initial treatment is usually 'reflex crawling' (the so called Vojta's method).

Rehabilitation – physiotherapy is the most fundamental part o treatment for CP. There is a number of rehabilitation methods with varying degrees of difficulty and efficacy. The aforementioned Prof. Vojta's method of reflex crawling is the most prevalent method used in the Czech Republic. The Bobath concept is the most prevalent method used in the English speaking world. However there are a number of methods, some more effective than others. The basic principle is always the same – initiating intensive rehabilitation therapy early so that the consequences of CP can be minimalized.

There are also other methods that can influence symptoms associated with CP. When it comes to the spastic forms of CP it is possible to use Botox – that is only in certain cases. There are also other muscle relaxants, e.g. baclofen which has recently also been used in baclofen pumps. The pump is implanted into the subcutaneous tissue in the abdomen and a thin silicon tube delivers this anti-spasmodic right into the spinal canal. The advantage is that the medication delivered in this way can be efficacious in very small doses and so overdosing is not an issue and side effects can also be avoided.

Part of the care for patients with CP is orthopaedic surveillance. Again, when it comes to the spastic forms of CP orthopaedic procedures and operations can benefit the motor function of the patient. This is especially important in the hips, knees, hock and feet.

When it comes to established forms of CP it is necessary to use compensatory and prosthetic aids according to individual needs of the patient: orthoprosthetics, prams, wheel chairs etc. The aim is always to compensate moving disorders so that their impact on the patient's life is minimalized.

As we have already mentioned, the care of the CP patient is complex, including the treatment of complications. This is a multidisciplinary care approach including many specialists – doctors (neurologists, orthopaedic surgeons, ophthalmologists, ENT, psychiatrists, neurosurgeons, gastroenterologists etc.) and allied health professionals (psychologists, speech and language therapists, ergotherapists, special educationalists, prosthetic technicians, social workers etc.)

Czech artist Kamil Lhotak had cerebral palsy (image from here).

And this picture made 4 year old Ladik's parents happy. He has cerebral palsy. There is always a new beginning when it comes to cerebral palsy...