Bowing
Parents of children who have bowed legs often want to know if the child's legs are abnormal. To help answer that question, here are some basic facts about bowing. This section will give you an idea of what the physician is thinking about when he or she is examining your child.
First, bowing or the technical term genu varum (genu = knee, varus / varum = angles in) is a part of the normal development of a child. The role of the physician is to determine if the bowing is physiologic (part of normal development) or pathologic (due to some disease process). Physiologic bowing will improve as the child grows without treatment, while pathologic bowing will tend to worsen over time without treatment. The bowing can arise from the lower portion of the femur near the knee, the knee joint itself, the upper shin bone near the knee, or a combination of these areas.
Normally, an infant is born with bowed legs. Over time, the leg alignment will correct and usually straightens out by about eighteen months of age. By the time the child is three to four years old, he or she will normally develop a knock-kneed alignment. The technical term for this is genu valgum (valgus/valgum = angles out). This genu valgum will then correct somewhat by the age of five to six years old, leaving the normal adult alignment of slight genu valgum (slight knock-kneed).
Listed above are the mean ages for these changes to occur so half of the children will correct their bowing earlier and half will correct it later. Occasionally, the bowing never fully corrects. That is why some adults have bowed legs. So you can see, there is a wide range of normal when looking at bowed legs. Physiologic bowing does not require any treatment other than observation for correction as the child grows.
Internal tibial torsion (inward twist of the tibia caused by intrauterine positioning), also called medial tibial torsion, can complicate matters by making the bowing appear worse than it really is, as we see the side of the knee relative to the foot rather than the front. Correction of the torsion will make the legs appear straighter. Fortunately, internal tibial torsion tends to correct itself without treatment up until the age of four to six years, thereby correcting the visual bowing also.
Many disease processes effecting bone growth cause pathologic bowing. Two of the more common diseases known to cause bowing are Rickets and Blount's disease.
Rickets:
Rickets is a generalized skeletal disease involving Vitamin D metabolism. Vitamin D is vital for bone mineralization. Although this vitamin is important it does not act alone. The term 'rickets' predates the later and current notions of the actual causal chemistry. So older usage's run counter to current more precise etiologic (based on cause) uses of the term. In the older sense, a child with bowing of bones, with thickened ends of bones (including ribs), often irritable, and eventually (when x-ray allowed) noted to be associated with widened growth plates which did not fully calcify - that was called rickets. Calcium as Ca++ interacts with Phosphate as PO4= such that at a certain concentration, the calcium can precipitate. The body uses several mechanisms to keep the two at a certain level. When that is off - either by the Ca++ or by the PO4= then the syndrome may manifest.
Dietary deficiency of Vitamin D is the most familiar (to the public) form of rickets. Dietary supplementation of Vitamin D has gone a long way toward abolishing dietary rickets, but it still occasionally seen in less developed countries and in circumstances of dietary peculiarity. Because of this, the hereditary forms of rickets are more commonly seen. Rickets causes a distinctive cupping and widening of the growth plates which can be recognized on a plain x-ray along with other characteristic findings.
However, rickets, in today's terminology, is really a family of entities. Vitamin D in the diet isn't really an active agent, but rather a precursor, a build it yourself kit for what is often called "active vitamin-D". The substance in the diet must first be absorbed, altered by the liver, then altered further by the kidney, then changed again in the skin by sunlight before it is in the active form. If any of those steps is faulty, then dietary vitamin D will be no more active than sand or jelly beans.
Therefore, even with a normal intake of "vitamin-D", if any of the needed bodily steps are not functional, a rickets syndrome may be seen. Caught early, while there is lots of growth remaining, corrected growth can undo deformations which have not gone too far. Correction by supplements is from corrected growth. No growth, no correction. Adults will not correct bowed bones by diet.
The little girl on the right has a genetic form of rickets seen only in the females of her family (four generations). A dominant defective gene disabled her ability to activate the vitamin D form found in food. Dietary change would do little.
At an early time, by giving her a processed already activated form of vitamin D which gets around her inherited bodily inability to activate it, her deformities went away. Her younger sister with similar findings behaved in exactly the same manner. Although boys in alternate generations could also land this particular gene defect, four generations in this girl bearing family managed to dodge this outcome. The girls treated early have statures greater then mother, grandmother and great grandmother by age 8.
Active vitamin supplementation will not undo deformities if they are addressed too late for remaining corrective growth to get the job done. If the activated form of the vitamin fails to alter the course of things then rather than blame the key (vitamin D) we need to suspect the lock. Hormones or vitamins work like keys by fitting into something that responds. If that something is defective, then it gets even more difficult to get around.
On the left we see an extreme form of rickets with multiple tiny fractures caused by a defect in the mechanism which uses vitamin D, that is there is no deficiency of the vitamin or the activated form. Odd metabolic work around tricks are required when this occurs. This form of rickets has interaction with zinc, magnesium, and interestingly, growth hormone. In genetic disorders, it is not uncommon that a so called something defect actually involves more than the something that names it, as deep biochemical alterations often have broad, metabolic echoes.
The complexity of the treatment of rickets varies with the complexity of the curvatures. Most cases are treated with medicine alone, but extreme cases, such as the one above, require surgical correction.
Blount's Disease:
Blount's disease affects the inner edge of the upper shin bone at the knee growth plate (epiphyseal plate - runs horizontally across the knee), causing it to decrease its rate of growth in the portion of the growth plate that is closest to the leg's inseam. The outside part of the growth plate continues to grow normally, leading to progressive bowing.
Blount's disease affects two different age groups. There is infantile Blount's, seen in young children, and adolescent Blount's, seen in teenagers. In both groups, the children tend to be overweight for their age. This bowing deformity is always associated with internal tibial torsion (an inward direction of the ankle and foot relative to the direction of the knee - see above picture). The left knee, above, is aimed dead straight ahead, yet the ankle is directed toward the child's right.
If infantile Blount's is diagnosed early enough, bracing can be instituted. We have had good results bracing children as young as two years old. Usually by the age of three, treatment will require a tibial osteotomy (surgery of the tibia) to straighten the lower extremity. Many will wait and "see how it goes", and let the most effective bracing period go right by. In a special parallax-free three exposure x-ray of the full leg from hip to ankle, with the knee carefully aimed straight ahead, a line through hip and ankle centers ought to pass through knee center. If that line passes outside the bone of the knee, then the angulation will worsen with time and not self-correct. We have seen no such reversals in that subset of children. We prefer to brace as bracing early not only works better but heads off the addition damage to the inner growth plate caused by the angular mechanical (nut cracker) compression caused by the bowed leg.
Depending on how crushed the growth plate is, the bowing may recur after surgery. Tibial osteotomy (tibia = shin bone, osteo = bone, tome = to cut) is also part of the treatment for the adolescent. There are many different techniques for performing the osteotomy. No matter what technique is chosen, the osteotomy must correct the bowing and twist (tibial torsion) at the same time. Bracing also attempts to correct both deformities at the same time.
X-rays are helpful for diagnosing Blount's disease as well. But there is an important detail to be aware of when taking these x-rays. Usually an anterior -posterior (AP) view of the lower extremity is obtained with the knee pointed straight ahead (ignoring the foot direction). The growth plates are checked for any abnormality, such as is seen in rickets and other diseases. Angle measurements about the proximal tibia as well as between the tibia and femur are made, which will help determine if Blount's disease is present. Importantly, a line from the center of the hip joint to the center of the ankle joint is drawn as discussed above. This is the best prognosticator for progression.
This line is the weight bearing line of the lower extremity. If it passes completely beyond the knee joint substance, then whenever weight is placed on the leg it is passed from the hip to the ankle levered through the very medial part of the knee. The leverage amplifies the forces. This will tend to make the bowing worse over time, damaging the growth plate, and is an indication for treatment of the bowing.
गुरुवार, 1 जुलाई 2010
मंगलवार, 29 जून 2010
Definition of Cerebral Palsy
The syndrome is caused by non-progressive brain damage occurring before birth or within 1 month after birth.
The damage is to the brains motor control centers, inhibiting the development of movement and causes abnormal posture.
Diagnosis of cerebral palsy has several essential factors: Bodily movement shows obvious signs of impairment, dystonia, unusual posture and abnormal motion patterns, abnormal reflexes (unconditional reflex, sets up straight reflection, balanced reflection).
Primary high-risk factors for cerebral paralysis: suffocation, premature birth, nuclear jaundice, congenital heteroplasia.
Cerebral palsy complications: Mental handicap, barrier to cognitive development, epilepsy, sensory impairments.
Cerebral palsy classifications:
Spastic type
Involuntary athletic type: athetoid , myodystony, fremitus
Ataxia type
Mixed type
Atonia type
Characteristics of the spastic type:
Upper limbs: increased muscle tension, shoulder joint adduction, elbow flexing, forearm pronation, bending of the finger joints and palm, thumb adduction
The lower limbs extensor tension is increased, hip adductor group, quadriceps femoris, triceps surae muscle tension is increased, hip joint flexure, adduction and involute, knee joint flexure, sharp foot, strephenopodia, strephexopodia
Seat: pelvis caster, round back when sitting with legs extended, ??W?? sitting posture
Standing: sharp foot, walking with a scissors gait, hemiparalysis towing gait
Characteristics of involuntary athletic:
The muscular tone is unstable, increases when anxious, during the infant stage polymyarian tension is low, and the symptoms are obvious when the patient is two or three years old
Involuntary body movements, especially in the face, arms and torso, uncoordinated movements, loss of motion increases
A lack of continuous control over posture
Restricted movement in the oral-facial muscles affecting the tongue, the throat and swallowing capability, dyslalia, dysphonia, laryngeal stridor, disturbance of food intake, increased salivation
Movement range is large
A characteristic symptom is dehise yawning with effort
Unusual posture with low muscular tone:
1. Frog position posture
2. While in a sitting position, there is difficulty raising the head
3. Sitting with upper body anteversion
4. Inverted ??U" posture while the patient is bolstered up horizontally
5. Winged shoulder posture
Unusual posture with hypermyotonia:
1. Head dorsiflexion
2. Opisthotonos
3. Upper limbs: shoulder joint adduction and involute, forearm pronation and extended back, hand makes a fist, hand too far extended
4. Lower limbs: Rigid extension, scissors shaped, sharp foot (6 months later)
5. Kneeling warrior, sitting with legs extended straight
6. TLR (buttocks is higher while the head is low), ATNR posture (asymmetrical tonic neck reflex) Because of the high muscle tone of the neck, the posture mimics the pose of an archer
Methods to treating cerebral palsy:
Physical therapy, PT
Occupational therapy, OT
Speech therapy, ST
Education therapy
Pharmacotherapy: neurophic medication infusion , botulinus toxin A infusion
Chinese traditional treatment: Medicinal bath, wax therapy, massage, acupuncture
Surgical therapy-neural stem cells transplantation and surgery
The treatment principle with regards to cerebral palsy:
The convulsions (including infant hemiparalysis) mainly reduces muscular tone, promotes the infant??s motor ability growth, and encourages the infant to become more active.
Movement principle of involuntary movement: stabilize, median line, flexure pattern, controlling the posture
During daily treatment the nurses should pay special attention to:
Training time
Helping to correct the posture while the patient is seated
Making sure there is plenty of opportunity to practice standing and walking
Focusing on oral cavity mastication, question movement difficulties as soon as possible
Raise the infants level of intelligence
The damage is to the brains motor control centers, inhibiting the development of movement and causes abnormal posture.
Diagnosis of cerebral palsy has several essential factors: Bodily movement shows obvious signs of impairment, dystonia, unusual posture and abnormal motion patterns, abnormal reflexes (unconditional reflex, sets up straight reflection, balanced reflection).
Primary high-risk factors for cerebral paralysis: suffocation, premature birth, nuclear jaundice, congenital heteroplasia.
Cerebral palsy complications: Mental handicap, barrier to cognitive development, epilepsy, sensory impairments.
Cerebral palsy classifications:
Spastic type
Involuntary athletic type: athetoid , myodystony, fremitus
Ataxia type
Mixed type
Atonia type
Characteristics of the spastic type:
Upper limbs: increased muscle tension, shoulder joint adduction, elbow flexing, forearm pronation, bending of the finger joints and palm, thumb adduction
The lower limbs extensor tension is increased, hip adductor group, quadriceps femoris, triceps surae muscle tension is increased, hip joint flexure, adduction and involute, knee joint flexure, sharp foot, strephenopodia, strephexopodia
Seat: pelvis caster, round back when sitting with legs extended, ??W?? sitting posture
Standing: sharp foot, walking with a scissors gait, hemiparalysis towing gait
Characteristics of involuntary athletic:
The muscular tone is unstable, increases when anxious, during the infant stage polymyarian tension is low, and the symptoms are obvious when the patient is two or three years old
Involuntary body movements, especially in the face, arms and torso, uncoordinated movements, loss of motion increases
A lack of continuous control over posture
Restricted movement in the oral-facial muscles affecting the tongue, the throat and swallowing capability, dyslalia, dysphonia, laryngeal stridor, disturbance of food intake, increased salivation
Movement range is large
A characteristic symptom is dehise yawning with effort
Unusual posture with low muscular tone:
1. Frog position posture
2. While in a sitting position, there is difficulty raising the head
3. Sitting with upper body anteversion
4. Inverted ??U" posture while the patient is bolstered up horizontally
5. Winged shoulder posture
Unusual posture with hypermyotonia:
1. Head dorsiflexion
2. Opisthotonos
3. Upper limbs: shoulder joint adduction and involute, forearm pronation and extended back, hand makes a fist, hand too far extended
4. Lower limbs: Rigid extension, scissors shaped, sharp foot (6 months later)
5. Kneeling warrior, sitting with legs extended straight
6. TLR (buttocks is higher while the head is low), ATNR posture (asymmetrical tonic neck reflex) Because of the high muscle tone of the neck, the posture mimics the pose of an archer
Methods to treating cerebral palsy:
Physical therapy, PT
Occupational therapy, OT
Speech therapy, ST
Education therapy
Pharmacotherapy: neurophic medication infusion , botulinus toxin A infusion
Chinese traditional treatment: Medicinal bath, wax therapy, massage, acupuncture
Surgical therapy-neural stem cells transplantation and surgery
The treatment principle with regards to cerebral palsy:
The convulsions (including infant hemiparalysis) mainly reduces muscular tone, promotes the infant??s motor ability growth, and encourages the infant to become more active.
Movement principle of involuntary movement: stabilize, median line, flexure pattern, controlling the posture
During daily treatment the nurses should pay special attention to:
Training time
Helping to correct the posture while the patient is seated
Making sure there is plenty of opportunity to practice standing and walking
Focusing on oral cavity mastication, question movement difficulties as soon as possible
Raise the infants level of intelligence
Cerebral Palsy Diagnosis
How is the diagnosis of cerebral palsy made? When an infant or child has brain damage, a variety of symptoms can lead doctors and parents to suspect that something is wrong. In the first few months of life, an infant with brain damage may demonstrate some or all of the following symptoms that can indicate cerebral palsy:
* Lethargy, or lack of alertness
* Irritability or fussiness
* Abnormal, high-pitched cry
* Trembling of the arms and legs
* Poor feeding abilities secondary to problems sucking and swallowing
* Low muscle tone
* Abnormal posture, such as the child favoring one side of the body
* Seizures, staring spells, eye fluttering, body twitching
* Abnormal reflexes.
During the first six months of life, other signs of brain injury suggestive of cerebral palsy also may appear in an infants muscle tone and posture. These signs include:
* Muscle tone may change gradually from low tone to high tone; a baby may go from floppy to very stiff.
* The child may hold his or her hand in tight fists.
* There may be asymmetries of movement, that is, one side of the body may move more easily and freely than the other side.
* The infant may feed poorly, with their tongue pushing food out of their mouth forcefully.
Once a baby with brain damage reaches six months of age, it usually becomes quite apparent that he or she is picking up movement skills slower than normal. Infants with cerebral palsy are more often slow to reach certain developmental milestones, such as rolling over, sitting up, crawling, walking and talking. Parents are more likely to notice developmental delays, abnormal behaviors, and signs of cerebral palsy, especially if this is not their first child. Sometimes when they express their concerns to their physicians, their child is immediately diagnosed as having cerebral palsy. More often, however, medical professionals hesitate to use the term "cerebral palsy"at first. Instead, they may use broader terms such as:
* Developmental delay, which means that a child is slower than normal to develop movement skills such as rolling over and sitting up
* Neuromotor dysfunction, or delay in the maturation of the nervous system
* Motor disability, indicating a long term movement problem
* Central nervous system dysfunction, which is a general term to indicate the brain's improper functioning
* Static encephalopathy, meaning abnormal brain function that is not getting worse.
So why do doctors frequently delay making a final diagnosis and prognosis when a child may have cerebral palsy? Part of the answer lies in the plasticity of a child's central nervous system, or it's ability to recover completely or partially after an injury occurs. The brains of very young children have a much greater capacity to repair themselves than do adult brains. If a brain injury occurs early, the undamaged areas of a child's brain can sometimes take over some of the functions of the damaged areas. Although the child may have some motor impairment, he or she can often make great progress in other motor skills.
Another reason doctors may delay a diagnosis of cerebral palsy is that a child's nervous system organizes over time. Damage to the brain may affect your child's motor abilities differently. For example, tone can go from low to high or vice versa, or involuntary movements can become more obvious. Generally, however, a child's motor symptoms stabilize by two to three years of age. After this age, tone is probably not going to change dramatically.
So what does all of this mean? It means that a cerebral palsy diagnosis is not made over night. Since the extent of your child's problems will probably not be clear for some time, his or her symptoms need to be monitored by an interdisciplinary team. This is a group of professionals with specialties in different areas. These health care professionals gather information on the child's accomplishments and make comparisons over the months and years of the child's life. They will keep you up to date on your child's current needs and problems, as well as the medical reasons for these problems, if known. When diagnosing cerebral palsy, the interdisciplinary team must first conduct an assessment, or evaluation of the child's strengths and needs in all areas. As your child grows older, additional assessments may be necessary.
In conclusion, cerebral palsy is diagnosed by a complete examination of your child's current health status. Doctors will test your child's motor skills and look carefully at his or her medical history. They will also look for slow development, abnormal muscle tone, and unusual posture. When diagnosing cerebral palsy, doctors must rule out other disorders that can cause abnormal movements. Cerebral palsy does not get worse. In other words, it is not progressive. Based on this fact, doctors must make the determination that your child's condition is not progressively getting worse. Doctors will also use a number of different specialized tests in diagnosing cerebral palsy. For example, the doctor may order a CT (computed tomography). This is an imaging of the brain that can determine underdeveloped areas of brain tissue. The doctor may also order an MRI (magnetic resonance imaging). This test also generates a picture of the brain to determine areas that may be damaged. In addition to these imaging tests, intelligence testing is also used. This helps to determine if a child is behind from a mental standpoint. In addition to diagnosing cerebral palsy through a complete and thorough examination of the child's abnormalities and behaviors, a review of the mother's pregnancy, labor and delivery and care received is also conducted.
* Lethargy, or lack of alertness
* Irritability or fussiness
* Abnormal, high-pitched cry
* Trembling of the arms and legs
* Poor feeding abilities secondary to problems sucking and swallowing
* Low muscle tone
* Abnormal posture, such as the child favoring one side of the body
* Seizures, staring spells, eye fluttering, body twitching
* Abnormal reflexes.
During the first six months of life, other signs of brain injury suggestive of cerebral palsy also may appear in an infants muscle tone and posture. These signs include:
* Muscle tone may change gradually from low tone to high tone; a baby may go from floppy to very stiff.
* The child may hold his or her hand in tight fists.
* There may be asymmetries of movement, that is, one side of the body may move more easily and freely than the other side.
* The infant may feed poorly, with their tongue pushing food out of their mouth forcefully.
Once a baby with brain damage reaches six months of age, it usually becomes quite apparent that he or she is picking up movement skills slower than normal. Infants with cerebral palsy are more often slow to reach certain developmental milestones, such as rolling over, sitting up, crawling, walking and talking. Parents are more likely to notice developmental delays, abnormal behaviors, and signs of cerebral palsy, especially if this is not their first child. Sometimes when they express their concerns to their physicians, their child is immediately diagnosed as having cerebral palsy. More often, however, medical professionals hesitate to use the term "cerebral palsy"at first. Instead, they may use broader terms such as:
* Developmental delay, which means that a child is slower than normal to develop movement skills such as rolling over and sitting up
* Neuromotor dysfunction, or delay in the maturation of the nervous system
* Motor disability, indicating a long term movement problem
* Central nervous system dysfunction, which is a general term to indicate the brain's improper functioning
* Static encephalopathy, meaning abnormal brain function that is not getting worse.
So why do doctors frequently delay making a final diagnosis and prognosis when a child may have cerebral palsy? Part of the answer lies in the plasticity of a child's central nervous system, or it's ability to recover completely or partially after an injury occurs. The brains of very young children have a much greater capacity to repair themselves than do adult brains. If a brain injury occurs early, the undamaged areas of a child's brain can sometimes take over some of the functions of the damaged areas. Although the child may have some motor impairment, he or she can often make great progress in other motor skills.
Another reason doctors may delay a diagnosis of cerebral palsy is that a child's nervous system organizes over time. Damage to the brain may affect your child's motor abilities differently. For example, tone can go from low to high or vice versa, or involuntary movements can become more obvious. Generally, however, a child's motor symptoms stabilize by two to three years of age. After this age, tone is probably not going to change dramatically.
So what does all of this mean? It means that a cerebral palsy diagnosis is not made over night. Since the extent of your child's problems will probably not be clear for some time, his or her symptoms need to be monitored by an interdisciplinary team. This is a group of professionals with specialties in different areas. These health care professionals gather information on the child's accomplishments and make comparisons over the months and years of the child's life. They will keep you up to date on your child's current needs and problems, as well as the medical reasons for these problems, if known. When diagnosing cerebral palsy, the interdisciplinary team must first conduct an assessment, or evaluation of the child's strengths and needs in all areas. As your child grows older, additional assessments may be necessary.
In conclusion, cerebral palsy is diagnosed by a complete examination of your child's current health status. Doctors will test your child's motor skills and look carefully at his or her medical history. They will also look for slow development, abnormal muscle tone, and unusual posture. When diagnosing cerebral palsy, doctors must rule out other disorders that can cause abnormal movements. Cerebral palsy does not get worse. In other words, it is not progressive. Based on this fact, doctors must make the determination that your child's condition is not progressively getting worse. Doctors will also use a number of different specialized tests in diagnosing cerebral palsy. For example, the doctor may order a CT (computed tomography). This is an imaging of the brain that can determine underdeveloped areas of brain tissue. The doctor may also order an MRI (magnetic resonance imaging). This test also generates a picture of the brain to determine areas that may be damaged. In addition to these imaging tests, intelligence testing is also used. This helps to determine if a child is behind from a mental standpoint. In addition to diagnosing cerebral palsy through a complete and thorough examination of the child's abnormalities and behaviors, a review of the mother's pregnancy, labor and delivery and care received is also conducted.
About cerebral palsy
Definition of cerebral palsy
Definition of Cerebral Palsy The syndrome is caused by non-progressive brain damage occurring before birth or within 1 month after birth. The damage is to the brains motor control c...
Causes of cerebral palsy
Causes of Cerebral Palsy Why does your child have cerebral palsy? The simplest answer to this question is because your child has brain damage.This leads naturally into the second qu...
Cerebral palsy diagnosis
Cerebral Palsy Diagnosis How is the diagnosis of cerebral palsy made? When an infant or child has brain damage, a variety of symptoms can lead doctors and parents to suspect that so...
Cerebral palsy statistics
Cerebral Palsy Statistics Because cerebral palsy influences the way children develop, it is known as a developmental disability. In the United States today, more people have cerebra...
Definition of cerebral palsy
Definition of Cerebral Palsy The syndrome is caused by non-progressive brain damage occurring before birth or within 1 month after birth. The damage is to the brains motor control c...
History of cerebral palsy in children
History of Cerebral Palsy in Children Cerebral palsy is not a new disorder.There have probably been children with cerebral palsy as long as there have been children. But the medical...
Types of cerebral palsy
Types of Cerebral Palsy Cerebral palsy is a broad term that encompasses many different disorders of movement and posture. To describe particular types of movement disorders covered ...
Definition of Cerebral Palsy The syndrome is caused by non-progressive brain damage occurring before birth or within 1 month after birth. The damage is to the brains motor control c...
Causes of cerebral palsy
Causes of Cerebral Palsy Why does your child have cerebral palsy? The simplest answer to this question is because your child has brain damage.This leads naturally into the second qu...
Cerebral palsy diagnosis
Cerebral Palsy Diagnosis How is the diagnosis of cerebral palsy made? When an infant or child has brain damage, a variety of symptoms can lead doctors and parents to suspect that so...
Cerebral palsy statistics
Cerebral Palsy Statistics Because cerebral palsy influences the way children develop, it is known as a developmental disability. In the United States today, more people have cerebra...
Definition of cerebral palsy
Definition of Cerebral Palsy The syndrome is caused by non-progressive brain damage occurring before birth or within 1 month after birth. The damage is to the brains motor control c...
History of cerebral palsy in children
History of Cerebral Palsy in Children Cerebral palsy is not a new disorder.There have probably been children with cerebral palsy as long as there have been children. But the medical...
Types of cerebral palsy
Types of Cerebral Palsy Cerebral palsy is a broad term that encompasses many different disorders of movement and posture. To describe particular types of movement disorders covered ...
Cerebral Palsy Statistics
Because cerebral palsy influences the way children develop, it is known as a developmental disability. In the United States
Although children with very mild cerebral palsy occasionally recover by the time they are school-aged, cerebral palsy is usually a lifelong disability. In most cases, the movement and other problems associated with cerebral palsy will affect to varying degrees what a child is able to learn and do throughout life.
Although children with very mild cerebral palsy occasionally recover by the time they are school-aged, cerebral palsy is usually a lifelong disability. In most cases, the movement and other problems associated with cerebral palsy will affect to varying degrees what a child is able to learn and do throughout life.
Types of cerebral palsy
Cerebral palsy is a broad term that encompasses many different disorders of movement and posture. To describe particular types of movement disorders covered by the term, pediatricians, neurologists, and therapists use several classification systems and many labels. To understand different types of cerebral palsy more clearly, you must first understand what professionals mean by muscle tone.
All children with cerebral palsy have damage to the area of the brain that controls muscle tone. As a result, they may have increased muscle tone, reduced muscle tone, or a combination of the two (fluctuating tone). Which parts of their bodies are affected by the abnormal muscle tone depends upon where the brain damage occurs.
There are three main types of cerebral palsy:
All children with cerebral palsy have damage to the area of the brain that controls muscle tone. As a result, they may have increased muscle tone, reduced muscle tone, or a combination of the two (fluctuating tone). Which parts of their bodies are affected by the abnormal muscle tone depends upon where the brain damage occurs.
There are three main types of cerebral palsy:
- Spastic Cerebral Palsy
(stiff and difficult movement) - Athetoid Cerebral Palsy
(involuntary and uncontrolled movement) - Ataxic Cerebral Palsy
(disturbed sense of balance and depth perception) - Mixed Cerebral Palsy
There may be a combination of these types of cerebral palsy for any one person.
Causes of Cerebral Palsy
Causes of Cerebral Palsy
Why does your child have cerebral palsy? The simplest answer to this question is because your child has brain damage. This leads naturally into the second question: Why does your child have brain damage? There are many possible answers to this second question, because there are many reasons children can sustain brain damage. Your doctor must carefully review your child's health history and conduct a variety of medical and neurological tests to help determine the cause. Cerebral palsy is caused by an injury to the brain before, during, or shortly after birth. In many cases, no one knows for sure what caused the brain injury or what may have been done to prevent the injury. A large number of factors which can injure the developing brain may produce cerebral palsy. In general, however, there are two problems that can cause cerebral palsy:
1. Failure of the brain to develop properly (developmental brain malformation)
2. Neurological damage to the child's developing brain
Whatever the cause of your child's cerebral palsy, the severity of the brain damage generally depends on the type and timing of the injury. For example, in very premature babies, bleeding into the brain (intraventricular hemorrhage) can cause extensive damage. Also, the longer an unborn child goes without oxygen, the greater the extent of brain tissue damage.
Ten to fifteen percent of cerebral palsy is caused from a recognized brain injury, such as infection (like meningitis), bleeding into the brain, and damage caused by lack of oxygen. It is very important that you understand that a brain injury caused during delivery in many cases could have been prevented. Medical mistakes are responsible for thousands and thousands of cerebral palsy cases. It would be virtually impossible for a parent, on their own, to determine if a medical mistake caused their child's cerebral palsy or brain damage. It is only through the concerted efforts of a legal/medical team that can answer the question, "was my child's cerebral palsy preventable?"
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