Cerebral Palsy: What You Should Know
Receiving a diagnosis of “cerebral palsy (CP)” can be frightening for a parent, because of the perceived negative connotations associated with the disorder, and because the definition may have different meanings to different people. CP is a neurological disorder characterized by abnormal motor function due to some type of insult to the developing brain. There are many different causes of CP, including prenatal insults, birth-related problems, and prematurity. Any early injury to the developing brain within the first several years of life, including trauma, metabolic disorders, infections, and other problems, can lead to CP.
The spectrum of CP is vast, and can range from mild tightness in a limb, causing little to no gait disturbance, to severe global involvement, with significant cognitive delay, language and intellectual impairments, and severe tightness and disuse of arms and legs. Thus, a child with CP may function with only a very mild problem requiring nothing more than observation, or may be wheelchair bound, requiring maximal assistance with all activities.
Children with CP may have delayed growth and development, intellectual disabilities, spinal deformities, impaired vision, and speech and language disorders. Almost half of all children with CP have seizure disorders.
The motor manifestations of CP are commonly divided into three broad categories:
Spastic CP is the most common type, and is associated with increased muscle tone or stiffness, in the legs more so than arms, often resulting in gait impairment or difficulties with fine motor tasks. Dyskinesia is characterized by uncontrollable movements or abnormal, involuntary postures, and can lead to problems with limb function, as well as embarrassment in social situations. Children with ataxia have difficulties with coordination and balance.
Often, the clinical picture is mixed, with a variety of motor disturbances. Most cases of CP are due to a “one-time” insult to the brain, although the motor manifestations may change, particularly during the first decade of life, and different problems may become manifest with growth and maturation. Additional, orthopedic disorders involving the limbs and spine often worsen with linear growth of the child.
Many studies have shown that early intervention can help improve the quality of life of children with CP. This is why multidisciplinary care may lead to the best possible outcome for a child. This approach at Phoenix Children’s Hospital Center for CP and Barrow Neurological Institute at Phoenix Children’s Hospital allows us to individualize and optimize the care that a child will receive. Our multidisciplinary team includes some of the most respected pediatric cerebral palsy and neurological specialists in the country. A comprehensive approach to treating cerebral palsy begins with early awareness of an episode or event that puts a child at risk for cerebral palsy. The neonatal intensive care unit and the Phoenix Children’s Fetal Care Network are especially equipped to recognize these high-risk situations, to ensure close surveillance of at-risk children.
Dedicated specialists provide a multidisciplinary approach for children with these complex conditions and a variety of interventions which improve the quality of life for children with CP. These pediatric specialties include physical medicine and rehabilitation, orthopedics, neurosurgery, neurology, pulmonology, gastroenterology, and developmental pediatrics. Additionally, physical, occupational, and speech / swallowing therapists, social workers, adaptive seating specialists, and psychologists play vital roles in optimizing patient outcomes. These specialists work together in order to develop a comprehensive and patient-focused treatment plan, personalized to a child and his or her family.