Cerebral palsy refers to non-progressive posture and movement disorder and weakness due to a condition to which the developing brain is exposed. The prevalence of this disease in our society is 4 in 1000. This condition is usually accompanied by epilepsy, mental retardation, hearing and vision problems. It may develop in the period before the age of two years due to intrauterine, intrapartum and postnatal causes.
What is Cerebral Palsy?
Cerebral palsy is also popularly known as cerebral palsy. Cerebral palsy occurs due to damage to the brain during or after birth. It is a lifelong disease in which the person cannot control their muscles, their movements and posture are severely affected and even motor skills become dysfunctional.
Types of Cerebral Palsy
Close neurologic follow-up of all high-risk infants is important for early recognition and rehabilitation of the disease. Cerebral palsy is classified as spastic, dyskinetic, ataxic and mixed type.
- Spastic type may be bilateral (quadriparesis, diparesis) or unilateral (hemiparesis).
- Dyskinetic type is divided into choreoatetoic and dystonic types.
- Ataxic type is the least common.
- In mixed type, two clinical types are observed together.
Spastic diparesis is the most common type in premature babies. Dyskinetic type is observed in infants who undergo exchange transfusion due to high jaundice (kernicterus picture). The most severe prognosis is in the spastic quadriparesis type. Spastic hemiparesis is caused by congenital brain development disorders, vascular causes and bleeding. Brain imaging (CT, MRI) is used in the diagnosis of cerebral palsy.
Causes of Cerebral Palsy
Factors that causecerebral palsy are examined in three different periods. These are prenatal, birth and postnatal periods.
Inthe prenatal period, maternal diseases and drug use, as well as radiation intake or trauma can cause cerebral palsy. Consanguineous marriage is also an important factor.
At the time of birth, cerebral palsy may occur due to cord entanglement, premature or late delivery, multiple pregnancy and birth traumas, and oxygen deprivation of the baby at birth.
In the postnatal period, cerebral hemorrhage, convulsions, febrile diseases and hypoglycemia can also cause cerebral palsy.
Symptoms of Cerebral Palsy
The main symptoms of this disease, also called cerebral palsy, are difficulty in movement, coordination problems, difficulty in speaking, and constant irritability. Symptoms of cerebral palsy can be listed as follows.
- Frequent falls
- Difficulty swallowing
- Poor muscle coordination
- Delays in motor skill development
- Speech retardation and impairment
- Involuntary movements
How is Cerebral Palsy Diagnosed?
Babies should be examined by a specialist if there is constant crying, if they always close their hands and do not open them, if there is no symmetry in their arms and legs. A pediatric neurology specialist should also examine the baby if the baby is in the period when he/she can normally do so but cannot hold his/her head upright, sit without support or stand and walk. A pediatric neurologist can diagnose this disease in children and infants from the outside. However, he/she may delay the diagnosis because the brain development of children progresses very rapidly. EEG examination is also necessary in patients with epilepsy.
In the early diagnosis of cerebral palsy, the prechtl method called gait analysis and movement analysis is used. Babies with cerebral palsy between the ages of 0-5 are videotaped for 30 minutes and their general movements are analyzed.
Cerebral Palsy Treatment
Cerebral palsy is not a completely curable disease. Treatment methods can be applied to alleviate the side effects and symptoms of the disease. Treatment of cerebral palsy includes medications for convulsions, physiotherapy, botulinum toxin, and orthopedic interventions for permanent contractures. A multidisciplinary approach is essential for these patients due to feeding difficulties due to swallowing dysfunction that may accompany especially in severe cases, respiratory problems in bedridden patients, behavioral problems in patients with moderate and severe mental retardation, hearing and visual defects.
New treatment models, intravenous and intrathecal methods, can be applied according to the patient's condition. In the treatment of Cerebral Palsy (CP), intravenous applications are the method of administering various drugs or biological agents directly into the circulation through the vein. Intrathecal applications are the treatment method of administering drugs directly into the spinal fluid (cerebrospinal fluid or CSF). Such treatment methods are used to alleviate the symptoms of the disease and improve the patient's quality of life. Intranasal intramuscular applications are also added and even applied in the form of cures.
