Description of cerebral palsy
Cerebral palsy (CP) is a term that represents a group of chronic diseases, which are characterized by disorders of central control momentum. The term children is the period in which the disease begins to manifest, label the brain, indicates the place where there is a fault (in the brain) and polio term indicates that the disease causing problems with the momentum of the body.
DMO only affects the brain, which means that does not involve movement disorders caused by disease, peripheral nerves or muscles. Palsy leads to poor development or damage to motor (driving) of the brain, and this results in insufficient control of momentum and faulty posture (posture), trunk and limbs. DMO are seen already in the first months or years of life, but usually with increasing age has been getting worse.
Risk factors for cerebral palsy
Experts had years to observe the course of pregnancy for expectant mothers, track the delivery and monitoring of early neurological development, so they can mark certain characteristic phenomena called. Risk factors that increase the likelihood of illness of a child this serious disease.
Children who later develop symptoms of cerebral palsy are often born legs first place with a header, which is called the breech.
Abnormal brain development in children with cerebral palsy can be caused by various circulatory or respiratory problems during a complicated birth of a child.
The risk of cerebral palsy can also affect children who are born with visible developmental defects and congenital malformations outside the nervous system, which eg. Include spina bifida (spina bifida), facial malformations etc.
Also, children who are born with malformations of the nervous system, may suffer from cerebral palsy. As an example, microcephaly (small head).
Low Apgar score (AS) also has an effect on the risk of disease poliomyelitis. AS characterizes the condition of the newborn. To determine the values AS doctors regularly monitor novorozencovu heart rate, respiration, reflexes, muscle tension and skin color. Individual awards will judge points from 1 to 10. The higher the value, the state is closer to the norm.
Multiple pregnancy can also influence the formation of cerebral palsy. Twins or multiples have a higher risk of developing this serious disease.
Another risk factor may be low birth weight and prematurity (prematurity). DMO risk increases proportionally with decreasing birth weight. The risk can represent weight under 2500 g birth before the 37th week of pregnancy.
The risk also brings vaginal bleeding between 6 to 9 months or proteinuria (high content of protein in the urine) mothers in the last weeks of pregnancy.
Finally, we have included risk factors and hyperthyroidism (overactive thyroid gland), mental retardation (mental retardation) and epilepsy mother.
Pay special attention and possible seizures that can affect newborns at an early age, because even this can be a warning sign that the child in later life reflected DMO. Epileptic seizures are caused by brain injury, but they are not the cause of cerebral palsy, but one of the many symptoms.
The aforementioned warning signs may help experts in identification of a child who would in later times could suffer from neurological disorders. However, if your child has one or more factors, not a cause for concern.
Preventing cerebral palsy
First, it should be noted that the DMO can be divided into two categories, depending on when the disease began to show. There DMO acquired and congenital.
The resulting cerebral palsy is caused by brain damage in the first months or years of life. It could also be brain infections, eg. Bacterial meningitis (inflammation of the brain) or viral encephalitis (inflammation of the brain). For the formation of the DMO and mechanical brain injury, eg. In childbirth, after the fall, when abuse etc.
Congenital cerebral palsy occurs prenatally (before birth), but may not be in the first months of life recognized, but in most cases will occur within three years of life. The cause of congenital cerebral palsy is still unclear. However, experts have found a few specific situations that can lead to impaired development of the brain motor centers, and thereby to discover the DMO. Among these events we can arrange an example. Neonatal jaundice, Rh incompatibility, infection during pregnancy (German measles-rubella, toxoplasmosis, cytomegalovirus), an insufficient amount of oxygen in the brain (hypoxia) or injury to the head during childbirth, or stroke affecting the unborn fetus or newborn.
Congenital cerebral palsy mother can prevent healthy lifestyle, regular prenatal care and varied diet.It is necessary that the future mother refrain from smoking tobacco, drinking alcohol and taking drugs.
The incidence of rubella vaccine prevents.
Head injury, which may be the cause of acquired cerebral palsy can be prevented by using protective helmets, child seats and prevent child abuse.
This effective preventive measures are limited, as the exact causes of cerebral palsy are not fully understood despite the best efforts of parents can not always guarantee that the disease does not DMO.
Signs and symptoms of cerebral palsy
There are several forms of cerebral palsy, which can be divided according to the type of locomotor disorders to form spastic, athetoidní, ataxic and mixed.
Spastic affects 70-80% of patients. It is characterized by stiff and permanently downloaded (spastic) muscles on the affected areas. In this case, we encounter two problems. With paresis (weakness) and plegia (paralysis). Depending on the number of affected limbs may indicate a spastic diparesis / diplegic (involvement of both lower limbs), hemiparesis / hemiplegia (involvement of limbs on one side of the body), triparézu / triplegii (involvement of both lower and one upper limb) or quadruparézu / quadriplegic (impairment in all four limbs ).
Patients who suffer from spasticity of both legs and are able to walk, stand called. Scissor gait(Eng. Scissors gait) when their lower limbs stiff and turning inwards knees are touching each other.In patients with spastic hemiparesis may appear so. Hemiparetický tremor, at which an uncontrollable movement of the limbs affected part of the body.
Athetoidní (dyskinetic) form is typical 10-20% of patients with a diagnosis of cerebral palsy.These patients suffer from involuntary torsional and slow movements of hands, feet, or entire upper and lower extremities. These movements can also affect the muscles of the face, causing the emergence of various grimaces, smacking and žmoulání mouth.
Athetoidní movements are stronger and more aggressive in stressful situations, for example, but in sleep disappear altogether. Athetoidní people with cerebral palsy may not be able to speak (to suffer so. Dysarthria), because they are not able to control muscle coordination necessary for articulation.
Ataxic cerebral palsy is rare, affecting 5-10% of patients. This form of damages the perception of balance and proprioception (sensitivity). Patients with this disease have poor motor coordination, their gait is very unstable and on a broad basis (considered feet apart), they are called.Drunken gait. These people also have problems with accurate and fast movements that we use when writing. They suffer so. Intenčním tremor, a tremor that occurs during activities governed by the will.
Combining these three species may develop a mixed form of cerebral palsy. Most frequently, a combination of spastic and athetoidní mold.
Symptoms usually appear in the third year of life. We can notice a child abnormal or delayed development of motor skills, for example. Retake, climbing, sitting, standing, walking).
You can also observe abnormal muscle tone (muscle tension). There are two types of muscle tension. Hypotonia is a condition where the muscle tone is lowered and the child operates flabby appearance. Conversely hypertonia, increased muscle tone causes topornost, stiffness and rigidity of the child. The child may initially be hypotonic and during development may occur twist to hypertension.
Children diagnosed with cerebral palsy may have an abnormal attitude (posture) or they may unconsciously prefer one half of the body (predilection).
Treatment of cerebral palsy
The illness is unfortunately impossible to cure. But treatment can bring positive results and may pleasantly affect the quality of life of the patient. It is proven that children who were started on time, proper treatment can lead a normal daily life. This disease is also complicated in that there is no standard treatment thereof. Each child has their own individual neurological disorders and resulting specific needs that doctor must recognize and take into account.
Because disorders also affect many other organ systems, we need to cooperate in therapyspecialists from various fields.
Leading the team is generally appointed neurologist who is responsible for the conduct of the therapeutic program, and to coordinate the investigation. Another member of the physiotherapistpreparers a targeted exercise program for improving the residual motor abilities.
This group includes medical and orthopedic surgeon, specialist in impaired development of bones, muscles, tendons and the entire locomotor (musculoskeletal) system.
An essential member is a neurosurgeon who can operatively or conservatively solve the defects of the nervous system and its supporting tissues.
Even in this team includes speech therapist who cares for patients with speech impairments,special educator and a social worker.
To complete assembly should be added as well as a psychologist who helps the patient and his family cope with disabilities, handle stressful situations associated with this disease.
However, the key and most important member of the team is very patient and his family. From the outset of treatment should be all members involved in the planning, decision-making and to the realization of therapy.
Do therapy can also include administration of anti-epileptic drugs (AEDs), medications to ease muscle spasms (botulinum toxin, myorelaxantia), drugs that supports brain metabolism(nootropics). The patient can also help various splints and braces, which mitigate the effects of muscle imbalance, and other aids to help him overcome his disability.
Treatment goal should not be focused only on movement disorders, but also to develop the skills and the whole personality, which will later on be able to itself, to the extent possible, take care and to learn to cope with all sorts of different tasks alternative methods.
How can I help myself
The place is a question of how you can help your child just you.
For a child is most especially your full support, patience and loving care. Try to involve the child inthe company of other healthy children to learn the base and communicate with their peers, and that among them found their place. There is nothing worse than a child to keep his illness in isolation.
Teach him movement and various skills, which can be paid in their spare time. Remind him that some activities can perform just as well or even better than healthy children, and vice versa leave aside the mention of its limitations.
Help your child quietly and gently to overcome his handicap, but leave him alone to test their limits, because it is best to recognize and cope with them. In any case, avoid any pity or compassion.
Complications of cerebral palsy
Disease DMO may be accompanied by other problems, for example. Mental retardation, epilepsy, hydrocephalus (disorder of creation and circulation of cerebrospinal fluid, which causes abnormal growth of brain and Moks chambers and skull), growth retardation (lower growth, delayed development of secondary sexual characteristics at puberty , weakening the affected limbs), impaired vision and hearing (squint – strabismus), impaired sense of touch and pain, impaired body image.
Other names: cerebral palsy, infantile cerebral paresis, ICP, spastic cerebral palsy, ataxic cerebral palsy, dyskinetic cerebral palsy, spastic cerebral palsy, ataxic cerebral palsy
