Cerebral Palsy

This term is applied to several disorders caused by damage to the brain. Symptoms usually appear in the first year of life and include poor head control, feeding difficulties and delays in motor development. As children get older, they have difficulty moving and controlling the arms, legs and trunk, and they may be unable to stand or walk.

Depending on the type of cerebral palsy the child has, one or both sides of the body may be affected. The disease does not progress with age, but other factors, such as excess weight gain, may lead to increasing disability over time.

WHAT CAUSES CEREBRAL PALSY?
Cerebral palsy is often found in children who have suffered brain damage before, during or immediately after birth. Not all children with cerebral palsy have such a history, though.

During birth, lack of oxygen and bleeding in the baby's brain may result in cerebral palsy. Head trauma and meningitis in the first days after birth are other potential causes. Premature babies are at a higher risk of developing cerebral palsy than babies born at full term.

WHEN SHOULD I SUSPECT THAT MY CHILD HAS CEREBRAL PALSY?
The disorder is sometimes difficult to detect before the baby is one year old, particularly if he was born prematurely. You should, however, suspect some kind of neurologic problem if your baby:

• Has difficulty sucking and feeding

• Lies in an awkward position, especially with one arm stretched out, the other arm above her head, and her neck turned toward the outstretched arm

• Startles excessively

• Shows a delay in reaching such development milestones as rolling over and pushing up on all fours.

• Prefers using one hand before the age of one year (suggesting weakness in the other)

• Crawls abnormally, using hands only or relying on one arm and one leg on the same side

• Seems to be either excessively stiff or floppy

HOW CAN THE PEDIATRICIAN TELL IF MY CHILD HAS CEREBRAL PALSY?
The diagnosis begins with a neurologic examination, which is usually supplemented by studies such as computed tomography (CT), which produces an image of the brain that may show abnormalities characteristic of cerebral palsy. In addition, doctors usually order a series of tests to exclude other possible causes.

WHAT TREATMENTS ARE AVAILABLE?
Cerebral palsy cannot be cured, but it can be managed to prevent complications and maximize the child's independence.

The program of management involves specialists from several disciplines who work as a team. Specifics vary according to each child's needs, but most treatment programs include physical, occupational and speech therapy.

Many children with cerebral palsy use mobility aids such as scooter boards, special strollers and wheelchairs. These aids, as well as newly developed electronic devices that enhance disabled children's communication abilities, are often ordered through the clinic that coordinates all the child's care. About one-half of children with cerebral palsy have some degree of mental retardation, so the child may need to be in a special education program. Children with cerebral palsy may also require frequent medical attention for seizures, skeletal problems and other complications.

PREVENTING CEREBRAL PALSY
Most factors that result in cerebral palsy are beyond the parents' control. You can, however:

• Consult a doctor before using medications during pregnancy.

• Take measures to prevent premature birth.

CARING FOR A CHILD WITH CEREBRAL PALSY

• Use feeding techniques that make it easier to suck, chew or swallow food. For specific pointers, consult an occupational therapist.

• Feed the child plenty of fiber-rich foods to reduce constipation.

• Get involved in the child's speech therapy and physical therapy. Find out about exercises and techniques you can perform at home.

• If the child has speech or hearing difficulties, use alternative ways of communication, such as gestures, sign language, a communication board or book or an adapted typewriter or computer.

• Look into special government-mandated early intervention programs.

Excerpt from THE DISNEY ENCYCLOPEDIA OF BABY & CHILD CARE, © 1995 DSH Communications, Inc. This material is based on current medical research and, to the best of the editors' knowledge and understanding, is accurate and valid. However the reader should not use information contained in this material to alter a medically prescribed regimen or as a form of self-treatment, without seeking the advice of a licensed physician.