Cerebral palsy is an abnormality of motor function that is acquired before or during early childhood and affects movement, posture, and balance. It can be caused by events during pregnancy like premature birth, genetic disorders, infections, strokes or lack of oxygen to the brain. The main types of cerebral palsy are spastic, which affects muscle tone, ataxic which affects coordination, and athetoid with involuntary movements. Treatment involves physical, occupational and speech therapy as well as medications to address symptoms, with the goal of helping those with cerebral palsy to lead full lives.

1. Cerebral Palsy Maria Vander Kolk Dr. Gayheart

2. What is Cerebral Palsy Cerebral palsy (CP) is an abnormality of motor function (as opposed to mental function) and postural tone that is acquired at an early age, even before birth. Signs and symptoms of cerebral palsy usually show in the first year of life.

3. What Causes Cerebral Palsy Events that happen during pregnancy can cause Cerebral Palsy. The premature brain is at a high risk of bleeding, and when severe enough, it can result in cerebral palsy. Children that are born prematurely can also develop serious respiratory distress due to immature and poorly developed lungs. This can lead to periods of decreased oxygen delivered to the brain that might result in cerebral palsy White matter abnormalities are observed in many cases of cerebral palsy. Genetic disorders Stroke Blood Clots Infections of the brain Rare cause is lack of oxygen to the brain at delivery (seizures, irritability, jitteriness, feeding and respiratory problems, lethargy, and coma depending on severity.

4. Signs and symptoms Issues with the following… Muscle tone Movement, coordination, and control Reflexes Posture Balance Fine motor function Gross motor function Oromotor dysfunction- difficulty using the lips, tongue, and jaw Developmental delay Developmental milestones lacking

5. Types of Cerebral Palsy Spastic Ataxia Athetoid Mixed

6. Spastic Cerebral Palsy Spastic cerebral palsy, the most common form of the disease, occurs when the brain damage occurs in the outer layer of the brain, the cerebral cortex. It is estimated that this form of CP affects between 70 to 80 percent of patients. Spastic CP affects patients in different ways, depending on the areas of the body it affects. It can affect one side of the body or just the legs.

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9. Ataxia Cerebral Palsy Low muscle tone and poor coordination of movements is described as ataxic cerebral palsy. Children with ataxic cerebral palsy look very unsteady and shaky. This rare form of cerebral palsy affects the sense of balance and depth perception. Affected persons often have poor coordination and walk unsteadily with a wide based gait, placing their feet unusually far apart. They have a lot of shakiness, like a tremor you might have seen in a very old person, especially when they are trying to handle or hold a small object such as a pen. Because of the shaky movements and problems coordinating their muscles, children with ataxic cerebral palsy may take longer than other children to complete certain tasks such as writing a sentence. This form affects about 5-10 percent of the children diagnosed with cerebral palsy.

10. Athetoid cerebral palsy About 10 percent of children with cerebral palsy have athetoid cerebral palsy. Athetoid cerebral palsy is caused by damage to the cerebellum or basal ganglia. These areas of the brain are responsible for processing the signals that enable smooth, coordinated movements as well as maintaining body posture. Damage to these areas may cause a child to develop involuntary, purposeless movements, especially in the face, arms, and trunk. These involuntary movements often interfere with speaking, feeding, reaching, grasping, and other skills requiring coordinated movements. For example, involuntary grimacing and tongue thrusting may lead to swallowing problems, drooling and slurred speech. The movements often increase during periods of emotional stress and disappear during sleep. In addition, children with athetoid cerebral palsy often have low muscle tone and have problems maintaining posture for sitting and walking.

11. Mixed cerebral palsy About ten percent of children with cerebral palsy have what is known a mixed-type cerebral palsy. These children have both the tight muscle tone of spastic cerebral palsy and the involuntary movements of athetoid cerebral palsy. This is because they have injuries to both the pyramidal and extra pyramidal areas of the brain. Usually the spasticity is more obvious at first, with involuntary movements increasing when the child is between nine months and three years old. The most common mixed form includes spasticity and athetoid movements, but other combinations are also possible.

12. Treatment The physical therapist evaluates muscle tone, strength and gait (walking). The occupational therapist reviews the child's ability to perform tasks of self-help and care -- from feeding to manual dexterity. The speech therapist evaluates the child's ability to speak and understand speech. Medications for spasticity, seizures, surgery for spasticity, seizures, and vision issues are also treatment options. Children will need specialized medical care by a doctor to work with their diagnosis. Because physicians have offered limited hope in curing cerebral palsy, many families have turned to alternative methods in the treatment of their children. Such therapies may include diets, herbal remedies, aromas, play with animals, and hyperbaric oxygen.

13. Secondary impairments Some of them such as poor speech, swallowing disorders, drooling, and poor fine or gross motor coordination are the result of the motor disorder affecting specific muscles involved in those functions. Other conditions are the results of simultaneous injuries in areas of the brain besides the motor areas. Cognitive disabilities, sometimes referred to as developmental delay, is often associated with cerebral palsy. Up to 50% of patients with cerebral palsy have cognitive disabilities. However, many of these children can be educated and lead productive lives and are usually only mildly or not at all intellectually impaired. Small head size Seizures Vision issues It is difficult for children with cerebral palsy to gain weight and frequently have delayed growth. Can cause gastro esophageal reflux or obesity. Urinary tract infections Osteoporosis Fractures Constipation

14. Prognosis for recovery Since cerebral palsy is actually a set of symptoms associated with a variety of causes, potential treatments will have to be diverse. Many scientists are now focusing on recent discoveries that suggest we will be able to replace lost or damaged brain cells. We must recognize that many, and possibly most, children with cerebral palsy can lead full, meaningful, and happy lives. The team of parents, caregivers, and health practitioners have the responsibility to help the child with cerebral palsy achieve this goal. We must be sure not to leave children with CP behind and understand that they have unique qualities to share.

15. references www.medicinenet.com/cerebral_palsy/page6.htm www.cerebralpalsy.org/what-is-cerebral-palsy/symptoms/ http://www.cerebralpalsylawdoctor.com/cerebral-palsy/types/spastic/ http://www.about-cerebral-palsy.org/definition/mixed-cerebral-palsy.html