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Coping With Cerebral Palsy (CP)

 

What is CP ?

Cerebral palsy (CP) is a term used to describe disorders that affect a child's movements and posture. CP is the result of a brain injury suffered in while in the utero, while a baby is developing in the womb. Premature babies, especially those born before 28 weeks, are at a higher risk of being diagnosed with this disorder. CP can also result from an injury in a near drowning, infection or car accident. 

 

In general, CP does not get worse over time. There is no cure for the condition. Therapy can help your child.

CP has been noted to be 2-4 / 1000 births in Africa as at 2014. 

 

How do you know your child has CP?

If your child is not rolling, sitting or walking by the expected time, it may be a sign that they have CP. Children develop their milestones at different rates. It doesn't mean that if there is a delay it is CP. Children even among siblings they may walk at different times. You can consult with your doctor if not a delay. 

 

Symptoms of CP can be very different in every child. Children with cerebral palsy may have problems with:

  • Delayed Milestones: Sitting, standing , walking etc

  • Motor skills- unable to grasp objects well, swallow well.

  • Muscle weakness

  • Muscle tone (stiffness or abnormally loose)

  • Balance

  • Awkwardness: unusual muscle movements

  • Slowness

  • Seizures

  • Learning disabilities

  • Speech

These problems can range from mild to severe. In mild cerebral palsy, the child may be slightly clumsy in one arm or leg, and the problem may be barely noticeable. In severe cerebral palsy, the child may have a lot of difficulties in performing everyday tasks and movements.

 

What are the types of CP?

Different types of CP cause different symptoms:

Spastic

This is the most common form of CP. Symptoms include:

  • tight muscles and exaggerated reflexes

  • difficulty moving 

  • a few muscles or the whole body may be affected

Athetoid

This type of CP is marked by involuntary movements. Other symptoms include:

  • squirming

  • looking as if the child is constantly moving

Atonic

The atonic child is weak, floppy and lacks normal muscle tone. Symptoms of this type of CP include: 

  • poor balance

  • poor depth perception

  • an unsteady walk

  • poor coordination

Mixed

This type of CP occurs when the child has a combination of spastic, athetoid or atonic CP symptoms. 

CP can affect different parts of the body. There are terms to describe the part of the body affected:

  • Monoplegia: one arm or one leg is affected

  • Hemiplegia: the arm and leg on the same side are affected

  • Paraplegia: only the legs are affected

  • Diplegia: paralysis of similar parts on both sides of the body

  • Quadriplegia: both arms and both legs are affected

Does CP get worse ? 

 

No, the damage done to the brain does not become worse. However, as your child grows, it may seem that your child’s condition is changing or becoming worse. It may seem this way for a number of reasons. 

 

The bones in children with cerebral palsy grow more quickly than the muscles. Muscles are stimulated to grow in length by moving and being stretched. This normally occurs throughout the day during a child’s activities and play time. In children with cerebral palsy, decreased control of muscles and increased muscle stiffness prevent muscles from moving through their full range of motion as easily or as often as other children. Because the bones grow faster than the muscles, the muscles become tight. This is especially true during growth spurts. A problem such as toe walking may become more apparent as the muscles in the heel cord become increasingly tight. 

As children grow, their bones develop and change as they begin to use their muscles to move, particularly with standing and walking. This is called bone remodeling. Because children with cerebral palsy have decreased control of their muscles, have stiffness in their muscles, and/or are delayed in their independent mobility, bone development may not occur as expected. In addition, when bones do not develop as expected, the forces going through a child’s bones when they stand and move are different. These abnormal forces can cause the bones to “remodel” is a way that is not typical. These changes in the bone may become more noticeable as your child grows. To prevent deformities, equipment that supports posture and function may be recommended, from an early age, based on your child’s needs. Examples of equipment include orthotics, mobility aids such as a walker or crutches, standing frames, and wheelchairs with special seating,.

 

The muscles of young children are much larger compared to the size of their body than adolescents or adults. As they grow and gain weight, the force produced by the muscles does not increase as much as their size. This means that standing and walking may require more energy as children grow and become more difficult. For this reason, children should maintain a healthy body weight.

 

What are the treatment options for CP?

CP has no cure.  However there are options out there to make your child more comfortable.

 

Your child's doctor will determine the best line of treatment for your child. Treatment will depend on the severity of the condition.

  • Physical therapy will likely be a big part of the treatment program. Physical therapy will work on muscle strength, flexibility, balance and mobility.

  • Occupational therapy will work on hand and hand-eye coordination. The therapist may also help your child with equipment like wheelchairs, braces or talking devices.

  • Speech therapy can help your child to communicate better.

  • Some children need medicine to improve motor control and reduce spasticity.

  • Surgery: Some times surgery is needed to improve function. Incases where there muscle are very tight and there is difficulty in movement like walking , surgery maybe done to loosen up the muscles then physical therapy to ensure they improve their function. When some one recommends surgery- it should be clear that it will improve the function of your child. 

 

How do you cope with CP?

 

Seek support

As a parent of a child with CP, you may be overwhelmed by emotion. Feelings like fear of the future or guilt are common. There is help out there. Support groups, friends, family, therapists, places of faith or community centers can serve to strengthen your abilities as a parent. Ask your doctor for resources.

Encourage your child to be social

It can be difficult for children to cope with having CP. Encourage your child to express their feelings and help them work through them. Encourage your child to join in group activities with other children their age. Such interaction will help your child reach their fullest potential.

 

Source:

https://www.researchgate.net/publication/261032088_Pediatric_Cerebral_Palsy_in_Africa_A_Systematic_Review

https://www.aboutkidshealth.ca,

http://www.bcchildrens.ca/health-info/coping-support/cerebral-palsy