About Cerebral Palsy

Cerebral palsy (pronounced seh-ree-brel pawl-zee) is a blanket term commonly described by loss or impairment of motor function, cerebral palsy is actually caused by brain damage.

The brain damage is caused by brain injury or abnormal development of the brain that occurs while a child’s brain is still developing — before birth, during birth, or immediately after.

Cerebral palsy affects body movement, muscle control, muscle coordination, muscle tone, reflex, posture and balance. It can also impact fine motor skills, gross motor skills, oral motor functioning and vision.

Those with cerebral palsy are most likely born with the condition, although some acquire the condition at birth or shortly thereafter depending on cause. Signs and symptoms of cerebral palsy may not always be apparent at birth. The child will likely experience a delay in development and growth milestones.

ORIGIN AND HISTORY OF CEREBRAL PALSY

The origin and history of cerebral palsy includes a number of great minds, generous hearts, and dedicated people striving to improve the lives of individuals with disabilities. In the mid-1800s, Dr. William John Little pioneered the study of cerebral palsy using his own childhood disability as an inspiration. His innovative techniques are still helping people today.

Sir William Osler, considered an important figure in furthering modern medicine, expounded on Little’s research and wrote the first book on cerebral palsy. Dr. Sigmund Freud, the father of psychoanalysis, proposed the idea that cerebral palsy might result from abnormal fetal development – decades before the medical field embraced the concept.

Other individuals and organizations made historical strides toward helping those with cerebral palsy, as well. At different times, the U.S. government passed crucial legislation to modernize care and further the rights of individuals with disability. In 1963, President John F. Kennedy signed the Community Mental Health Act, which promoted community-based care as an alternative to institutionalization. On July 26, 1990, President George H. W. Bush passed the Americans with Disabilities Act, prohibiting employers from discriminating against people with disability.

Innovators continued to bring cerebral palsy into the national consciousness, as well. Marie Killilea wrote “Karen,” a novel about her daughter’s life with cerebral palsy. The book hit the New York Times bestseller list in 1952 and is still in print. Isabelle and Leonard Goldenson, and Ethel and Jack Hausman were also parents of children with cerebral palsy. Both couples were giants in their respective industries and well-known philanthropists who used their influence to found the organization that eventually became the United Cerebral Palsy Association (UCP).

Important breakthroughs in medicine, such as blood typing, the use of phototherapy to cure jaundice, and the development of a vaccine for rubella helped prevent cerebral palsy, and continue to do so today. Meanwhile, technological advances allow people to continually redefine what it means to live with disability.

CAUSE OF CEREBRAL PALSY (Brain Injury and Brain Malformation)

The cause of cerebral palsy is brain injury or brain malformation that occurs while the brain is developing — before, during, or after birth. Cerebral palsy affects muscle control, muscle coordination, muscle tone, reflex, posture and balance. It can also impact fine motor skills, gross motor skills and oral motor functioning.

Every case of cerebral palsy is unique to the individual. This is due in part by the type of injury and the timing of the injury to the developing brain. The brain damage that causes cerebral palsy is a result of either:

  • Prenatal disturbance of brain cell migration - Genetic and environmental factors disturb brain cell migration as cells move to their appropriate location during brain development.
  • Prenatal poor myelination (insulation) of developing nerve cell fibers - Brain function is impeded when poor myelin provides an inadequate protective covering over nerve cells that aid in transmission.
  • Perinatal brain cell death - Events in the birthing process that rupture blood vessels or starve oxygen to the brain.
  • Postnatal non-functional (synapses) between brain cells - Trauma, infections, and asphyxia that damage connections developed in the brain.

TYPES OF CEREBRAL PALSY

  • Spastic Cerebral Palsy - characterized by muscle stiffness and permanent contractions.

     

  • Athetoid or Dyskinetic Cerebral Palsy - characterized by uncontrolled, slow, writhing movements.

     

  • Ataxic Cerebral Palsy - characterized by poor coordination and balance. 

     

    CLASSIFICATIONS OF CEREBRAL PALSY BASED ON SEVERITY LEVEL

    Cerebral palsy is often classified by severity level as mild, moderate, severe, or no CP. These are broad generalizations that lack a specific set of criteria. Even when doctors agree on the level of severity, the classification provides little specific information, especially when compared to the GMFCS. Still, this method is common and offers a simple method of communicating the scope of impairment, which can be useful when accuracy is not necessary.

     

    • Mild - Mild cerebral palsy means a child can move without assistance; his or her daily activities are not limited.
    • Moderate - Moderate cerebral palsy means a child will need braces, medications, and adaptive technology to accomplish daily activities.
    • Severe - Severe cerebral palsy means a child will require a wheelchair and will have significant challenges in accomplishing daily activities.
    • No CP - No CP means the child has cerebral palsy signs, but the impairment was acquired after completion of brain development and is therefore classified under the incident that caused the cerebral palsy, such as traumatic brain injury or encephalopathy.