• Cerebral palsy, «SEHR uh bruhl or suh REE bruhl PAWL zee» is a general term for a variety of disorders caused by damage to the brain. The damage occurs before or during birth or in the first few years of life. The brain damage may cause severe crippling, or the symptoms may be so mild that they hardly interfere with the patient's activities.
    There are several types of cerebral palsy, and all involve lack of muscle control. Common effects of the disorder include a clumsy walk, lack of balance, shaking, jerky movements, and unclear speech. In many patients, the brain damage also causes intellectual disability, learning disability, seizures, and problems in sight and hearing. About half of 1 percent of the people in the world have cerebral palsy.
    Causes. In most cases, the causes of faulty growth of the brain that result in cerebral palsy cannot be determined. In some cases, however, brain damage may result from illness in the mother during pregnancy. For example, rubella can severely harm an unborn child, even though the mother may have had only mild symptoms or none at all during pregnancy. Cerebral palsy is rarely an inherited trait.
    Brain damage can also occur during the birth process, especially in premature births. In babies born after a normal term of pregnancy, brain damage may occur if there is a significant period of hypoxia (lack of oxygen), causing brain cells to die.
    After birth, a baby may develop cerebral palsy if disease or injury damages the brain. During the first year of life, infections and accidental head injuries are the most frequent causes of the condition. In some cases, child abuse has caused cerebral palsy.
    Types. There are four chief types of cerebral palsy. These types are (1) ataxic, (2) athetoid, (3) hypotonic, and (4) spastic. In the ataxic form, the patient's voluntary movements are jerky, and a loss of balance is suffered (see Ataxia). In the athetoid type, the person's muscles move continually. These movements prevent or interfere greatly with voluntary actions. A person with hypotonic cerebral palsy appears limp. The person can move little or not at all because the muscles cannot contract. Spastic cerebral palsy patients have stiff muscles and cannot move some body parts (see Spastic paralysis). A person with cerebral palsy may have more than one muscle disorder. The person may be only slightly disabled or completely paralyzed.
    Cerebral palsy does not worsen progressively but may appear to worsen if it is untreated. A child's spastic (tight) muscles become fixed from lack of use. Some patients lose the ability to walk if they gain too much weight.
    Treatment of cerebral palsy is aimed at preventing the condition from worsening and also helping the child use his or her abilities to the best possible advantage. Each type of cerebral palsy requires different therapy. Each patient needs individual care. The impact of cerebral palsy on people's lives depends on the extent of their disabilities.
    Most people with cerebral palsy can be helped by physical therapy. If possible, the patient learns to maintain balance and to move about unaided. The patient may develop such self-help skills as dressing, eating, and toilet care. See Physical therapy; Occupational therapy (Helping people with physical disabilities).
    A child with cerebral palsy may face the task of conquering problems of speech, sight, and hearing that could interfere with other learning. Speech therapy, glasses, and hearing aids may correct some of these problems. The child can then learn to communicate in order to continue an education. Later, the child may receive training that can help in finding a suitable job.
    Physicians may prescribe drugs for cerebral palsy patients to relax muscles and to control their convulsions. Braces and other mechanical devices provide support and help the victim walk. In some cases, a surgical operation called selective posterior rhizotomy can reduce the rigidity of spastic muscles. In this operation, the surgeon cuts selected nerve fibers in the spinal cord.
    Prevention of brain damage before, during, and soon after birth is the most important way of fighting cerebral palsy. Before becoming pregnant, a woman should be vaccinated against any disease that could harm her unborn baby. An expectant mother should only take drugs prescribed by her physician. A woman under the age of 16 or over 40 has a greater chance than other women of giving birth to a premature baby. After birth, a baby can be protected from brain damage by careful handling, proper care, and vaccination against childhood diseases.
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