Cerebral Palsy: From 3 Different Sources
A disorder of posture and movement resulting from damage to a child’s developing brain before, during, or immediately after birth, or in early childhood. Cerebral palsy is nonprogressive and varies in degree from slight clumsiness of hand movement and gait to complete immobility.
A child with cerebral palsy may have spastic paralysis (abnormal stiffness of muscles), athetosis (involuntary writhing movements), or ataxia (loss of coordination and balance). Other nervous system disorders, such as hearing defects or epileptic seizures, may be present. About 70 per cent of affected children have mental impairment, but the remainder are of normal or high intelligence.
In most cases, damage occurs before or at birth, most commonly as a result of an inadequate supply of oxygen to the brain. More rarely, the cause is a maternal infection spreading to the baby in the uterus. In rare cases, cerebral palsy is due to kernicterus. Possible causes after birth include encephalitis, meningitis, head injury, or intracerebral haemorrhage. Cerebral palsy may not be recognized until well into the baby’s 1st year. Initially, the infant may have hypotonic (floppy) muscles, be difficult to feed, and show delay in sitting without support.
Although there is no cure for cerebral palsy, much can be done to help affected children using specialized physiotherapy, speech therapy, and techniques and devices for nonverbal communication.
The term used to describe a group of conditions characterised by varying degrees of paralysis and originating in infancy or early childhood. In some 80 per cent of cases this takes the form of spastic paralysis (muscle sti?ness), hence the now obsolete lay description of sufferers as ‘spastics’. The incidence is believed to be around 2 or 2·5 per 1,000 of the childhood community. In the majority of cases the abnormality dates from well before birth: among the factors are some genetic malformation of the brain, a congenital defect of the brain, or some adverse e?ect on the fetal brain as by infection during pregnancy. Among the factors during birth that may be responsible is prolonged lack of oxygen such as can occur during a di?cult labour; this may be the cause in up to 15 per cent of cases. In some 10–15 per cent of cases the condition is acquired after birth, when it may be due to KERNICTERUS, infection of the brain, cerebral thrombosis or embolism, or trauma. Acute illness in infancy, such as meningitis, may result in cerebral palsy.
The disease manifests itself in many ways. It may not be ?nally diagnosed and characterised until the infant is two years old, but may be apparent much earlier – even soon after birth. The child may be spastic or ?accid, or the slow, writhing involuntary movements known as athetosis may be the predominant feature. These involuntary movements often disappear during sleep and may be controlled, or even abolished, in some cases by training the child to relax. The paralysis varies tremendously. It may involve the limbs on one side of the body (hemiplegia), both lower limbs (paraplegia), or all four limbs (DIPLEGIA and QUADRIPLEGIA). Learning disability (with an IQ under 70) is present in around 75 per cent of all children but children with diplegia or athetoid symptoms may have normal or even high intelligence. Associated problems may include hearing or visual disability, behavioural problems and epilepsy.
The outlook for life is good, only the more severely affected cases dying in infancy. Although there is no cure, much can be done to help these disabled children, particularly if the condition is detected at an early stage. Assistance is available from NHS developmental and assessment clinics, supervised by community paediatricians and involving a team approach from experts in education, physiotherapy, occupational therapy and speech training. In this way many of these handicapped children reach adulthood able to lead near-normal lives. Much help in dealing with these children can be obtained from SCOPE (formerly the Spastics Society), and Advice Service Capability Scotland (ASCS).
a disorder of movement and/or posture as a result of nonprogressive but permanent damage to the developing brain. This damage may occur before, during, or immediately after delivery and has many causes, including an inadequate supply of oxygen to the brain, low levels of glucose in the blood (*hypoglycaemia), and infection. It is often associated with other problems, such as learning difficulties, hearing difficulties, poor speech, poor balance, and epilepsy. There are three main types of cerebral palsy: spastic, in which the limbs are difficult to control and which may affect the whole body (quadriplegic), one side of the body (hemiplegic), or both legs (diplegic); ataxic hypotonic, in which the main problem is poor balance and uncoordinated movements; and dyskinetic, in which there is involuntary movement of the limbs. Management requires a multidisciplinary approach, the main components of which are physiotherapy, speech and language therapy, educational assistance, and appropriate appliances.
Another name for PARALYSIS. CEREBRAL PALSY involves total or partial paralysis of a limb or limbs due to a perinatal or early infancy brain lesion.... palsy
Paralysis of the 7th (facial) nerve which controls muscles of the face. One-sided stiffness and distortion of the face which lacks expression. Inability to close eyes or whistle. Rarely painful.
Aetiology. Injury, virus infection, cold, stroke. Recovery usually spontaneous. Herpes Simp. Alternatives. Chamomile, Wood Betony, Bryonia, Black Cohosh, Barberry, Asafoetida, Lobelia, Rosemary, Valerian, Sage. Echinacea has been used with convincing results internally and externally.
Tea. Equal parts. Chamomile, Wood Betony. Sage. 1 heaped teaspoon to each cup boiling water; infuse 15 minutes. 1 cup 3 times daily.
Decoctions. Black Cohosh, Rosemary, Valerian, Echinacea.
Tablets/capsules. Black Cohosh. Ginseng. Echinacea. Valerian.
Powders. Formula. Rosemary 1; Echinacea 2; Valerian 1. Dose: 500mg (two 00 capsules or one-third teaspoon) thrice daily.
Tinctures. Formula. Echinacea 2; Rosemary 1; Black Cohosh 1; Pinch Tincture Capsicum. 1-2 teaspoons 3 times daily.
Evening Primrose oil. 4 × 500mg capsules daily.
Aromatherapy. 10 drops Oil Juniper to eggcup Almond oil; gentle massage affected side of face. Diet. Lacto-vegetarian.
Vitamin E. (400iu daily). ... bell’s palsy
Crutch palsy is weakness or paralysis of muscles in the wrist and hand, due to pressure exerted by the CRUTCH head on the nerves that control the affected muscles. It usually occurs because the crutch is too long for the individual, and/or if he or she attempts too much walking. The nerve damage is temporary and symptoms disappear if the crutch is properly used or left aside for a time.... crutch palsy
Bleeding within the brain due to a ruptured blood vessel (see intracerebral haemorrhage; stroke).... cerebral haemorrhage
See BELL’S PALSY.... idiopathic facial nerve palsy
Another name for writer’s cramp (see MUSCLES, DISORDERS OF).... scrivener’s palsy
see abscess.... cerebral abscess
(aqueduct of Sylvius) the narrow channel, containing cerebrospinal fluid, that connects the third and fourth *ventricles of the brain.... cerebral aqueduct
one of the two paired halves of the *cerebrum.... cerebral hemisphere
the presence of thrombosis in the dural venous sinuses, which drain blood from the brain. Symptoms may include headache, abnormal vision, any of the symptoms of stroke (such as weakness of the face and limbs on one side of the body), and seizures. Treatment is with anticoagulants.... cerebral venous sinus thrombosis
(Steele–Richardson–Olszewski syndrome) a progressive neurological disorder resulting from degeneration of the motor neurons, basal ganglia, and brainstem. Starting in late middle age, it is characterized by a staring facial expression due to impaired ability to move the eyes up and down, progressing to difficulties in swallowing, speech, balance, and movement and general spasticity. The condition enters the differential diagnosis of *parkinsonism, with which it is often confused in its early stages.... progressive supranuclear palsy
the intricately folded outer layer of the *cerebrum, making up some 40% of the brain by weight and composed of an estimated 15 thousand million neurons (see grey matter). This is the part of the brain most directly responsible for consciousness, with essential roles in perception, memory, thought, mental ability, and intellect, and it is responsible for initiating voluntary activity. It has connections, direct or indirect, with all parts of the body. The folding of the cortex provides a large surface area, the greater part lying in the clefts (sulci), which divide the upraised convolutions (gyri). On the basis of its microscopic appearance in section, the cortex is mapped into *Brodmann areas; it is also divided into functional regions; including *motor cortex, *sensory cortex, and *association areas. Within, and continuous with it, lies the *white matter, through which connection is made with the rest of the nervous system.... cerebral cortex
an abnormal multiplication of brain cells. Any tumorous swelling tends to compress or even destroy the healthy brain cells surrounding it and – because of the rigid closed nature of the skull – increases the pressure on the brain tissue. Malignant brain tumours, which are much more common in children than in adults, include *medulloblastomas and *gliomas; these grow rapidly, spreading through the otherwise normal brain tissue and causing progressive neurological disability. Benign tumours, such as *meningiomas, grow slowly and compress the brain tissue. Both benign and malignant tumours commonly cause fits. Benign tumours are often cured by total surgical resection. Malignant tumours may be treated by neurosurgery, chemotherapy, and radiotherapy, but the outcome for most patients remains poor.... cerebral tumour
an archaic name for Parkinson’s disease (see parkinsonism).... shaking palsy
pertaining to the largest part of the brain, the cerebrum.... cerebral
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