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).... cerebral palsy
Complete or partial loss of controlled movement caused by the inability to contract 1 or more muscles. Paralysis may be temporary or permanent. There may also be loss of feeling in affected areas.
Paralysis of one half of the body is called hemiplegia; paralysis of all 4 limbs and the trunk is called quadriplegia. Paraplegia is paralysis of both legs and sometimes part of the trunk. Paralysis may be flaccid, causing floppiness, or spastic, causing rigidity.
Paralysis can be caused by brain disorders such as stroke, brain tumour, brain abscess, or brain haemorrhage. Some types of paralysis are caused by damage to parts of the nervous system (such as the cerebellum and basal ganglia) concerned with fine control of movement. Paralysis can also be caused by damage to or pressure on the spinal cord as a result of injury or disc prolapse. Diseases affecting the spinal cord (such as multiple sclerosis and poliomyelitis) and muscle disorders (such as muscular dystrophy) may also cause paralysis. Nerve disorders, called neuropathies, may cause varying degrees of paralysis.
The underlying cause is treated, if possible, and physiotherapy is used to prevent joints from becoming locked and to strengthen muscles and joints.... paralysis
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