Cerebral palsy is a group of neurological disorders characterized by paralysis resulting from abnormal development or damage to the brain before birth or during the first years of life.
There are four types of cerebral palsy: spastic, athetoid, ataxia, and mixed. In the spastic type, there is a severe paralysis of voluntary movements, with spastic contractions of the extremities on one side of the body (hemiplegia) or on both sides (diplegia). The neurological damage that causes spastic cerebral palsy primarily affects the neurons and connections of the cerebral cortex, either in one cerebral hemisphere (as opposed to paralysis), as in infantile hemiplegia, or in both hemispheres, as in diplegia.
In the athetoid type of cerebral palsy, there may be no paralysis of voluntary movements, and spastic contractions may be minor or absent. Instead, there are slow, involuntary spasms of the face, neck, and extremities, either on one side (hemarthrosis) or, more often, on both sides (double athetosis), resulting in involuntary movements of the whole body or parts thereof, leading to a facial grin. , and articulate speech (dysarthria) – all of which are increased in tension or excitement. Damage to the brain specifically affects the basal ganglia located beneath the cerebral cortex.
An ataxic cerebral palsy is a rare form of a condition characterized by poor coordination, muscle weakness, an unsteady gait, and difficulty performing rapid or fine movements. If two or more types of symptoms are present, most often spastic and athetoid, a person is diagnosed with mixed cerebral palsy.
Cerebral palsy does not necessarily include intellectual disability; Many children affected by cerebral palsy are mentally capable. However, any neurological disorder in early life can result in impairment of intellectual and emotional development, sometimes severe. Epileptic seizures, especially in the parts of the body affected by paralysis, occur in many children with cerebral palsy. In the spastic type of cerebral palsy, intellectual disability and epileptic attacks are especially frequent. In the athetoid type, the incidence of severe intellectual disability is very low, and the incidence of convulsive seizures is rare. Children affected by athetoid cerebral palsy can be perceptive and intelligent; However, due to involuntary movements and dysarthria, they are often unable to communicate by intelligible words or signs.
The causes of cerebral palsy are many but basically involve the malfunctioning of the complex neuronal circuits of the basal ganglia and cerebral cortex. Heredity plays only a small role. It may manifest itself in malformations of neurons, interstitial tissues, or blood vessels of the brain that can produce tumors, or it may express itself in abnormal brain chemistry. The more common causes of this condition are fetal diseases and embryonic malformations of the brain. Incompatibility of blood types of mother and fetus, leading to severe jaundice at birth, can cause brain damage and cerebral palsy. Fetal respiratory problems during birth may indicate earlier brain damage. Other less common causes of cerebral palsy are pediatric infections, severe head injuries, and poisoning.
There is no cure for cerebral palsy; Treatment includes drugs that relax muscles and prevent seizures. The basic program of treatment aims at the psychological management, education, and training of the child to develop sensory, motor, and intellectual property, in order to compensate for the physiological liabilities of the disorder.