Cerebral palsy (CP) is a complex group of neurological disorders that can have a profound impact on an individual’s life. The condition is caused by damage to the developing brain, which can occur before, during, or after birth. The damage affects the part of the brain that controls movement and muscle coordination, resulting in difficulties with movement, posture, and sometimes even speech and communication.
While there is no cure for CP, there are treatments and therapies available that can help improve quality of life for those affected. With early intervention and ongoing support from healthcare professionals, individuals with CP can learn to manage their symptoms and lead fulfilling lives. It’s important to remember that every person with CP is unique, with their own strengths and challenges, and should be treated as such.
Causes
Muscle control takes place in a part of the brain called the cerebrum. The cerebrum is the upper part of the brain. Damage to the cerebrum before, during, or within 5 years of birth can cause cerebral palsy.
The cerebrum is also responsible for memory, ability to learn, and communication skills. This is why some people with cerebral palsy have problems with communication and learning. Cerebrum damage can sometimes affect vision and hearing.
Some newborns are deprived of oxygen during labor and delivery.
In the past, it was thought that this lack of oxygen during birth led to brain damage.
However, during the 1980s, research showed that fewer than 1 in 10 cases of cerebral palsy stem from oxygen deprivation during birth.
Most often, the damage occurs before birth, probably during the first 6 months of pregnancy.
There are at least three possible reasons for this.
Periventricular leukomalacia (PVL)
PVL is a kind of damage that affects the brain’s white matter because of a lack of oxygen in the womb.
It may occur if the mother has an infection during pregnancy, such as rubella or German measles, low blood pressure, preterm delivery, or if she uses an illegal drug.
Abnormal development of the brain
Disruption of brain development can affect the way the brain communicates with the body’s muscles and other functions.
During the first 6 months of pregnancy, the brain of the embryo or fetus is particularly vulnerable.
Damage can stem from mutations in the genes responsible for brain development, certain infections such as toxoplasmosis, a parasite infection, herpes and herpes-like viruses, and head trauma.
Intracranial hemorrhage
Sometimes, bleeding inside the brain happens when a fetus experiences a stroke.
Bleeding in the brain can stop the supply of blood to vital brain tissue, and this tissue can become damaged or die. The escaped blood can clot and damage surrounding tissue.
Several factors can cause a stroke in a fetus during pregnancy:
- a blood clot in the placenta that blocks the flow of blood
- a clotting disorder in the fetus
- interruptions in arterial blood flow to the fetal brain
- untreated pre-eclampsia in the mother
- inflammation of the placenta
- pelvic inflammatory infection in the mother
During delivery, the risk is increased by the following factors:
- emergency cesarean
- the second stage of labor is prolonged
- vacuum extraction is used during the delivery
- fetal or neonatal heart anomalies
- umbilical cord abnormalities
Anything that increases the risk of preterm birth or low birth weight also raises the risk of cerebral palsy.
Factors that may contribute to a higher risk of cerebral palsy include:
- multiple births, for example, twins
- damaged placenta
- sexually transmitted infections (STIs)
- consumption of alcohol, illegal drugs, or toxic substances during pregnancy
- malnourishment during pregnancy
- random malformation of the fetal brain
- small pelvis in the mother
- breech delivery
- Brain damage after birth
A small proportion of cases happen because of damage after birth. This can happen because of an infection such as meningitis, a head injury, a drowning accident, or poisoning.
When damage occurs, it will do so soon after the birth. With age, the human brain becomes more resilient and able withstand more damage.
Symptoms
An infant with cerebral palsy may have muscular and movement problems, including poor muscle tone. Muscle tone refers to a person’s automatic ability to tighten and relax muscles when required.
Features can include:
- overdeveloped or underdeveloped muscles, leading to stiff or floppy movements
- poor coordination and balance, known as ataxia
- involuntary, slow writhing movements, or athetosis
- stiff muscles that contract abnormally, known as spastic paralysis
- crawling in an unusual way
- lying down in awkward positions
- favoring one side of the body over the other
- a limited range of movement
Other signs and symptoms include:
- late achievement of developmental milestones such as crawling, walking, or speaking
- hearing and eyesight problems
- problems controlling bladder and bowel movements
- seizures
- drooling, and problems with feeding, sucking, and swallowing
- being easily startled
Symptoms normally start to show during the first 3 years of life.