Cerebral palsy and occupational therapy

In order to recover the skills that are required for leading an independent and a satisfying life after any injury or disease, an occupational therapist is required. The word occupation refers to the tasks which one has to perform everyday not to one s profession. Muscle and joint coordination issues can be fixed with the help of occupational therapy in case if kids .These include the daily activities like eating, brushing using the toilet. With the help of OT your cognitive and social abilities and even your motor skills will improve at a very good rate.

How is this beneficial for children with cerebral palsy?

Occupational therapy will be helpful to the children who are specially suffering from cerebral palsy. These benefits includes:

- It will increase the chances of making your child more independent.
- It will boost their ability to play as well as to learn.
- The self esteem and the confidence of your child will readily increase.
- They ll have a sense of accomplishment.
- Their quality of life will improve as well.
- This is also beneficial for the parents as well. It will reduce your stress and will provide you with a sense of security.

What to expect?

Occupational therapy is different for different children who have cerebral palsy. It depends on one s physical, intellectual and social emotional abilities .The first session is basically done for evaluation where your child s fine motor and will be observed how your child responds to touch or any kind of movement. The parents are also interviewed in order to find out about the strengths and the weaknesses of your child. For children with cerebral palsy, a revaluation should be done in every 7-8 months in order to see the progress and change the treatment plan accordingly as per the improvement .The operational therapist will use some specific techniques which will help your child to improve very quickly and reach their destination.

These techniques are :

Paediatric constraint induced Movement therapy: This therapy helps your child to move the weaker parts of the body by restraining the stronger counterpart. If you child has a difficulty in moving one of the arms then the stronger arm will be restrained and the weaker arm will be trained in order to gain the strength.

Sensory integration therapy: This type of therapy will help your child to improve the ability bro receive , interpret and act on the information and situations that comes in your child s brain with the help of sensory receptors .

Occupational therapy has been a very important part in improving the physical and the mental discomfort faced by your child when he or she is suffering from cerebral palsy. The therapist may even provide your child with some gadgets in order to make his /her daily life easier and more independent. This helps your child to improve and gradually get better at it without any sort of negativity. While you re looking for a OT make sure the person has enough experience and knowledge, just to ensure that your child gets the right treatment.



Cerebral Palsy And Occupational Therapy

Brain cancer is a disease of the brain in which cancer cells (malignant cells) arise in the brain tissue. Cancer cells grow to form a mass of cancer tissue (tumor) that interferes with brain functions such as muscle control, sensation, memory, and other normal body functions. Tumors composed of cancer cells are called malignant tumors, and those composed of mainly non-cancerous cells are called benign tumors. Cancer cells that develop from brain tissue are called primary brain tumors while tumors that spread from other body sites to the brain are termed metastatic or secondary brain tumors.

Prologue:

Brain cancer is actually the abnormal growth and uncontrolled growth of the cancer cells in the brain,that forms a tumor in the brain.Tumours can be either benign or malignant.

Benign brain tumours are abnormal collections of cells that reproduce slowly and usually remain separate from the surrounding normal brain.

Malignant tumours reproduce and grow quickly. Their borders are hard to distinguish from the normal brain around them.

Symptoms:

There are few early symptoms of brain cancer, but as the tumour grows within the confines of the skull, it causes increased intracranial pressure and exerts pressure on the brain, causing signs to develop.

Brain cancer symptoms and signs are varied and depend on the area of the brain involved, but can include:

Headaches.

Seizures.

Nausea and vomiting, which, CANSA reports, may be worse in the morning or after a sudden position change.

Difficulty walking or clumsiness.

Vision changes.

Changes in alertness.

Behavioural impairment.

Causes:

Brain cancer occurs when there is an uncontrolled growth of cancer cells in the brain that form a malignant brain tumor. The underlying cause of primary brain cancer, cancer that begins in the brain, is not known. Secondary brain cancer is caused by a cancer of another organ in the body, such as the breast, prostate, kidney, skin, or bone, that has spread to the brain.

What are the risk factors for brain cancer?

Certain inherited conditions, including neurofibromatosis, Von Hippel-Lindau syndrome, Li-Fraumeni syndrome, and Turcot syndrome

Personal history of cancer or family history of brain cancer

Impaired immune system

Radiation therapy of the head

Treatments Options:

Treatment

Surgery is the main form of treatment for brain tumors that lie within the membranes covering the brain or in parts of the brain that can be removed without damaging critical neurological functions. The goal is to remove the entire tumor, whenever possible, as a tumor may recur if any tumor cells are left behind. Radiation therapy and chemotherapy are generally used as secondary treatment for tumors that cannot be cured through surgery alone.

Stereotactic radiosurgery

Stereotactic radiosurgery is a treatment option that delivers a high concentration of radiation directly to the tumor in order to stop its growth, while delivering only a minimal dose of radiation to the surrounding tissue. Unlike conventional surgery, stereotactic radiosurgery does not require making an incision to remove the tumor. It can be especially effective in patients with many small metastatic brain tumors.

Brain Cancer

Although surgery is considered to be the first step of treatment in any form of tumor, but its feasibility depends upon the type, size and location of the tumor. It is not necessary that every kind of brain tumor might require surgery.

Indications of Brain Tumor Surgery
- Diagnosis of the type of tumor by taking a sample of the tumor for laboratory examination
- Complete resection of tumor
- Removal of the tumor as much as possible to slow down its growth and improve the symptoms
- Remove the tumor in order to help other treatment
- Provide direct access for other forms of treatment like chemotherapy, radiotherapy etc.
- To relieve pressure caused by tumor on surrounding structures

Types of Brain Tumor Surgery
The different types of surgery that are performed in cases of brain tumor include the following:

Craniotomy: Craniotomy is the most commonly performed procedure to remove brain tumor along with a piece of bone. The removed bone is replaced and the tumor is sent for histopathology (biopsy). The surgery is performed using a high end microscope by any of the following techniques:
- Extended bifrontal craniotomy
- "Eyebrow" craniotomy (supraorbital craniotomy)
- "Keyhole" craniotomy (retro-sigmoid craniotomy)
- Orbitozygomatic craniotomy
- Translabyrinthine craniotomy

Shunt: A narrow piece of flexible tube with a pressure regulated valve in between is called a shunt. This is used to relieve the intracranial pressure caused by obstruction of the natural brain fluid, Cerebrospinal fluid (CSF) pathway by tumor mass. The procedure involves insertion of a drainage system into the brain to remove or drain excess of blocked fluid into the peritoneal cavity.

Stereotactic surgery: This surgery is done by creating a three dimensional image called stereotaxy using computers. It aims to find out the location and position of the tumor. In fact it can also be done to aid tumor removal, implant radiation pellets or for other treatments.

Embolization: It is a procedure used to reduce the amount of blood supply to a tumor by blocking the blood flow in the selected arteries. It is generally performed before the main surgery.

Endoscopy and endoscope assisted surgery: Endoscope is a tool, which helps to closely visualize the tissue through small openings in difficult to reach areas. This tool can be used in various brain surgeries to precisely reach the target location without damaging the adjacent structures.

Adjuvant modalities to improve outcome: In addition to above mentioned surgeries, following surgeries may also be performed in relation to brain tumor treatment:
- Laser surgery
- Photodynamic laser surgery
- Ultrasonic aspiration
- Fluorescence guided surgery (FGS)
- Electrophysiological monitoring

Brain Tumor Surgery

Migraine is a severe form of headache wherein, the excruciating pain is accompanied by an extreme sensitivity to sound and light; you also experience nausea. The headaches usually affect either side of the head and are throbbing in nature. Hot flashes, numbness of limbs and blind spots in the eye; these are often considered as warnings. In certain cases, migraines can cause blackouts that can range from a few seconds to a few minutes.

Migraine occurs in four stages:

Pro-drome (symptom indicative of an onset of an illness)
Aura (visual auras including blurred vision)
Headache
Post-drome (the residual effects of migraine characterized by fatigue and lethargy)
But the occurrence of these stages varies across individuals. The causes of migraines aren t specifically understood. It may be due to the interaction of the brain stem with the trigeminal nerve, which is an important pain pathway of the brain. Imbalances in hormonal levels or in the levels of neurotransmitters such as serotonin may also prove to be a causal factor.

Symptoms

Migraine may be triggered due to stress, physical exertion, and excess intake of alcohol or food additives such as MSG (Monosodium Glutamate). Changes in the environment and sleeping patterns may also be probable culprits.

Migraine can be easily distinguished from regular headaches, given the fact that migraines last longer and are rather severe in nature with pain felt in one part of the head. Most people experience the  Aura stage where they have visual flashes right before headache. Nausea, eye pain or sensitivity to light and sound are other factors helpful in distinguishing migraine from other headaches.

Symptoms can occur a while before headache, immediately before headache, during headache and after headache. Although not all migraines are the same.

Typical symptoms include:

Moderate to severe pain, usually confined to one side of the head during an attack, but can occur on either side of the head
The pain is usually a severe, throbbing, pulsing pain
Increasing pain during physical activity
Inability to perform regular activities due to pain
Feeling sick and physically being sick
Increased sensitivity to light and sound, relieved by lying quietly in a darkened room
Some people experience other symptoms such as sweating, temperature changes, tummy ache and diarrhea.
Complications in migraine may include:

Chronic migraine which last up to 15 days or more
Status Migrainosus where the attacks last for over 3 days
Migrainous infarction where the aura lasts longer than it should, cutting blood supply to the brain. 
If you wish to discuss about any specific problem, you can consult a neurologist.

Migraine - Know The Causes and Symptoms!

Epilepsy is a neurological condition that leads to recurrent seizures. Seizures arise when electrical activity in the brain suddenly surges causing a temporary disturbance within the messaging systems located between the brain cells.

Epilepsy is more common in children below the age of two years and adults above the age of 65 years.

Seizure Types

Seizures are classified into two main categories depending on their area of impact. 

A focal seizure is one that affects only one part or area of the brain whereas a generalised seizure affects the whole brain. Further, both focal and generalised seizures have various sub-categories which are as follows-

Previous nomenclature- 

Partial Seizure

  Simple Partial Seizure
  Complex Partial Seizure
  Partial Seizure with Secondary Generalization

Generalized Seizure

  Absence Seizures
  Myoclonic Seizure
  Atonic Seizure
  Tonic Seizure
  Tonic-clonic Seizure
  Mixed Seizure
  Status Epilepticus

Latest nomenclature of seizure types:

Focal seizures-

  Focal aware seizures
  Focal impaired awareness seizures (previously called complex partial seizures)
. Bilateral tonic clonic seizures

Generalised onset seizures-

  Tonic clonic seizures.
  Atonic seizures (sometimes called drop attacks) and tonic seizure.
  Myoclonic seizures.
  Absence seizures.

Symptoms

The well know symptom of epilepsy is a convulsion/ fit, a few other symptoms include-

  Intermittent spells of fainting. When this happens the patient is likely to lose control of his/her bladder or bowel movements. Following this, the person is likely to suffer from extreme tiredness.
  Spells of a blackout with difficulty in remembering
  Becoming unresponsive to any instructions or questions asked during brief periods of time
  Bouts of continuous blinking without any known reason
  Inappropriate movements that keep on occurring
  Changes in sensory perceptions
  Sudden stiffness in the body

Reasons for Epilepsy

Messaging systems within the brain are responsible for every function that goes about in your body. A disruption to this system caused by defective electrical activity leads to epilepsy in a person. Many people inherit epilepsy while others may develop this condition as a result of-

  Head trauma sustained during an accident
  A stroke or a tumour that has affected the brain impairing its normal capabilities
  An injury to the brain before or during birth
  Associated with developmental issues
  Infections of the brain

Treatment for Epilepsy

Epilepsy in childhood can be treated by using medications and by adopting dietary changes in some cases. Medications for epilepsy mainly include-

  Anticonvulsants - Helps control seizures and manages the symptoms of epilepsy
  Medications for nerve pain - Reduce pain that is caused by the damaged nerves

These medications should be consumed as and when prescribed by the doctor. You must consult a paediatrician for this, as he/she will take your child s physical and mental in consideration before starting the treatment.

Seizures that occur in childhood may be benign. This means that it will not continue into one s adult life. Further, those children who have suffered from epilepsy in their childhood have been seen to have normal mental and intellectual development in their adulthood. However, some epilepsy syndromes in children can have a devastating effect on the child.

Seizure threshold is a term that is used to refer to the conditions that are important for the production of seizures. The threshold is lower for people who are more prone to having seizures whereas the threshold is higher for those who do not have a tendency to suffer from seizures.

A Complete Guide To Childhood Epilepsy!

With age, most body organs begin to deteriorate in their function. This happens to the brain also, thereby reducing the overall speed of functioning of most organs. While slowing of bodily movement is visible, the internal organs functioning also slows down, which is not that obvious. Memory loss or dementia is one of the main manifestations of this degeneration of the brain.

Alzheimer s is the most common form of dementia, and the associated symptoms includes reduced reasoning abilities and cognitive defects. Though it is seen only in the elderly, not all elderly people will have Alzheimer s. The overall quality of life of the affected person is reduced with difficulty remembering things that were recently learned. It is a progressive disease and as it gets more severe, a full-time caretaker may be required.

Causes: The brain cells are affected by protein masses known as plaques and tangles. These hamper the way communication between the brain cells happens as well as affect nutrition from reaching all parts of the brain. This leads to shrinking of the brain, eventually leading to memory loss and other problems. There is also a strong genetic linkage, as most people with Alzheimer s have the lipoprotein A gene.

Symptoms: Though memory loss is the most common symptom, there are other symptoms:

Being confused about places, people, and times
Inability to find the right words during conversations
Regular objects are misplaced
Becoming irritable, (in someone who was not so previously)
Mood swings
Personality changes
Inability to organise thoughts
Not able to make the right decisions
Repetitive talks and actions
Forgetfulness (not something the person always does)
Difficulty with numbers (again, not something calculations
Difficulty managing everyday tasks and minor problems
Suspicion of others (like immediate family members and friends)
Risk factors: While age is definitely a risk factor, the fact that not all aged people develop Alzheimer s is to be borne in mind. Other risk factors include the history of stroke, high cholesterol, high blood pressure, diabetes, smoking, obesity, and poor lifestyle choices.

Diagnosis: While there is no definitive way to diagnose Alzheimer s, symptoms along with brain scans and neuropsychological function testing are useful ways to confirm the diagnosis.

Treatment: This is aimed at two things reducing the rate of disease progression and treat (or reverse) symptoms if possible.

Cholinesterase inhibitors improve cellular communication in the brain and also manage depression and agitation. Memantine is used to slow the pace of disease progression.
In people with the disease, small changes are useful to help them with the symptoms. These include keeping essential things like keys and wallet in the same place, keep a daily diary to help them remember things, keep pictures of friends and family within visible distance.

Alzheimer's - An Overview!

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