Cerebral palsy is a condition that mostly affects children. This is generally a disorder of movement, posture or muscle tone and it is the result of some damage to the immature, developing brain. It mostly affects a child even before its birth. Children generally experience the symptoms during the preschool years or infancy. A child may suffer from impaired movement which is associated with abnormal reflexes, abnormal posture, involuntary movement, unsteady walking, rigidity or floppiness of the trunk and limbs or a combination of all these symptoms. People suffering from this condition may also have problems with swallowing and even experience vision problems due to imbalance of the eye muscle. Cerebral palsy may cause a person to lose mobility while it may result in intellectual disability in some other person. Some of the other symptoms may include blindness, deafness and epilepsy.
Cerebral palsy may be caused due to a number of factors. So the treatment for cerebral palsy is also as complex as the disease itself. The main target of treating cerebral palsy includes: improving mobility, controlling pain, managing the primary conditions, maximizing independence, fostering self-care, improving interactions with the society and family, improving the potential to learn, controlling the pain and furnishing a better quality of life.
Treatment involves taking a lot of different steps. A child may require the services of an entire medical care team which can include a pediatrician, orthopaedic surgeon, speech-language specialist, mental health specialist, developmental therapist, physical therapist and even a special education teacher. Sometimes medications and alternative therapies are also used. In some cases, a physician my also recommend surgery.
Both children and adults afflicted with cerebral palsy require the services of a medical care team which includes a pediatrician or physiatrist who oversees the entire treatment plan. An orthopedic surgeon is required to treat the muscle and bone disorders. A child suffering from this condition may require the services of an occupational therapist, who will help him/her to develop the skills and to learn to use adaptive products that will help him/her in performing daily activities. A speech-language specialist helps a person to deal with problems with speech, language and swallowing problems. A special education teacher will help a person to address the problems associated with learning by identifying the special educational requirements of the person.
Sometimes a doctor may recommend medications to improve the functioning of the body, to treat pain or to manage any complications that may arise related to spasticity or other symptoms of cerebral palsy. Doctors may recommend Botox injections to be administered directly into the muscle or nerve if a person suffers from spasticity of a single muscle group. Drugs like Valium, dantrium and gablofen are oral muscle relaxants that are used to treat generalized spasticity.
Physical therapy, occupational therapy, recreational therapy and speech and language therapy help a person with cerebral palsy to improve his/her functional abilities. Furthermore, orthopedic surgery may be recommended to children suffering from severe contractures or deformities. This surgery is basically used to place arms, legs or hips in their correct positions. When all other treatments have failed, a surgeon may perform a procedure called selective dorsal rhizotomy. This involves cutting the nerves that serves the spastic muscle.
A person suffering from cerebral palsy may suffer from underdeveloped or overdeveloped muscles, poor balance and coordination known as ataxia, spastic paralysis, athetosis or involuntary and slow writhing movements and limited range of body movement. The child may have problems with his/her basic development; have problems with vision or hearing, may suffer from seizures, may drool and have problems with sucking, swallowing and feeding and also have difficulty in controlling bladder or bowel movements. A person experiencing some or most of these symptoms is eligible for treatment.
A physician may check an infant’s medical history and track his/her development to see whether he/she is suffering from cerebral palsy or not. A doctor will examine a child’s movements, posture, muscle tone and also his/her reflexes. A child not diagnosed by a doctor to be suffering from this condition is not eligible for treatment. A person may suffer from other conditions which have similar symptoms like tumor or muscular dystrophy. In such cases blood tests, head ultrasound or an MRI or CT scan may be performed for proper diagnosis.
Botox injections may cause side effects like allergic reactions, itching, rash, stiffness of muscles, shortness of breath, nausea, pain in the neck and back, muscle weakness, diarrhea, stomach pain and difficulty in swallowing. A person may also suffer from injection site reactions like bruising, bleeding, redness, swelling and infection. A person taking diazepam may suffer from shakiness, unsteadiness and even may experience problems with controlling or coordinating muscle. Patients may also suffer from post-surgical complications if he/she has undergone orthopedic surgery or selective posterior rhizotomy.
A child’s functional abilities are impaired if he/she suffers from cerebral palsy. The best treatment includes nondrug therapies like physical therapy, occupational therapy, recreational therapy and speech and language therapy. There is basically no cure for cerebral palsy. A person suffering from this will have some impairment and the most that can be done is manage the symptoms and ease the pain. So a person will have to undertake treatment for a long time. Hence, there are no such post-treatment guidelines.
There is no such treatment for cerebral palsy. The brain injury or the problem causing cerebral palsy does not get worse, but in some other cases, newer complications may arise. People with cerebral palsy are often considered healthy even if they have impairment. A child affected by this condition my live for 30-70 years depending on the severity of the condition.
Botox injections may cost between Rs 15000 – Rs 18000 in India. A speech and language therapy session may cost anything between Rs 6000 and Rs 10000. Physical therapy sessions cost around Rs 3000. Selective dorsal rhizotomy is expensive and may cost more than Rs 20 lakhs.
People with cerebral palsy suffer from some impairment. Drugs or different therapies may help them to lead a better life. But they do not normally provide a permanent cure. They help to contain the symptoms. Newer complications may arise as the child gradually ages. Thus, he/she will have to continue with the therapy or continue taking the prescribed drugs. Thus, in most cases, the results are not permanent.
Controlled clinical trials like hyperbaric oxygen therapy, resistance exercise training by using special clothing and even some types of electrical stimulation are used to treat cerebral palsy in spite of inconclusive treatment. Doctors are also exploring the reliability of stem cell therapy to treat cerebral palsy.
Rs 15000 - Rs 2 lakh
Some babies learn to walk by the age of nine to ten months, and others may take longer, much longer to start walking properly. By the age of 15 months, people may start asking you if your little munchkin is able to walk yet. These constant questions can eventually irk you off, and keep you wondering if truly your baby is facing any sort of disability or not. In most cases, you will probably find your baby was too lazy to start walking all along, and he has mastered the art of “toddling” a couple of months later. Other times, when your baby has not started walking in over 17 months, you may want to give your paediatrician a visit.
When should you not worry?
If your baby is an active child and is playing around normally, you may not worry about him or her too much. If you find your child able to move around crawling or rapidly kicking his legs around, then your child is probably a late bloomer when it comes to walking. Other factors that will indicate that your baby is not going through any developmental issues are when he or she is able to communicate with sounds or broken speech. Other thing that you must keep in your mind is the relative age of your baby if it is born premature. If your toddler was born two months prematurely, then you must consider his developmental age by adding two months to his actual birth. Also notice if your child is able to move positions on his own, like if he is able to change positions when he is sitting down or lying down. As such, inability to walk is not really a solid indicative of a developmental disorder.
When is it of concern?
When you go to your paediatrician with your child regarding his inability to walk, your doctor will firstly take a note of the general movement of your baby. Thus the “quality” of movement is what matters the most. If your baby is showing signs of rigidity or flaccidity in his limbs, it may concern your doctor, as it is the primary symptom of cerebral palsy. Nothing can be concluded unless your get proper reports of scans like MRIs which your doctor will recommend you to get.
If your child is not walking, avoid carrying him around too much to allow him to make movements on his own. Who knows, you may find yourself chasing him around all over in no time! If you wish to discuss about any specific problem, you can consult a pediatrician.
The placenta is a link between you and your baby during pregnancy. It helps your baby to grow normally by providing it with food and oxygen. When the placenta is not able to do its work properly, the condition is called placental insufficiency or dysfunction.
Placental insufficiency is a serious complication of pregnancy and can happen when the placenta does not develop properly or is damaged. If this condition develops, the baby doesn’t get the nutrition and oxygen it needs to grow and can develop complications like low birth weight, premature birth, and birth defects. The mother can also develop dangerous complications if it’s left undiagnosed. Thus placental insufficiency must be diagnosed as early into the pregnancy to avoid these complications.
Causes of placental insufficiency
Actually, placental insufficiency is a blood flow disorder which happens due to a reduction in the mother’s blood supply. It can be triggered by vascular disorders, medications, lifestyle and the following:
Other causes of placental insufficiency are cases where the placenta doesn’t attach properly to the uterine wall or if the placenta breaks away from it.
Unfortunately, there are no symptoms of this dangerous condition in the mother except that she may notice that the size of her uterus is smaller than in previous pregnancies. She may also notice that the fetus is moving less than before. As far as symptoms of placental abruption or disruption go, there may be vaginal bleeding or pre-term labour contractions. In case placental insufficiency is not diagnosed, the mother can experience a serious fatal condition called Preeclampsia, which means high BP and protein in the urine as well as disruption of the placenta and pre-term birth. The picture for the baby is pretty dim too. The earlier placental insufficiency happens, the more grave the risk for the baby. The baby can suffer from:
Placental insufficiency can’t be cured, but it can be managed. Once diagnosed, it can be managed through proper prenatal care like treating maternal high blood pressure or diabetes, education on preeclampsia and ways to self-monitor for the disease, frequent doctor visits, bed rest to conserve energy for the baby and consultation with a specialist. These can improve the baby’s chances of normal growth.
Proper prenatal care of pregnant women is thus, very important as it can diagnose placental insufficiency early. A simple ultrasound can diagnose this dangerous condition by measuring the baby's size and growth, and assessing the size and placement of the placenta. If you wish to discuss about any specific problem, you can consult a gynaecologist and ask a free question.
Cerebral palsy is a neurologic condition that occurs in children, and is due to brain injury that develops before, during, or after childbirth. The condition presents with motor impairment, and therefore there is generalized physical and mental dysfunction. The brain continues to develop for the first two years of life, and so conditions like premature birth, asphyxia at birth, and postnatal meningitis and encephalitis.
The diagnosis could be trigged by the slow motor development, poor muscle tone, and delayed response of the baby. One of the main noticeable feature that becomes evident is the spasticity of the limbs. The child may not be able to voice it out, but pain is a significant disabling factor too. While doctors would advise that physical movement is required to keep the spasticity at bay, the pain keeps the child away from most activities. This further adds to the spasticity and worsening of the condition.
Pain control therefore assumes a significant role and the modes can range from physical therapy to pain killers to injections to surgery. The idea, in addition to pain control, is also to:
Some of the non-medical ways to control pain are listed below.
Of course, pain killers and injections are always used when immediate relief is required. A structured physical therapy program that includes medications and exercise is the best way to manage cerebral palsy pain. Though initially difficult, over a period of time, it improves range of motion and improves joint movement.
What do we mean by the term cerebral palsy?
A cerebral palsy is a group of permanent movement disorders which occur in early childhood. It is a neurological disorder which can occur due to many causes, such as hypoxia, injury, infection, hypoglycemia, or any other cause.
What are the symptoms of cerebral palsy?
Stiffness; tightness in the muscles of the extremities either upper or lower extremity; exaggerated movements; limited movements; abnormal gait; crossed knees; and abnormal reflexes are the common presentations of this disease.
How does physiotherapy help in cerebral palsy?
Physiotherapy is one of the best methods to assist patients with cerebral palsy. It helps in following ways:
What are the goals of the physiotherapy in patients with cerebral palsy?
The main goals of the physiotherapy are as follows:
What methods are used in physiotherapy for the patients with cerebral palsy?
It includes following methods:
The human brain develops astonishingly during the first three years of life. Compared to the rest of the life, the initial three years are crucial to acquire a majority of social and cognitive skills. The brain evolves during this phase immensely. However, the development milestones are not crossed by all the kids in the same manner. In a few kids, the advancement is delayed, and the progress does not happen as desired. For optimal development, such children need additional support. This is where occupational therapy comes into the picture. Yes, this therapy is not related to adults alone and can do wonders for kids. This therapy helps such children to overcome the barriers and lead a normal life gradually.
When you take the kids to an occupational therapist, he or she observes the kid. The apt plan or method to improve the skills or to train the kid to do a specific set of daily chores is devised based on the kid's condition. The age group of the kid, too, plays a vital role in designing the therapy. The therapy can be conducted in a hospital, school, home, or a specialized care center.