Cerebral Palsy, a developmental neurological disorder

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Anthony Golden
Cerebral Palsy, a developmental neurological disorder

In the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), cerebral palsy (CP) is understood as a neurodevelopmental disorder, it is also known by some health professionals as “central motor dysfunction”, it can be mild, moderate, severe or profound and implies a group of conditions that affect the psychomotor skills of the person, characterized by a control of balance, movement and / or posture "different from normal".

This neuropathology is associated with problems during the brain development of the fetus, in gestation, near the time of delivery, during birth, in the first days of life or due to strong trauma, either prenatal, perinatal or postnatal, destruction of nerve cells causes functional impairments, such as cognitive and sensory difficulties. When the child has a communication or motor disorder, the severity should also be assessed and specified.

Contents

  • Etiology of Cerebral Palsy (CP)
  • Incidence of cerebral palsy
  • Types of Cerebral Palsy
  • Cerebral Palsy: Risk Indicators
  • Family of a patient with cerebral palsy (CP)
    • Links

Etiology of Cerebral Palsy (CP)

The causes can be very varied, some of them can be: some infections or diseases during pregnancy, such as encephalitis and meningitis, intrauterine growth restriction, intrauterine infection, fetal coagulation disorders, multiple pregnancies, bleeding during pregnancy, when born prematurely, neonatal stroke, hypoxia, trauma, microcephaly at birth, chromosomal and congenital abnormalities. Some signs of fetal compromise that they take into account are: changes in the heart rate or the passage of meconium.

Incidence of cerebral palsy

Damage can occur prenatally, perinatally, or postnatally. According to estimates by the Centers for Disease Control and Prevention (CDC), in the world for every 1,000 births, between 1.5 to more than 4 suffer from CP. It is essential that children with cerebral palsy and their families seek support and guidance from a multidisciplinary health team that includes: neurologist, pediatrician, physiatrists, psychologists, speech therapists, in general they require psycho-pedagogical guidance.

It is estimated that in half of the cases it becomes a childhood motor disability (CDC, 2017), although a little more than half of children with CP can walk independently, one in ten children affected by this condition employs a device that helps them ease their movement. The CDC also estimates that approximately four out of ten cerebral palsy patients have epilepsy and roughly one in ten has autism spectrum disorder (ASD)..

Types of Cerebral Palsy

By tone and body posture:

  1. Spastic, it arises due to damage to the cerebral cortex and manifests itself with muscular rigidity and lack of control of muscular movements, it is estimated that between 70 and 85% of patients with CP share these characteristics.
  2. Athetoid or dyskinetic. Slow and involuntary movements, muscle tone can change from rigid to lax, especially in the upper and lower limbs, likewise, they have difficulty controlling their breathing, their vocal cords and their tongue, so often, it is necessary to pay a lot of attention to understand them.
  3. Ataxic. Due to lesions in the cerebellum, the patient has difficulty controlling balance.
  4. Mixed, the brain shows damage to different structures, for which it has clinical manifestations with variants to those previously described.

The classification based on the affected parts of the body or the "topographic criteria" are:

  1. Hemiplegia: Motor difficulties manifest only on the left or right side of the body.
  2. Paraplegia: Affects the lower limbs.
  3. Quadriplegia: Involvement in both arms and both legs.
  4. Monoplegia: only one part of the body is affected.

Cerebral Palsy: Risk Indicators

There are certain skills or abilities that "average" children develop as they grow older. The best results are achieved when the family also receives psychotherapeutic support and health professionals, join forces with teachers and caregivers. Social interaction is important for them, who attends school is highly recommended, remember that: "all children have the right to education", as far as possible it is beneficial to allow and support them to develop their independence.

The way your child develops in areas such as family and academics, their verbal and body language, the way they process new information, are aspects that you should observe, it is important to be aware of them and their needs, when children have CP they need an extra dose of love, patience, understanding, containment, acceptance and above all inclusion.

The game is an excellent tool to observe in the child various aspects of its development, the way in which your child does it, as well as his way of learning, speaking and behaving offers us key guidelines in his development. Recognizes some indicators of cerebral palsy in the first years of life, the Centers for Disease Control and Prevention (CDC), give us the following tips to observe in infants and young children:

SIGNS OF CEREBRAL PARALYSIS (CP)

AGEPC RISK INDICATORS
2 monthsThe baby does not follow moving objects with his eyes, does not respond to loud noises, does not smile or put his hands in his mouth. While on his stomach, he cannot hold his head up when he pushes his body up.
4 monthsHas difficulty moving one or both eyes in all directions and does not follow moving objects with his eyes, does not smile at people, cannot hold his head firmly, does not make sounds with his mouth or brings his hands to it , Does not push with the feet when supported on a hard surface.
6 monthsHe looks rigid and with tense muscles like a doll, does not show affection for those who care for him, does not laugh or make sounds of pleasure, does not try to grab things that are within reach, does not react to sounds, does not make vowel sounds, has Difficulty putting things in the mouth, does not turn in any direction to turn.
9 monthsDoes not seem to recognize acquaintances, does not respond when called by name, does not babble, does not pass toys from one hand to another, cannot sit up even with help, and does not hold onto his legs with support.
1 yearDoes not crawl, cannot stand with help, does not say simple words such as “mom”, does not learn to use gestures to communicate, such as saying hello, does not point to things, and loses skills that it has acquired.
18 monthsThey cannot walk, they do not imitate others, they do not point to things to show something to other people, they seem indifferent to whether their caregiver is present or not. Loses acquired skills and does not know what things that are in common use to him are for.
Does not handle at least 6 words or learn new ones.
2 yearsDoes not use phrases with 2 words: "I want milk", does not know how to use common objects, does not copy actions or words, cannot follow simple instructions, loses skills that had been achieved and does not walk with stability.
3 yearsFalls more often than children his age, may have trouble going up and down stairs, does not use sentences to speak, or understands simple instructions, drools or is not understood when speaking, cannot operate simple toys, does not imitate The others, in the playful aspect, do not use their imagination in their games, they do not want to play with other children or with toys, they do not look people in the eye, and they lose skills that they had acquired.
4 yearsCannot jump in place, has difficulty scribbling, is not interested in interactive or imaginative games, ignores other children or does not respond to people outside the family, refuses to dress, sleep, and use the bathroom . He does not understand what “the same” and “different” mean, he is not able to tell his favorite story, he does not follow 3-part instructions, he does not use the words “I” and “you” correctly, he speaks poorly and he loses skills that I had acquired.
5 yearsHe is too withdrawn and passive, trouble concentrating on an activity for more than 5 minutes and is easily distracted, has very extreme feelings and emotions eg: too fear, aggression, shyness or sadness. He does not respond to people or does so only superficially. He also cannot distinguish fantasy from reality, does not play with a variety of activities, cannot say his first and last name, does not use plurals and past tense correctly, does not talk about his daily activities or experiences, does not draw, cannot brush teeth, washing and drying hands or undressing without assistance and losing skills acquired in advance.

Family of patient with cerebral palsy (CP)

The person with cerebral palsy (CP), with the appropriate adaptations, can have a happy life and have great vital achievements. However, they have special attention needs, due to differences in their adaptive functioning. Technology offers new tools, find out about those that can make life easier for them, adaptations at home promote the independence of the child with cerebral palsy, it is advisable to do the necessary ones so that the child can cultivate good personal hygiene habits and others, go from bathroom chairs, mobility devices, canes, electronic home assistance to facilitate functions, among many more.

Without adequate support, their performance in daily living can be limited in terms of independent living in different settings such as school and work. Social participation and inclusion begins in the cell of society: the family! The educational programs and services provided by health professionals represent great support, there are some that have home assistance for patients with cerebral palsy (CP), which represents a great relief for parents.

Family dynamics is a core point, many of the warnings and learnings can be acquired through play, look for special programs and inclusive environments for them to develop extracurricular activities.

Motivation is one of the "keys" that will open the "door" of persistence and perseverance in treatments, both on the part of the patient and the family; Often times, resources may not appear to be necessary for the child's needs, parents may be invaded by doubts and fears about the future of their children, training to manage emotions in patients with CP and parents provides great benefits, some parents struggle day by day for a better tomorrow for your children:

"Many warriors need to heal their wounds, in order to move forward in battle"

Sometimes there is limitation of some resources necessary to give them the care required by the patient with CP, they can be of all kinds or a combination of them: economic, temporary, when "time is not enough" to take them to their treatments with different specialists ... Therefore, a resource that should not be lacking is love, because when there is a strong affective bond, there is also greater inclusion, because:

"Love often makes parents break their limitations and motivates them to go beyond their" capacities ": 'when you have a child with CP, you discover many skills that you didn't think you had"

Sometimes things get "more than difficult", it is natural that there are certain periods of excessive stress: the work and social obligations of parents can be many too ... Despite this, when everything looks "darker", and When they feel that their efforts "will not be worth it", it is necessary to reduce stress levels, seek psychological assistance and move on: love can give you that "extra energy" when you feel that you can't take it anymore.

Links

  • https://www.fondationparalysiecerebrale.org/quest-ce-que-la-paralysie-cerebrale
  • https://www.cdc.gov/ncbddd/cp/data.html
  • http://www.mychildwithoutlimits.org/understand/cerebral-palsy/cerebral-palsy-prognosis/10-myths-about-cerebral-palsy/?lang=es
  • https://www.nhs.uk/conditions/cerebral-palsy/
  • https://www.understood.org/es-mx/school-learning/your-childs-rights/basics-about-childs-rights/idea-fact-sheet
  • http://www.mychildwithoutlimits.org/understand/cerebral-palsy/cerebral-palsy-treatment/assistive-technology/?lang=es

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