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Cerebral palsy

Cerebral palsy
A child with cerebral palsy being assessed by a physician
Specialty
Symptoms
Complications
Usual onsetPrenatal to early childhood[1]
DurationLifelong[1]
CausesOften unknown[1] or brain injury
Risk factors
Diagnostic methodBased on child's development[1]
Treatment
Medication
Frequency2.1 per 1,000[2]

Cerebral palsy (CP) is a group of movement disorders that appear in early childhood.[1] Signs and symptoms vary among people and over time,[1][3] but include poor coordination, stiff muscles, weak muscles, and tremors.[1] There may be problems with sensation, vision, hearing, and speech.[1] Often, babies with cerebral palsy do not roll over, sit, crawl or walk as early as other children.[1] Other symptoms include seizures and problems with thinking or reasoning. While symptoms may get more noticeable over the first years of life, underlying problems do not worsen over time.[1]

Cerebral palsy is caused by abnormal development or damage to the parts of the brain that control movement, balance, and posture.[1][4] Most often, the problems occur during pregnancy, but may occur during childbirth or shortly afterwards.[1] Often, the cause is unknown.[1] Risk factors include preterm birth, being a twin, certain infections or exposure to methylmercury during pregnancy, a difficult delivery, and head trauma during the first few years of life.[1] About 2% of cases are believed to be due to an inherited genetic cause.[5]

Sub-types are classified, based on the specific problems present.[1] For example, those with stiff muscles have spastic cerebral palsy, poor coordination in locomotion have ataxic cerebral palsy, and writhing movements have dyskinetic cerebral palsy.[6] Diagnosis is based on the child's development.[1] Blood tests and medical imaging may be used to rule out other possible causes.[1]

Some causes of CP are preventable through immunization of the mother, and efforts to prevent head injuries in children such as improved safety. There is no known cure for CP, but supportive treatments, medication and surgery may help individuals.[1] This may include physical therapy, occupational therapy and speech therapy.[1] Mouse NGF has been shown to improve outcomes[7][8] and has been available in China since 2003.[8] Medications such as diazepam, baclofen and botulinum toxin may help relax stiff muscles.[1][9][10] Surgery may include lengthening muscles and cutting overly active nerves.[1] Often, external braces and Lycra splints and other assistive technology are helpful with mobility.[11][1] Some affected children can achieve near normal adult lives with appropriate treatment.[1] While alternative medicines are frequently used, there is no evidence to support their use.[1] Potential treatments are being examined, including stem cell therapy.[1] However, more research is required to determine if it is effective and safe.[1]

Cerebral palsy is the most common movement disorder in children,[12] occurring in about 2.1 per 1,000 live births.[2] It has been documented throughout history, with the first known descriptions occurring in the work of Hippocrates in the 5th century BCE.[13] Extensive study began in the 19th century by William John Little, after whom spastic diplegia was called "Little's disease".[13] William Osler first named it "cerebral palsy" from the German zerebrale Kinderlähmung (cerebral child-paralysis).[14]

  1. ^ a b c d e f g h i j k l m n o p q r s t u v w x y z aa ab ac ad ae Cite error: The named reference NINDS2013 was invoked but never defined (see the help page).
  2. ^ a b Cite error: The named reference Osk2013 was invoked but never defined (see the help page).
  3. ^ Haak P, Lenski M, Hidecker MJ, Li M, Paneth N (October 2009). "Cerebral palsy and aging". Developmental Medicine and Child Neurology. 51 (4): 16–23. doi:10.1111/j.1469-8749.2009.03428.x. PMC 4183123. PMID 19740206.
  4. ^ "Cerebral Palsy: Overview". National Institutes of Health. Archived from the original on 15 February 2017. Retrieved 21 February 2017.
  5. ^ Cite error: The named reference omim was invoked but never defined (see the help page).
  6. ^ Rosenbaum P, Paneth N, Leviton A, Goldstein M, Bax M, Damiano D, et al. (February 2007). "A report: the definition and classification of cerebral palsy April 2006". Developmental Medicine and Child Neurology. Supplement. 109: 8–14. doi:10.1111/j.1469-8749.2007.tb12610.x. PMID 17370477. S2CID 24504486.
  7. ^ Cite error: The named reference Huiling2019 was invoked but never defined (see the help page).
  8. ^ a b Cite error: The named reference Zhao2015 was invoked but never defined (see the help page).
  9. ^ Cite error: The named reference Farag2020 was invoked but never defined (see the help page).
  10. ^ Cite error: The named reference Blumetti2019 was invoked but never defined (see the help page).
  11. ^ Elliott CM, Reid SL, Alderson JA, Elliott BC (1 February 2011). "Lycra arm splints in conjunction with goal-directed training can improve movement in children with cerebral palsy". NeuroRehabilitation. 28 (1): 47–54. doi:10.3233/nre-2011-0631. ISSN 1878-6448. PMID 21335677.
  12. ^ "How many people are affected?". National Institutes of Health. 5 September 2014. Archived from the original on 2 April 2015. Retrieved 4 March 2015.
  13. ^ a b Cite error: The named reference History2013 was invoked but never defined (see the help page).
  14. ^ "What is cerebral palsy?". The Cerebral Palsied Association of the Philippines Inc. Archived from the original on 20 December 2016. Retrieved 4 December 2016.

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