Cerebral palsy or CP is a group of disorders that are associated with developmental brain injuries that occur during fetal development, birth, or shortly after birth. It is also known as static encephalopathy and Little's disease after its discoverer. Cerebral palsy is no longer considered a disease, but rather it is a chronic nonprogressive nuerological disorder. The incidence is about 1.5 to 4 per 1000 births. There is no cure, but therapy may be helpful.
Cerebral palsy, then known as "Cerebral Paralysis", was first identified by a British surgeon named William Little in 1860. Little raised the possibility of asphyxia during birth as a chief cause of the disorder. It was not until 1897 when Sigmund Freud suggested that the problems with birth were not the cause but rather only a symptom of other effects on fetal development. Modern research has proved that Freud was correct, however, Little's view became the traditional explanation.
The disorder is marked by several important signs. All persons with cerebral palsy developed it while the brain was under development. This limits the age at which the disorder can develop to at most 5 years old. Secondly, it is a nonprogressive disorder, that is, once the damage to the brain is done no additional damage occurs. Cerebral palsy never worsens, though its symptoms may change with time. The disorder also never improves. It is a permanent disability which stays with a person their entire life. Any temporary problems would suggest a disorder other than cerebral palsy. Additionally, the disorder is characterized by disruption of the motor skills of the person. There is a wide range of severity in the loss of motor skills from normal. Lastly, even though there is a loss of motor skils, the muscles themselves are not defective. The problem lies solely in the brain's ability to control those otherwise healthy muscles.
Since cerebral palsy refers to a group of disorders, there is no exact known cause. Some major causes are asphyxia or hypoxia of brain, birth trauma or premature birth, genetic susceptibility, certain drugs or infections in the mother which reach the fetus during pregnancy, central nervous system infections trauma, consecutive hematoma. After birth, the condition may be caused by toxins, physical brain injury, and meningitis.
Recent research has demonstrated that asphyxia is not the most important cause as it was once considered to be, though it still plays a role. The research has shown that infections in the mother, even infections that are not easily detected, drastically increase the risk of the unborn child developing the disorder.
The classical symptoms are spasticity, paralysis, seizures, unsteady gait, and dysarthria. While mental retardation and cerebral palsy do not cause each other, the two disorders are found together in approximately 40%-70% of all persons with cerebral palsy.
Treatment
The treatment is usually symptomatic and the development of intensive care units for newborns has not resulted in a dramatic decrease in the incidence. This is suggestive of the fact that the people suffering from this disease are genetically susceptible and can only have some benefit from a life-long care. The expected length of life does not seem to be affected.
References
- "Conditions in Occupational Therapy: effect on occupational performance." ed. Ruth A. Hansen and Ben Atchison (Baltimore: Lippincott Williams & Williams, 2000), 8-21. ISBN 0-683-30417-8
- "Cerebral Palsy Explained." October 3, 2002, http://www.cerebralpalsy.cc/cerebral_palsy_explained.html
- "William and Spackman's Occupational Therapy 9th Edition." ed. Maureen E. Neistadt and Elizabeth Blesedell Crepeau (Lippincott-Raven Publishers, 1998), 233, 589-598. ISBN 0-397-55192-4