Cerebral Palsy
The words Cerebral Palsy are used to describe a medical condition that affects control of the muscles. The movement problems vary from barely noticeable to extremely severe. Cerebral means anything in the head and palsy refers to anything wrong with control of the muscles or joints in the body. If someone has cerebral palsy it means that because of an injury to their brain (that's the cerebral part) they are not able to use some of the muscles in their body in the normal way (that's the palsy part). Thus Cerebral Palsy is not a disease or an illness. Children with cerebral palsy have many problems, but not all of them are related to the brain injury. Most of these complications are nevertheless neurological. They include epilepsy, mental retardation, learning disabilities, and attention deficit-hyperactivity disorder. Problems that occur less commonly, are swallowing problems in children with spastic quadriplegia. Children with cerebral palsy may also develop hip subluxation or have problems with the gait. No two people with cp are the same; it is as individual as people themselves.
Depending on which areas of the brain have been damaged, one or more of the following may occur:
- Muscle tightness or spasm
- Involuntary movement
- Difficulty with gross motor skills such as walking or running
- Difficulty with fine motor skills such as writing and speaking
- Abnormal perception and sensation
These effects may cause associated problems such as difficulties in feeding, poor bladder and bowel control, breathing problems and pressure sores.
The brain damage, which caused CP, may also lead to other conditions such as:
- Seizures
- Learning disabilities
- Developmental delay
It is important to remember that limbs affected by CP are not paralyzed and can feel pain, heat, cold and pressure. It is also important to remember that, just because someone with CP may not be able to speak, it does not mean he has nothing to say. The degree of physical disability experienced by a person with CP is not an indication of his level of intelligence.
Children with CP have damage to the area of their brain that controls muscle tone. Depending on where their brain injury is and how big it is, their muscle tone may be too tight, too loose, or a combination of too tight and loose. Muscle tone is what lets us keep our bodies in a certain position, like sitting with our heads up to look at the teacher in class. Changes in muscle tone let us move.
Cerebral palsy may be classified by the type of movement problem (such as spastic or athetoid cerebral palsy) or by the body parts involved (hemiplegia, diplegia, and quadriplegia).
Spastic Cerebral Palsy
If muscle tone is too high or too tight, the term spastic is used to describe the type of cerebral palsy. Children with spastic CP have stiff and jerky movements because their muscles are too tight. They often have a hard time moving from one position to another or letting go of something in their hand. This is the most common type of CP. About half of all people with CP have spastic CP.
Ataxic Cerebral Palsy
Low muscle tone and poor coordination of movements is described as ataxic (a-tax-ick) CP. Kids with ataxic CP look very unsteady and shaky. They have a lot of shakiness, like a tremor you might have seen in a very old person, especially when they are trying to do something like write or turn a page or cut with scissors. They also often have very poor balance and may be very unsteady when they walk. Because of the shaky movements and problems coordinating their muscles, kids with ataxic CP may take longer to finish writing or art projects.
Athetoid Cerebral Palsy
The term athetoid is used to describe the type of cerebral palsy when muscle tone is mixed - sometimes too high and sometimes too low. Children with athetoid CP have trouble holding themselves in an upright, steady position for sitting or walking, and often show lots of movements of their face, arms and upper body that they don't mean to make (random, involuntary movements). These movements are usually big. For some kids with athetoid CP, it takes a lot of work and concentration to get their hand to a certain spot (like to scratch their nose or reach for a cup). Because of their mixed tone and trouble keeping a position, they may not be able to hold onto things (like a toothbrush or fork or pencil).
Mixed Cerebral Palsy
When muscle tone is too low in some muscles and too high in other muscles, the type of cerebral palsy is called mixed. Besides different kinds of muscle tone, kids with CP also show different parts of their bodies that are affected by the CP. This is also due to what part of their brain was hurt and how big the injury was.
Quadriplegia
When a child shows CP in all four of their limbs--both arms and both legs, it is called quadriplegia. Quad means four. Usually kids with quadriplegia have trouble moving all the parts of their bodies, their face and trunk as well as their arms and legs, and may need a wheelchair to get around. Because of the problems controlling the muscles in their face and upper body, they also have trouble talking and eating.
Hemiplegia
Hemiplegia means that the CP affect one side of the child's body. Hemi means half, so the right arm and leg or the left arm and leg are affected. The other side of the child's body works just fine. Many kids with hemiplegia are able to walk and run, although they may look a little awkward or have a limp.
Diplegia
Some children have CP just in their legs or much more severe in their legs than in their arms. This is called diplegia. Di means two, so in diplegia only the two lower limbs are affected. As you probably can guess, the difficulty for children with diplegia is using their legs, so walking and running may be hard for them. Because their upper bodies are usually not affected they have good ability to hold themselves upright and good use of their arms and hands. You may wonder whether anyone ever has CP in their arms but not their legs. This happens sometimes, but it is very, very rare.
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