Cerebral palsy

Cerebral palsy (CP) is a neurological disorder which affects the brain and nervous system.  Cerebral referring to the brain and palsy which means complete – or partial paralysis.  The communication between the brain and muscles are affected and CP is a lifelong condition.   Body movements, coordination and ability to maintain or change positions are affected in people with CP.

Causes of Cerebral Palsy:

1. During pregnancy

• Infection during early stages of pregnancy
• Abnormal brain development

2. During birth process

• Prolonged birth process
• Premature birth
• Lack of oxygen

3. After birth process

• Traumatic brain injury
• Any incident resulting in a lack of oxygen e.g. child that almost drowned
• Stroke
• Diseases such as meningitis, jaundice and measles

Let’s make sense of Cerebral Palsy:

CP is classified in different subtypes, thus diagnosis is made by taking in account the following:

1. Classification based on severity level: mild, moderate and severe.
2. Classification based on topographical distribution. Monoplegia which means one limb is affected, diaplegia which indicates that the legs are more affected than the arms.  Hemiplegia which means one side of the body is weak or paralyzed, double hemiplegia indicates all four limbs are involved, but one side of the body is more affected.  Paraplegia which indicates that both legs are affected.  Triplegia which indicates three limbs are affected and quadriplegia affects all four limbs.  Pentaplegia involves all four limbs as well as the neck and head paralysis, this is also accompanied with eating and breathing complications.
3. Muscle tone: Hypertonia referring to increased muscle tone and stiff limbs. Hypotonia means decreased muscle tone and floppy limbs.
4. Motor function: Spastic and non-spastic. Non-spastic children with CP are characterized by voluntary movement.  This can be classified into two types:
   1. Ataxic, which affects coordinated movements
   2. Dyskinetic which is divided into two sub groups Athetiod and Dystonic. Involuntary movement in the arms, hands and legs can be observed in children with Athetiod CP.  Dystonia affects the trunk muscles more than the limb muscles, thus children with dystonia will often have twisted postures.

Complications:

Children with CP can suffer from a wide variety of complications.  Contractures can develop, this is the shortening of muscle tissue and caused by the spasticity.  Malnutrition can occur due to children with CP struggling to swallow. Lung disease and breathing difficulties can be present.  Early onset osteoarthritis can develop due to the pressure on the joints and the abnormal alignment of the joints which causes degeneration of the joints.

Management:

Occupational therapy will be focussed on promoting the child with CP’s independence in daily activities e.g. focussing on teaching the child to reach and grasp for independent feeding or playing.  Every child with CP is unique and treatment aims and objectives will be specialized for the child’s classification and abilities.  Assistive devices e.g. wheelchairs will also be recommended by the Occupational Therapist for your child with CP.

For any enquiries contact 056 816 2155

Compiled by

Lize van der Linde

Community service Occupational Therapist