Cerebral Palsy in the Infant and Child
A child is usually about 18 months old before a doctor can accurately diagnose a condition or cerebral palsy. Every child develops at his/her own pace, but if a child is not developing appropriate motor skills by this time or is exhibiting signs of weakness or paralysis of limbs, it usually takes this long before it becomes really noticeable.
There are several tests the doctor will schedule to make the diagnosis:
CT Scan. This X-ray will be able to see the child’s brain and determine if there is any damage to the structure of the brain and the extent of the damage.
MRI Scan. This creates tissue slice images of the brain without using X-Ray technology to allow doctors to have a look at the brain.
Other tests. There may be genetic or metabolic tests required to rule out other medical conditions that may have similar symptoms.
There are four categories of cerebral palsy that are found when the diagnosis is made in childhood:
Spastic cerebral palsy occurs when the muscles are too tight. Children who exhibit this form of the condition have short jerky movements and often have difficulty opening their hands to let go of objects. This category can be further subdivided into five other categories:
Diplegia – affects both arms or both legs
Hemiplegia – only affects the arms and/or legs on one side of the body
Quadriplegia – affects both arms and both legs
Monoplegia – only one limb is affected
Triplegia – three limbs are affected
Ataxic cerebral palsy occurs when the child’s muscles are too weak. Children will be very shaky and unsteady with poor balance meaning they will begin walking at a later than normal age.
Athetoid cerebral palsy exhibits itself as fluctuating between weak and rigid muscles. There are usually involuntary movements in the face and the children usually have difficulty holding themselves up.
Mixed cerebral palsy refers to a combination of any of the above three categories.
Children with cerebral palsy may also have other medical conditions. In addition to varying degrees of physical impairment, the children may have visual problems or speech problems. They may be prone to seizures and may be mentally handicapped. The problems may also extend to not being able to eat on their own and behavior problems.
This is not to say that all children with cerebral palsy also have some degree of mental retardation. Some only have a mild physical impairment and are able to get around on their own. At the same time, other children may be severely affected. Ongoing therapy is needed and often children need braces or wheelchairs.
There is no known cure for cerebral palsy, but with the various treatments available children can go on to lead happy and productive lives. They regularly require physical therapy of muscle training and strengthening exercises to help improve the child’s balance. The use of braces can help prevent contractures – a condition where the muscles become fixed in an abnormal position. Occupational therapists also work with children with cerebral palsy to teach them coping strategies and other strategies that will help give them some independence in their lives, such as how to feed and dress themselves.
Speech therapists also work with children who have communication problems and the doctor will prescribe muscle relaxants to help ease the pain of muscle spasms and contractions. Medications can also help prevent seizures. For children with contractures, surgery often helps to adjust the abnormal positions of the limbs to make life more endurable. There are also many assistive technologies that can be installed in the home, such as grab rails magnifiers and even Velcro strips attached to cutlery.
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