Understanding and Overcoming Challenges of Cerebral Palsy

By Dr. Smilu Mohan Lal, Consultant – Paediatric Neurology, Aster MIMS, Calicut

The theme for World Cerebral Palsy Day in 2023 is “Together Stronger.” This theme highlights the importance of unity, collaboration, and mutual support within the cerebral palsy community and beyond. The article below discusses some of the important concepts of Cerebral Palsy.

Cerebral palsy is a movement disorder that affects millions of people worldwide. According to available information, the earliest references to it are in the writings of Hippocrates, who is known as the father of modern medicine. These are believed to be from the 5th century BC. Coming to modern times, in the 1860s, William John Littlenall, a surgeon, described this disease under the name ‘Cerebral Paralysis’. Cerebral palsy was named by William Osler, who was a prominent physician.

What is Cerebral Palsy?
Cerebral palsy is a common form of brain insult that occurs in a baby during pregnancy or before birth, during birth, or after birth. It cannot be considered as a separate disease. It can refer to various forms of difficulty such as problems affecting movement, body balance, standing, coordination, communication, ability to learn, eating and sleeping. At the same time, children’s brain areas that control movement are mostly affected. Statistics show that in every 1000 babies born in India, three are affected by cerebral palsy.

Difficulties faced by cerebral palsy sufferers
Cerebral palsy affects each person differently. People with severe cerebral palsy can have great difficulty swallowing, breathing, and controlling the head, neck, bladder, and bowel movements. Some have weakness in only one arm. Some may need full-time assistance.

A significant proportion, approximately one in four individuals with cerebral palsy, experiences difficulties in verbal communication, sometimes being unable to produce any sounds. Additionally, accompanying disorders can lead to severe pain, impacting behaviour, self-care, and sleep adversely.

Main reasons for cerebral palsy
The main cause of cerebral palsy is due to the insult and strain to the brain during the early stages of development. The famous psychologist and neurologist Sigmund Freud found the main reason for this to be growth disorders.

Infections of the mother during pregnancy, various viral diseases, high blood pressure, diabetes, premature delivery, underweight baby, shortness of breath during pregnancy, umbilical cord around the neck, irregular changes in blood glucose, respiratory problems during birth, Infections of the brain such as meningitis and encephalitis, accidents to children after birth, head injury and bleeding, and epilepsy after birth can all cause cerebral palsy. It can also be caused by the mental stress experienced by the mother during pregnancy.

Can it be identified early?
Cerebral palsy can be detected early by carefully observing the baby.

Signs of concern in infants may manifest as difficulty in sucking, persistent crying, inadequate body strength, or uncontrolled movements. A two-month-old baby not responding with smiles or avoiding eye contact, using only one part or limb of the body, and displaying a lack of attention to sounds or developmental milestones like turning the head, falling down, swimming, sitting, standing, and walking can be indicative of underlying issues.

It is crucial to share the birth history with expert medical professionals. A comprehensive evaluation, including a detailed physical examination and essential tests such as blood tests, EEG, CT, MRI, as well as hearing and vision assessments, is imperative for accurate diagnosis and appropriate intervention.

Treatment options
There are currently no specific treatments that can completely cure cerebral palsy. It cannot be cured by medicine alone. Various types of therapy are also essential. For this, Treatment is determined after examining and evaluating the child by a team of experts including Paediatrician, Paediatric Neurologist, Early Developmental Therapist, Paediatric Physiotherapist, Occupational Therapist, Speech Language Therapist, Psycho-Behavioural Therapist, Special Teachers, social workers. Meanwhile, delaying treatment will reduce effectiveness.

At least 40 percent of children with cerebral palsy have normal intelligence. Such children’s mobility, communication skills and learning skills should be determined through special tests and appropriate treatment should be given.

Let’s stand with them!
Living with disabilities caused by cerebral palsy can present challenges in leading a normal life. However, it’s crucial to emphasize that individuals with cerebral palsy can cultivate confidence and strength, enabling them to actively participate in society. Empowering them through skill development is also instrumental in fostering self-sufficiency.

Children with cerebral palsy have unique needs, and while medical professionals play a significant role in their treatment, parents and family members can contribute significantly to improving their lives. Monitoring the child’s health and actively participating in treatment are essential steps for parents. This involvement helps assess the effectiveness of prescribed treatments by doctors and therapists.

Recognizing that a child with cerebral palsy may face limitations compared to their siblings or peers, it becomes a family responsibility to provide the necessary support. Rather than focusing on limitations, family members should collaborate to broaden the child’s horizons. Engaging in various activities such as beach outings, park visits, exposure to diverse music, participation in games, and encouraging the child to take an active role in trying new things can contribute to their overall development and well-being.