CEREBRAL PALSY: BASIC FACTS

Cerebral palsy (CP) is a permanent physical condition that affects movement. Its effect can be as mild as just a weakness in one hand ranging to almost complete lack of movement.

There are three main types of cerebral palsy and each involves the way a person moves. Movements can be unpredictable, muscles can be stiff or tight and in some cases people can have shaky movements or tremors.

People with cerebral palsy may have seizures and other impairments affecting their speech, vision, hearing and/or intellect.

Cerebral palsy, except in its mildest forms, can be seen in the first 12-18 months of life. It presents when children fail to reach movement milestones. Babies most at risk of cerebral palsy are those born prematurely or with low birthweight.

In Australia it is estimated that a child is born with cerebral palsy every 18 hours. Worldwide, the incidence is the same - 1 in 400 births. There is no pre-birth test and no known cure. For most, the cause is unknown.

MORE DETAILS ABOUT CEREBRAL PALSY
TYPES OF CP

There are three main types of cerebral palsy:

Spastic cerebral palsy
This is the most common type of cerebral palsy. Spasticity means stiffness or tightness of muscles. The muscles are stiff because the message to the muscles is sent incorrectly through the damaged part of the brain. This is the most common type, affecting 70-80% of the people with the condition.

When people without cerebral palsy perform a movement, some groups of muscles become tighter and some groups of muscles relax. In people with spastic cerebral palsy, both groups of muscles may become tighter. This makes movement difficult or even impossible.

Dyskinetic cerebral palsy
This type affects about 10-20% of people with cerebral palsy. There are two forms:
- Athetosis is characterised by uncontrolled, slow, ‘stormy’ movements;
- Dystonia is characterised by sustained or intermittent muscle contractions causing twisting or repetitive movement.

Ataxic cerebral palsy
This is the least common type of cerebral palsy and is characterised by shaky movements. It affects a person’s balance and coordination.

Many people have signs of more than one of the three types. The most common mixed form includes spasticity and dystonic movements, but other combinations are also possible.

What part of the body is affected by CP?

This is different from one person to another. In cerebral palsy, certain words are used to describe the parts affected:

Hemiplegia - the leg and arm on one side of the body are affected.

Diplegia - both legs are affected significantly more than the arms. Children with diplegia usually have some clumsiness with their hand movements.

Quadriplegia - Both arms and legs are affected. The muscles of the trunk, face and mouth can also be affected.

WHAT CAUSES CEREBRAL PALSY?

Cerebral palsy results from damage to part of the brain. The term is used when the problem has occurred to the developing brain, usually before birth. For most people with cerebral palsy, the cause is unknown.

The risk is greater in babies born preterm and with low birthweight. Whilst the reasons for this remain unclear, cerebral palsy may occur as a result of problems associated with preterm birth or may indicate an injury has occurred during the pregnancy that has caused the baby to be born early.

In some cases, damage to the brain may occur:
- in the early months of pregnancy, for example, if the mother is exposed to certain infections such as German Measles;
- due to the baby not growing at the correct rate during the pregnancy;
- at any time if there is a lack of oxygen supplied to the baby. This is of particular concern during birth. Current research suggests that in some cases this may be due to abnormalities already present in the baby which affect the baby during the birth process;
- in the period shortly after birth, if an infant develops a severe infection such as meningitis or encephalitis, which, in rare cases, may result in brain damage;
- accidentally in the early years of life; for example, with a near drowning or car accident.

Ongoing research is vital for the management of cerebral palsy. An Australian CP Register has been set up to record the incidence and will guide future research in prevention, intervention and service provision.

WHAT OTHER CONDITIONS MAY PEOPLE WITH CEREBRAL PALSY HAVE?

Disorders of hearing - People with cerebral palsy sometimes also have hearing problems.

Disorders of eyesight - People with cerebral palsy may have squints or other visual problems.

Epilepsy - People with cerebral palsy may also have recurring seizures (fits).

Intellectual disability and learning difficulties - Children and adults with cerebral palsy vary widely in their intellectual and learning capabilities. Some will show the same intellectual capabilities as other children, in spite of their physical difficulties. Others will have some degree of intellectual disability, ranging from mild through to very significant.

Perceptual difficulties - Perception is making sense of information gained from the senses. This enables people to do things such as move around obstacles, judge size and shape of objects and understand how lines are connected to form letters. People with cerebral palsy can have problems with perception as the brain may have difficulty interpreting the messages it receives from the senses.

Speech difficulties - Because the muscles of the mouth may be affected, some people with cerebral palsy may find talking difficult. Some people may be mildly affected whilst others cannot say any words at all. People who cannot speak clearly may use a communication board or electronic communication device.

Eating and drinking difficulties - CP may affect the muscles that open and close the mouth and move the lips and the tongue. Some children have difficulty chewing and swallowing certain foods.

WHAT IS THE FUTURE FOR PEOPLE WITH CEREBRAL PALSY?

Cerebral Palsy is a life-long condition - generally the weakness, stiffness or unwanted movements remain throughout the person’s life. People with cerebral palsy live with it all their lives. It is important for children to receive support from an early age to ensure they have every opportunity to reach their full potential. There is, however, no cure for the condition.

Many people with cerebral palsy are healthy and live to old age. Those people with the more severe forms of the condition may have many health problems that result in a shortened life span. They may also experience signs of ageing at a much earlier age. For example a person with cerebral palsy may have problems with osteoporosis (brittle bones) from their early twenties. This disease would normally not be present in a non-disabled person until they were in their fifties, or older.

Parents often ask, 'Will my child lead a "normal" life?'

This varies from person to person. People with mild cerebral palsy often need no additional support to undertake the activities that most people enjoy. Others may need assistance to eat their meals, go to the toilet, or need special equipment to communicate or move around (wheelchairs and walkers).

New technology has made a huge difference. Using special accessing devices, people with cerebral palsy can now use computers like everyone else - to ‘surf’ the net, email friends, apply for jobs and work in regular employment. Computer based technology allows people with disabilities to operate everyday appliances, such as TVs, CD and DVD players and air conditioners.

Like the rest of the community, people with cerebral palsy have a wide range of skills, qualifications and experience. Some have abilities at work entry level, whilst many have tertiary qualifications such as TAFE certificates, diplomas and university degrees