|
| |
|
 What
is cerebral palsy?
Cerebral palsy is a term used to describe a
group of chronic conditions affecting body movement and muscle coordination. It is caused
by damage to one or more specific areas of the brain, usually occurring during fetal
development; before, during or shortly following birth; or during infancy.
"Cerebral" refers to the brain and "palsy" to muscle weakness; poor
control. Cerebral palsy itself is not progressive (i.e., it does not get worse); however,
secondary conditions can develop which may get better over time, get worse, or remain the
same. Cerebral palsy is not communicable. It is not a disease and should never be referred
to a s such. Although cerebral palsy is not "curable" in the accepted sense,
training and therapy can help improve function.
What are the effects?
Cerebral palsy is characterized by an
inability to fully control motor function, particularly muscle control and coordination.
Depending on which areas of the brain have been damaged, one or more of the following may
occur: muscle tightness or spasm; involuntary movement; disturbance in gait and mobility;
abnormal sensation and perception; impairment of sight, hearing or speech; seizures; and
mental retardation. Because of these, other problems may arise, such as difficulties in
feeding, bladder and bowel control, problems with breathing because of postural
difficulties, skin disorders because of pressure sores, and learning disabilities.
|
|
 What
are the causes?
Any damage to the brain, whereto caused by
genetic or developmental disorders, injury or disease, may produce cerebral palsy. One
important cause is an insufficient amount of oxygen reaching the fetal or newborn brain.
Oxygen supply can be interrupted by premature separation of the placenta from the wall of
the uterus, awkward birth position of the baby, labor that is too long or too abrupt, or
interference with circulation in the umbilical cord. Premature birth, low birth weight, RH
or A-B-O blood type incompatibility between mother and infant, infection of the mother
with German measles or other virus diseases in early pregnancy, and micro-organisms that
attack the infant’s central nervous system also are risk factors for cerebral palsy.
Most causes of cerebral palsy are related to the developmental and childbearing processes
and, since the condition is not inherited, the condition is often called congenital
cerebral palsy. A less common type is acquired cerebral palsy; head injury is
the most frequent cause, usually the result of motor vehicle accidents, falls, or child
abuse; another cause is brain infection.
|
|
PreventionAcquired cerebral
palsy can be prevented in part by widespread education about and efforts toward accident
prevention, particularly accidents involving automobiles and hazards in the home.
Prevention of child abuse and neglect is also important, as is regular pediatric
well-child supervision, including complete recommended basic and booster immunizations,
monitoring of growth and development, and proper nutrition guidance throughout infancy and
the preschool years. As mentioned previously, prevention of hyperbilirubinemia has almost
eliminated the athetoid type of cerebral palsy. There is evidence, however, that good
health practices preceding and during pregnancy can to some extent prevent prematurity,
which is so closely associated with a substantial fraction of cerebral palsy cases.
Such practices include good nutrition,
particularly during adolescence and early adulthood, and up-to-date immunization status,
with particular emphasis on German measles (rubella) immunization. (There are a number of
American women in the childbearing years who may be susceptible to the rubella virus, as
they did not have the disease in childhood and were not in the first groups of children to
be immunized when the vaccine was approved for use in 1969.)
Recommended measures for women who are or
want to become pregnant also include correction of any physical conditions, such as
diabetes or anemia, elimination of infections, particularly those of the genital tract,
and avoidance of smoking, alcohol, and addictive drugs. Women who become pregnant before
18years of age or after 35 face a higher risk of premature delivery. Regardless of age, it
is of the utmost importance that prenatal care be started as early as possible and
continued under the regular supervision of a qualified obstetrician.
While no guarantee can ever be given, the
observance of good health practices both before and during pregnancy will increase
considerably the chance of having a sound and healthy baby. |
|
Management
Cerebral palsy is a life-long condition.
There is as yet no way to repair the original lesion in the brain, and cerebral palsy is
not a disease amenable to treatment and cure. The major goal is to maximize the functional
abilities of the person with cerebral palsy and minimize the handicapping effects.
This involves as early intervention as is
feasible by physical, occupational, and speech therapists. (Occupational therapy involves,
learning coordination and how to manage daily routines, such as dressing oneself and
eating.) An expert in special education, a nurse, and a social worker frequently join this
team. With the active participation of a family member, generally the mother but including
both parents if possible, and with input from the medical specialists, the team develops
an individual management plan to attain specified goals and objectives. This plan is
reviewed periodically and is modified as appropriate.
Many communities how have "early
development" programs in centers where, in addition to the professional services for
the affected child, parent counseling and support groups are available to help other
members of the child’s family.
Medications have so far not been effective
over long periods of time, except for standard anticonvulsant drugs given to children with
seizures. The levels of these medications in the blood must be carefully monitored. So
must medications sometimes given to control drooling. Muscle relaxants have not been too
effective and do have side effects, serious and dangerous in some instances.
Orthopedic surgery and the use of orthotic
appliances such as braces play a significant role in both the prevention and correction of
deformities, particularly of the lower extremities and the back. In recent years gait
analysis laboratories have accumulated considerable data about normal and abnormal
walking. This work has been of great value in enabling orthopedic surgeons, orthotists,
and physical therapists to provide better services to persons with cerebral palsy.
(Orthotists specialize in the support and bracing of weak or deformed muscles.)
Various neurosurgical procedures have been
tried in the past, only to be abandoned because they proved to be ineffective. Currently,
a number of pediatric neurosurgeons in the United States are performing a procedure called
selective dorsal (or posterior) rhizotomy. In this procedure, the dorsal nerve rootlets
emerging from the lumbar (lower) part of the spinal cord are tested to find which of them
are causing spastic contraction of the muscles in the legs. Those responsible are then
cut, which relieves the spasticity and enables physical therapy to be more effective. The
strict eligibility requirements that the surgeons have stipulated are met only by a
limited number of children with spastic diplegia. No thorough evaluation of the procedure
has been made to date. |
|
History of UCPA at National
United Cerebral Palsy (UCP) is a nationwide network of
approximately 153 state and local voluntary agencies (UCP affiliates) which provide
services, conduct public and professional education programs, and support research in
cerebral palsy. Among its founders were many parents of children with cerebral palsy.
United Cerebral Palsy Associations, Inc., the national organization, was formed in 1950 to
coordinate and assist affiliates. Seven years later, the UCP Research and Educational
Foundation, Inc. was established to stimulate and fund research and the training of
personnel. An estimated 1,750,000 volunteers donate time and energy to UCP, assisting in
all facets of affiliate and national programs.
Did you know that nationally. . .
- UCP is the 2nd largest non-profit health care
organization in the United States and is the nation’s leader in the disability field.
- UCP makes a major difference in people’s lives,
providing services to more than 30,000 people a day, 65% of whom do not have cerebral
palsy.
- UCP is one of America’s most financially responsible
charities. Eighty-three cents out of every dollar is spent on programs and services.
- UCP is supported by a family of long-term corporate sponsors
that provides an extensive range of support and commitment.
Governance
United Cerebral Palsy Association (UCPA) of Hawaii is a
non-profit, volunteer health organization. Its focus is to positively affect the quality
of life for children and adults with cerebral palsy or other severe disabilities with
similar service needs. Support for the families is seen as an important part of the
organization’s mission. Additional energies are placed on preventing cerebral palsy
and minimizing its effect. UCPA’s goal is to empower people with choices and to
provide opportunities for independence. UCPA of Hawaii is part of a nationwide network of
approximately 153 state and local affiliates which provide services, conduct public and
professional education programs and support research in cerebral palsy. The local UCP has
been providing services in the islands since 1959.
|
|
