Cerebral refers to the cerebrum, which is the affected area of the brain (although connections between the cortex and other parts of the brain can be affected). Palsy refers to disorder of movement. Cerebral palsy is a non-progressive disorder involving movement due to brain damage acquired in utero, during birth or infancy.
Etiology – CP can occur before or during birth and is caused by a lack of oxygen, maternal infections, drug or alcohol abuse, placental abnormalities, toxemia, prolonged labor, prematurity, and Rh incompatibility. The etiology of acquired CP includes meningitis, CVA, seizures, and brain injury.
Signs and symptoms – Characteristics vary from mild and undetectable to severe loss of control accompanied by profound mental retardation. Severity depends on the amount of brain damage. All types of CP demonstrate abnormal muscle tone, impaired modulation of movement, presence of abnormal reflexes, and impaired mobility.
CP Primary Motor Patterns:
-Spastic – stiffness and difficulty with movement (indicating a lesion in the motor cortex of the cerebrum, upper motor neuron damage)
-Athetoid – involuntary/uncontrolled movements (indicating a lesion involving the basal ganglia; cerebellum and cerebellar pathways)
Distribution of Involvement:
-Monoplegia – one extremity
-Diplegia – bilateral lower extremity involvement, however upper extremities may be affected
-Hemiplegia – unilateral involvement of the upper and lower extremities
-Quadriplegia – involvement of the entire body
Treatment – There is no cure, just help the person be as independent as possible. Intervention includes ongoing family and caregiver education, education by a Physical Therapist to teach caregivers and the patient normalization of tone, stretching, strengthening, developmental milestones, positioning, weight bearing activities, and mobility skills. Splinting, assistive devices, and specialized seating may be indicated. Surgical intervention may be required for orthopedic management or reduction of spasticity.
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