MANAGEMENT OF CEREBRAL PALSY: A

MULTI DISCIPLINARY APPROACH

BY
DR. C.S. UMEH
DEPT. OF
PSYCHIATRY, CMUL.

What is Cerebral Palsy?

Cerebral Palsy (CP) is a group of non-inherited

neuromuscular disorders resulting from damage
primarily to the motor region of the brain, causing
impairment in control over voluntary muscles.
It may occur through anoxia (lack of oxygen during
birth.
It is one of the commonest neurodevelopmental
disorders seen in clinics.

What is CP Contnd
The

majority of children with cerebral

palsy are born with it, although it may
not be detected until months or years
later. The early signs of cerebral
palsy usually appear before a child
reaches 3 years of age.

What is CP Contnd
The

most common symptoms are:

a lack of muscle coordination when performing
voluntary movements (ataxia);
stiff or tight muscles and exaggerated reflexes
(spasticity);
walking with one foot or leg dragging;
walking on the toes, a crouched gait, or a
scissor gait;
and muscle tone that is either too stiff or too
floppy.

What is CP Contnd
A

small number of children have cerebral

palsy as the result of:
brain damage in the first few months or
years of life,
brain infections such as bacterial
meningitis or viral encephalitis,
or head injury from a motor vehicle
accident, a fall, or child abuse.

What is CP Contnd
The

brain damage that leads to cerebral

palsy can also lead to other health issues,
including:
vision,
hearing,
speech problems,
and learning disabilities.

Types of CP

spastic cerebral palsy causes stiffness and

movement difficulties
Dyskinetic: which can be either athetoid
cerebral palsy leads to involuntary and
uncontrolled movements or ataxic cerebral palsy
causes a disturbed sense of balance and depth
perception
Mixed: This is a mixture of different types of
cerebral palsy. A common combination is spastic
and athetoid

Causes of Cerebral Palsy

The exact causes of most cases of CP are unknown,

but many are the result of problems during
pregnancy in which the brain is either damaged or
doesn't develop normally. This can be due to:
infections,
maternal health problems,
a genetic disorder,
or something else that interferes with normal brain
development.

Causes of CP contnd
Problems

during labor and delivery can

cause CP in some cases, but this is the
exception.
Premature babies particularly those who
weigh less than 3.3 pounds (1,510 grams or
1.5kg) have a higher risk of CP than
babies that are carried full-term.
Falls and birth traumas

Treatment of CP

Cerebral palsy cant be cured, but treatment will

often improve a child's capabilities and quality of life.

Many children go on to enjoy near-normal adult lives

if their disabilities are properly managed.
In general, the earlier treatment begins the better
chance children have of overcoming developmental
disabilities or learning new ways to accomplish the
tasks that challenge them.

Treatment of CP contnd
CP

usually affects several areas of

functioning, as a result, several disciplines
are involved in its management.
The activities of the disciplines must be
coordinated in order to yield effective
treatment outcome.
The disciplines usually involved in CP
management include:

Treatment of CP contnd
Pediatricians

they take care of

development, care and diseases of children
and are in the position to coordinate the
management of CP.
Surgeons they carryout surgeries to correct
anatomical abnormalities or release tight
muscles.
Occupational therapists- they take care of
fine motor activities.

Treatment of CP contnd
Physiotherapists-

they take care of gross

motor activities.
Speech therapists -they apply remedies,
treatment, and counselling for the
improvement of speech functions.
Clinical Psychologists- they provide
emotional wellbeing as well as cognitive
evaluation for school placement.

Treatment of CP contnd
Special

need educators the provide the

kind of education CP children with cognitive
impairment could benefit from.

Other CP treatment Aids

The

quality of life of CP clients could be

improved using the following aids:
Prosthetic devices such as braces and other
orthotic devices;
wheelchairs and rolling walkers;
and communication aids such as computers
with attached voice synthesizers.

Prognosis

Cerebral palsy doesnt always cause profound

disabilities.
While one child with severe cerebral palsy might be
unable to walk and need extensive, lifelong care,
another with mild cerebral palsy might be only
slightly awkward and require no special assistance.
Supportive treatments, medications, and surgery can
help many individuals improve their motor skills and
ability to communicate with the world.

Conclusion

CP is a non progressive brain disorder, meaning the

brain damage does not continue to worsen
throughout life, and usually develops by age 2 or 3.
However, the symptoms due to the brain damage
often do change over time -- sometimes getting
better and sometimes getting worse.
CP is one of the most common causes of chronic
childhood disability. It may not be curable but could
be managed.

Thanks for your attention