Friday, July 10, 2009

Understanding Cerebral Palsy - Part I

by CDC

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Cerebral palsy refers to a group of disorders that affect a person's ability to move and to maintain balance and posture. It is due to a nonprogressive brain abnormality, which means that it does not get worse over time, though the exact symptoms can change over a person's lifetime.

People with cerebral palsy have damage to the part of the brain that controls muscle tone. Muscle tone is the amount of resistance to movement in a muscle. It is what lets you keep your body in a certain posture or position.

For example, it lets you sit up straight and keep your head up. Changes in muscle tone let you move. For example, to bring your hand to your face, the tone in your biceps muscle at the front of your arm must increase while the tone in the triceps muscle at the back of your arm must decrease. The tone in different muscle groups must be balanced for you to move smoothly.

There are four main types of cerebral palsy - spastic, athetoid, ataxic, and mixed.

People with spastic cerebral palsy have increased muscle tone. Their muscles are stiff. Their movements can be awkward. Seventy to eighty percent of people with cerebral palsy have spasticity. Spastic cerebral palsy is usually described further by what parts of the body are affected. In spastic diplegia, the main effect is found in both legs. In spastic hemiplegia, one side of the person's body is affected. Spastic quadriplegia affects a person's whole body (face, trunk, legs, and arms).

Athetoid or dyskinetic:
People with athetoid cerebral palsy have slow, writhing movements that they cannot control. The movements usually affect a person's hands, arms, feet, and legs. Sometimes the face and tongue are affected and the person has a hard time talking. Muscle tone can change from day to day and can vary even during a single day. Ten to twenty percent of people with cerebral palsy have the athetoid form of the condition.

People with ataxic cerebral palsy have problems with balance and depth perception. They might be unsteady when they walk. They might have a hard time with quick movements or movements that need a lot of control, like writing. They might have a hard time controlling their hands or arms when they reach for something. People with ataxic cerebral palsy can have increased or decreased muscle tone. Five to ten percent of people with cerebral palsy have ataxia.

Some people have more than one type of cerebral palsy. The most common pattern is spasticity plus athetoid movements.

The symptoms of cerebral palsy vary from person to person. Symptoms can also change over time. A person with severe cerebral palsy might not be able to walk and might need lifelong care. A person with mild cerebral palsy, on the other hand, might walk a little awkwardly, but might not need any special help.

People with cerebral palsy can have other disabilities as well. Examples of these conditions include seizure disorders, vision impairment, hearing loss, and mental retardation.

How common is cerebral palsy?

Photo of child with cerebral palsy painting a pictureCDC is tracking the number of children with cerebral palsy in a five-county area in metropolitan Atlanta (Georgia). This activity is part of the Metropolitan Atlanta Developmental Disabilities Surveillance Program (MADDSP). For 1991-1994, we found that, on average, 28 of every 10,000 children 3 through 10 years of age had cerebral palsy.

CDC also studied how many children in metropolitan Atlanta had cerebral palsy in the mid-1980s. This project was done as part of the Metropolitan Atlanta Developmental Disabilities Study (MADDS), which studied how common certain disabilities were in 10-year-old children. We found that 23 of every 10,000 10-year-old children had cerebral palsy. Eighty-one percent of the children had spastic cerebral palsy. Seventy-five percent had one or more other disabilities (epilepsy, mental retardation, hearing loss, or vision impairment.

In another study, CDC used data from the National Health Interview Survey - Child Health Supplement to find the number of children with cerebral palsy in the United States in 1988. The survey asked parents, or other adults, if children in the home had cerebral palsy. The study showed that 23 of every 10,000 children 17 years of age or younger had cerebral palsy.

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