Cerebral Palsy

-Spastic CP: this is where the muscles are stiff and tight, especially when trying to move them quickly, making it difficult to move and reduces the overall range of movement that is possible.

-Dyskinetic CP: this is where the muscles switch between stiffness and floppiness, causing random, uncontrolled body movements and sometimes tremors.

-Ataxic CP: where a person has balance and coordination problems, resulting in shaky or clumsy movements and possible tremors.

The body can be affected in different ways depending on the severity of the condition.

The condition can result in:

• Hemiplegia:  where one side of the body is affected
• Diplegia:  where two limbs are affected
• Monoplegia:  where one limb is affected
• Quadriplegia:  where all four limbs and usually the whole body is affected.

The symptoms of CP are not usually obvious straight after a baby is born with symptoms usually becoming noticeable during the first two-three years of a child’s life.

As a child gets older, the following symptoms could start to show:

• Delays in reaching development milestones, for example, not sitting by 8 months or not walking by 18 months.
• Appearing too stiff or too floppy
• Weak arms or legs
• Fidgety, jerky, clumsy movements
• Random, uncontrolled movements
• Walking on tip-toes
• A range of other problems, for example, swallowing difficulties, speech problems, vision problems and learning disabilities.

The severity of symptoms varies significantly between individuals with some having very minor problems while others may be severely disabled.

CP can occur if a baby’s brain does not develop normally whilst in the womb or it is damaged during or soon after birth.

The main causes of CP include:

• Bleeding in the baby’s brain or reduced blood and oxygen supply to their brain.
• An infection caught by the mother during pregnancy
• The brain temporarily not getting enough oxygen (asphyxiation) during a difficult birth
• A serious head injury

In many cases, the exact cause may not be clear.

Cerebral Palsy is most commonly due to a problem that affects the development of a baby’s brain while it is growing in the womb such as:

• -Periventricular Leukomalacia (PVL) which is damage to part of the brain called white matter, possibly as a result of a reduction in the baby’s blood or oxygen supply to the brain.
• An infection caught by the mother such as the cytomegalovirus, rubella, chickenpox or toxoplasmosis.
• A stroke in the baby caused by a bleed in the brain or the blood supply to the brain being cut off.
• A head injury.

It is estimated that 10% of children with Cerebral Palsy develop the disorder as a result of damage to their brain during or after birth. The most common causes being:

• Asphyxiation
• Infection such as meningitis
• Serious head injury
• Choking or nearly drowning
• A stroke
• Very low blood sugar levels left untreated

The above risks are increased in premature babies (those born before 37 weeks, particularly those born before 32 weeks), babies that have a low birth weight, twins or a multiple pregnancies and in babies whose mother is aged 35 or over.

Cerebral palsy negligence claims usually arise if there is a failure to deliver a child quickly when there are indications of stress.

A delay in delivery could mean that the child is deprived of oxygen, which causes permanent damage to the baby’s brain often resulting in Cerebral Palsy. Negligence can also arise following errors after delivery such as failing to treat infection, jaundice, or meningitis.

In addition to this, failing to treat hypoglycemia (low blood sugar levels) and a slow response to the umbilical cord being wrapped around the baby’s neck are also ways in which CP can be caused by medical negligence.

There is currently no cure for CP but there are various treatments available to help people with the condition to lead as much of a normal and independent life as possible.

Treatments include:

• Physiotherapy-techniques such as exercise and stretching to help maintain physical ability ad hopefully improve movement issues.
• Speech therapy-to help with speech and communication difficulties as well as swallowing problems.
• Occupational therapy-where a therapist identifies problems that the mother and child are facing and suggests ways to make these easier.
• Medications for muscle stiffness and other disabilities
• Surgery-in cases where surgery is necessary to treat any movement or growth problems.

CP affects each person differently and therefore it can be difficult to predict the outlook of an individual. Most children live into adult life with some living for many decades and, although the condition can limit a child’s activities and independence, many go on to have full, independent lives.

Many children go to mainstream school but some may have special educational needs and therefore would benefit from attending a specialist school. CP, although not a progressive disease, can put a strain on the body and cause problems such as painful joints in later life.

Statistics:

• CP is the most common motor-disability in children with 1 in 400 babies in the UK being born with some form of CP. This accounts for approximately 1,800 babies every year.
• 2/3 of children with CP are able to walk
• 1/4 are able to do every day tasks such as feeding themselves
• 1/10 individuals have a visual impairment
• 1/50 have a hearing impairment.