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Infantile Cerebral Palsy – Causes, Symptoms, Diagnosis, Treatment

In this article, let’s discover: how to describe infantile cerebral palsy? What are the causes of infantile cerebral palsy? How to treat cerebral palsy? Here are sample questions that will be the subject of this article.

Infantile cerebral palsy is one of the conditions that cause severe disability in children and is a relatively large proportion of children with disabilities.

Children with cerebral palsy end up being unable to participate fully in behavioral, intellectual, and language matters. As they age, their interaction and behavior in society become severely limited; their initiative and motivation gradually diminish as a result of repeated failures, and their entrenched dependence delays the development of their bodily functions. They end up experiencing muscular atrophy and deformity of their skeleton, they are unable to use their bodies effectively, unable to maintain social relationships, they develop timid personalities, their temperament becomes unstable, and their rigid way of thinking.

Cerebral palsy has changed dramatically in the last fifteen years, from symptoms to management. In France, she also regularly changes her name, as she does not find a clear definition of all aspects of a pathology that affects each patient differently.

France has therefore chosen the term cerebral palsy (cerebral palsy) or cerebral palsy (Imoc).

I – Description of Infantile Cerebral PalsyHow to describe infantile cerebral palsy?

Infantile cerebral palsy is the name given to a group of various disorders of the nervous system present at birth or appearing in the next 3 years. It is a general term for permanent disorders of movement and posture development, which are responsible for activity limitations caused by non-progressive impairments during brain development in the fetus or infant. Motor disorders of infantile cerebral palsy are often accompanied by sensory, perceptual, cognitive, communication, and behavioral disorders, epilepsy, and secondary musculoskeletal problems.

Overall, infantile cerebral palsy affects between 1 and 2 out of every 1,000 newborns, although some of them suffer only mild damage. Premature infants and newborns whose weight is lower than normal are at greater risk. In recent years, the number of new cases of cerebral palsy has actually increased slightly, in part because the improvement in intensive care is leading to the survival of more preterm children, but also because Infertility leads to an increase in multiple pregnancies in which the probability of giving birth to a baby with cerebral palsy is higher.

II – Causes of Infantile Cerebral Palsy

Although infantile cerebral palsy is often considered a congenital syndrome (present at birth), it can also appear after birth. Acquired cerebral palsy is defined as brain damage resulting from a cerebral infection (eg, meningitis, encephalitis), a fall, or other types of accidents. On the other hand, congenital cerebral palsy arises from an error that occurs during the development of the fetus or a problem during delivery itself.

Various types of nerve cells form and migrate to their proper locations throughout the brain. This process is extremely complicated.

Errors may occur as a result of the following phenomena:

– A stroke that cuts off the blood supply to the developing brain, thereby causing an injury. This phenomenon can be caused by infections or the high blood pressure of the mother.

– The presence of maternal or fetal infections can damage the white matter of the brain, which causes nerve transmission problems between the brain and the body.

– Mutations can occur in genes that control the brain development of the fetus. These mutations can be caused by infections, fever, a trauma in the mother, and exposure of the fetus to toxins.

– A prolonged lack of oxygen for the brain is caused by complicated labor and delivery, very low maternal blood pressure, uterine rupture, or problems with the placenta or umbilical cord.

Infantile cerebral palsy affects 6-8% of children whose birth weight is less than 1500 grams or who are born before 30 weeks of pregnancy. Cerebral palsy is all the more common if the birth is early and/or the child has a low birth weight.

*** Risk Factors

A number of factors are associated with an increased risk of infantile cerebral palsy.

1 – Maternal Health

Some infections or health problems during pregnancy can significantly increase the risk of giving birth to a baby with cerebral palsy.

Rubella. A viral infection that can be prevented by a vaccine.

Chickenpox. A viral infection that can be prevented by a vaccine and can emerge later in life.

Cytomegalovirus. A very common virus that causes flu-like symptoms and can lead to birth defects if the mother experiences her first active infection during pregnancy.

Toxoplasmosis. A parasitic infection is caused by a parasite present in the soil and the excrement of infected cats.

Syphilis. A bacterial infection is transmitted sexually.

Exposure to toxins. Like methylmercury and other neurotoxins.

Other conditions. That can increase the risk of cerebral palsy, such as thyroid problems, mental retardation, or seizures (convulsions).

2 – Diseases of the Child

Diseases in a newborn can significantly increase the risk of infantile cerebral palsy.

Bacterial meningitis. A bacterial infection that causes inflammation of the membranes that surround the brain and spinal cord.

Viral encephalitis. A viral infection that causes inflammation of the brain.

Severe or untreated jaundice. A condition that appears as a yellowing of the skin and that occurs when certain byproducts of used blood cells are not filtered from the bloodstream.

3 – Other Factors of Pregnancy and Birth

Other factors in pregnancy or at birth are associated with an increased risk of cerebral palsy.

Premature birth. A normal pregnancy lasts 40 weeks. Babies who are born less than 37 weeks of pregnancy are at greater risk for infantile cerebral palsy.

Low birth weight. Babies weighing less than 2.5 kg are at a higher risk of developing infantile cerebral palsy.

Presentation of breech at birth. Babies who have cerebral palsy are more likely to be born in feet, the first position (presentation of the seat) at the beginning of work rather than in a head-down position.

Multiple babies. The risk of infantile cerebral palsy increases with the number of babies sharing the uterus.

III – Symptoms of Infantile Cerebral Palsy

Ordinarily, it is primarily the parents who notice the symptoms of cerebral palsy of their child from the age of 6 months. There is no fixed pattern of cerebral palsy symptoms because it is a general term that encompasses many symptoms.

Early symptoms include :

– unusual positions, and the preferential use of one side of the body;

– excessive rigidity (increased muscle tone) or an excessive lack of tone (softness);

– convergent strabismus (the shady child);

– stunted, with the child not reaching key milestones such as sitting, smiling, or walking;

– muscle wasting, slow or asymmetrical growth;

– convulsions;

– a slumber of the senses or apparent deafness.

1 – Motor Symptoms (Muscular)

The spastic form is more common, it affects about 3/4 of people with cerebral palsy. The muscles tend to be contracted, the growth of affected limbs can be slowed down and hindered considerably, that of the feet, legs, and hands.

Spasticity of the muscles. A spastic muscle is in a state of permanent contraction and never relaxes.

The athetotic form is characterized by slow convulsive movements, usually limbs, but also facial muscles, including the tongue.

The ataxic form affects less than 1 in 10 people. In the case of ataxia, poor coordination and a poor perception of depth make the gait unstable with an enlargement of the base of levitation. Ataxia also makes it difficult to perform fast and precise movements such as writing.

In many cases, people with cerebral palsy have a combination of these forms. The most common combined form combines spasticity and athetosis. In all cases, the symptoms can be very mild or very severe.

This lack of adaptation is accentuated by a lack of proprioception. The latter is the perception of oneself, conscious or not, that is to say of the position of the different members and their tone in relation to the situation of the body in space.

2 – Cognitive Symptoms

One-third of all people with cerebral palsy have a severe intellectual deficit and a mental age that will never exceed 3 or 4 years. Another third suffers from a slight intellectual deficit, and the rest has no intellectual deficit. However, even a child of normal intelligence may have learning disabilities due to the presence of vision, hearing, and speech problems. Social isolation, resentment, and depression may accompany cerebral palsy unless he is supported and encouraged along the way.

IV – Diagnosis

Although all newborns with cerebral palsy have deficits caused by the condition, it is usually impossible to diagnose this condition until the child has missed an important stage of development, such as crawling or form forceps with his fingers to grab objects. By observing a newborn, however, it is occasionally possible to predict which babies have a higher risk of cerebral palsy.

Although there is no blood or chemical test for infantile cerebral palsy, there are several clinical tests that help establish the diagnosis. Many children have a strong predominance of one limb over the other. When a baby is still grasping objects with his right hand, even when the object is placed much closer to his left hand, it is a possible sign of cerebral palsy.

Primary (or archaic) reflexes are involuntary automatic movements characteristic of infants. These are the basics of the nervous system and muscle tone. They are mainly controlled by the brainstem.

During the first year of life, they are inhibited and replaced by postural reflexes. Thanks to the voluntary control of movements, it is a sign that myelination has reached the cerebral cortex. This transition is indicative of neurological maturity.

Sometimes, medical imaging techniques can highlight an abscess or other physical brain injuries. There are also intelligence tests and sight and hearing tests to determine whether infantile cerebral palsy is accompanied by other problems.

Thus, a graphic delay in kindergarten, learning difficulties in CP reading, difficulty in numeracy and arithmetic in CP-CE, partial or total school failure at all stages of schooling must make a psychological assessment, a psychometric evaluation, and a neuropsychological examination, which will make it possible, in the event of a specific learning disorder, early diagnosis and the prescription of rehabilitation and implementation of appropriate responses.

V – Complications

Contracture. This is the shortening of muscle tissue due to severe muscle tightness (spasticity). It can inhibit bone growth, which results in joint deformities, dislocation.

Malnutrition. Ingestion or feeding problems. It can be difficult for someone with cerebral palsy, especially a child, to get enough nutrition.

Depression. Social isolation and the challenges of coping with a disability can contribute to depression.

Premature aging. People often experience health problems at an average age that are most often associated with old age.

Post-depreciation syndrome. This condition is characterized by pain, fatigue, and weakness resulting from stress on the body, movements to compensate for the handicaps, and the considerable energy effort required for daily functions.

Osteoarthritis. The pressure on the joints or the abnormal alignment of the joints of the muscular spasticity can lead to the early development of the degenerative disease of the painful bones.

Motor and/or cognitive disorders and/or associated disorders, all related to early brain injury, achieve, in each child, a unique mosaic: some have isolated motor disorders (without cognitive impairment), very moderate to intense, others present isolated cognitive disorders (without motor disorders) of very discrete to severe, with or without epilepsy or other associated disorder, others finally a personal combination of these various pathologies. Each child presents a unique picture that must be specified in order to propose therapeutic actions and adapted school tracks.

VI – Treatment of Infantile Cerebral Palsy

Although there is no cure for infantile cerebral palsy, there are many treatments that can help reduce the symptoms they suffer from. The goal of treatment is to make life as normal as possible and to provide maximum independence to people whose mental abilities permit it.

The primary goal is to minimize disability. Physical therapy aims to prevent contractures and insufficient growth due to atrophy. Injections of botulinum toxins are sometimes given against severe contractures. The toxin paralyzes the muscle and allows it to relax.

As the age of schooling approaches, treatment focuses on improving communication and alleviating socially problematic symptoms. Parents take care of much of the therapy once they have learned the techniques.

Seizures and spasticity can often be managed with anticonvulsant medications or that promote muscle relaxation. When symptoms cannot be eliminated, their effects can be minimized by using modern devices such as computer-aided prostheses to help talk and electric wheelchairs.

1 – Therapies

Physiotherapy. Muscle training and exercises can help the child’s strength, flexibility, balance, motor development, and mobility.

Occupational therapy. Use alternative strategies to promote independent child participation in daily activities and routines at home, school, and community.

Speech therapy. Improve the child’s ability to speak clearly or communicate. Speech-language pathologists can also treat difficulties with the muscles used in feeding and swallowing.

2 – Rehabilitation Methods

Bobath method. This is the method used by pediatric physiotherapists in France for neuro-motor rehabilitation. The therapist helps the child to increase his repertoire of sensorimotor experiences and improve the quality of his daily movements.

Medek method. “M” for Engine, “K” for kinetic. To provoke active and automatic motor responses. The idea is to get the brain to create a postural control response by bypassing the injured areas of the nervous system.

The horse therapy. In France, the psychological contribution of the activity with the horse is more exploited than the motor aspect. It has a significant impact on motor function (balance, coordination, flexibility, strength, trunk tone). The goal is not to teach horseback riding but to use the possibilities offered by the horse to improve the deficit functions.

Tomatis method. The voice reproduces only the harmonics that the ear can hear. Any auditory change brings a noticeable change in a person’s speech pattern. It is possible to transform phonation through sustained auditory stimulation by re-educating the receivers of the ear. Through gymnastics auditory muscles.

Method of integration of primitive reflexes. Inhibitory exercises of persistent primary reflexes, consisting of massages, body movements or isometric pressures (against resistance), very specific, performed slowly.

Vojta method. The practitioner manipulates the child by pressing specific points of the body in a specific direction. Gradually, the child responds to the pressure by initiating a movement.

Fine motor skills and Ipad. There are educational applications that allow the child to work fine motor skills but also the preparation required for entry to kindergarten (shapes, colors, sizes, emotions, visual discrimination, etc.).

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