Disease

Cerebral Palsy

One of the main diseases causing motor disabilities in children.

Characterized primarily by motor impairment, potentially accompanied by intellectual disabilities, seizures, and more.

Early diagnosis and treatment are crucial.

Survival rates among severely affected children are considerably lower than in healthy individuals.

Cerebral Palsy, or CP, is a non-progressive brain injury syndrome occurring during early brain development from before birth to within one month after birth in infants. It manifests as central motor impairment and postural abnormalities, potentially accompanied by intellectual disabilities, seizures, sensory impairments, language disorders, and abnormal behaviors, serving as one of the primary diseases leading to motor disabilities in children.

Etiology

The causes of CP are complex, including genetic and acquired factors. The latter encompasses factors before birth, during the perinatal period, and in the neonatal period, with some cases lacking clear causes. Presently, the four significant factors associated with CP are premature birth or low birth weight, perinatal asphyxia or hypoxic-ischemic encephalopathy, neonatal hyperbilirubinemia, and intrauterine infections. Additionally, CP occurrence is related to genetic factors.

Pre-birth factors

Embryo quality at conception
Parental smoking, alcohol abuse, or drug use before and during pregnancy can affect embryo quality.

Maternal health conditions

Factors like infections, poisoning, or exposure to radiation during early pregnancy may result in improper brain cell development.

Perinatal factors

Premature birth

Can lead to various pathological conditions, making children more susceptible to CP.

Birth trauma

Conditions like rapid delivery, vacuum extraction, and forceps delivery can potentially cause intracranial hemorrhage.

Hypoxia

Factors such as prolonged labor, nuchal cord, meconium aspiration, or placental dysfunction can lead to fetal brain hypoxia.

Hyperbilirubinemia

Several causes may result in severe jaundice in newborns, potentially leading to kernicterus.

Neonatal period factors

Various infections, severe neonatal conditions, brain trauma, and intracranial hemorrhages due to neonatal bleeding disorders can cause CP.

Genetic factors

Some CP cases may have a familial history of inherited diseases. If there are cases of epilepsy, CP, or intellectual disabilities in close relatives, the likelihood of CP occurrence increases.

Clinical Manifestation

The clinical manifestations of CP vary among individuals, primarily including:

Motor impairments like abnormal muscle tone, muscle spasms, or flaccidity.

Issues with posture control, making it challenging to maintain balance and control posture.

Coordination difficulties, leading to poor motor coordination, potentially affecting fine hand movements.

Limited motor functions involving activities like walking, crawling, and sitting.

Speech and language impairments; some patients may encounter issues in speech and language development.

Cognitive impairments; although most CP patients have normal intelligence, some may have cognitive issues.

Examination

Neurological assessment: Involves evaluating muscle tone, motor control, and sensory function.

Imaging studies: Brain MRI or CT scans help detect abnormal brain structures.

Electroencephalogram (EEG): Assesses brain electrical activity.

Blood tests: Rule out metabolic diseases and infections as potential causative factors.

Diagnosis

Doctors diagnose CP primarily based on medical history, symptoms, and physical examinations. Additionally, they may request imaging studies like CT or MRI for insights into any structural brain abnormalities, which hold significance in determining CP causes and predicting prognosis. EEG aids in understanding if seizures are present, providing guidance for treatment. Criteria for CP diagnosis include:

Causative factors occurring before birth, at birth, or during the neonatal period.

Central paralysis appearing in infancy without progression throughout the disease course.

Exclusion of progressive diseases (such as genetic metabolic disorders, tumors) causing central paralysis.

Exclusion of transient developmental motor delays in normal children.