What is infantile cerebral palsy?
Infantile cerebral palsy (ICP) is a set of non-progressive alterations of posture and movement that limit activity. This is due to a brain injury caused during the brain development of the fetus or young child, which may occur during gestation, birth or in the first years of the child’s life.
Currently, ICH is the most common cause of motor disability in children. It is common for motor disorders to be accompanied by perceptual, sensory, cognitive, communication, epilepsy or secondary musculoskeletal disorders.
We can classify ICI according to the time at which the brain damage occurs:
- Congenital: in prenatal stage.
- Natal or neonatal: when the injury occurs at birth or shortly thereafter.
- Acquired or postneonatal: the injury occurs after the first month of age.
There are several types of infantile cerebral palsy, depending on the type of motor disorder the child presents:
- Spastic Cerebral Palsy: it is the most frequent. We can identify several types such as tetraplegia, diplegia, spastic hemiplegia, monoparesis.
- Athetotic or dyskinetic cerebral palsy: it is a sudden fluctuation and change of muscle tone. Presence of involuntary movements and reflexes.
- Ataxic Cerebral Palsy: sufferers have difficulty controlling balance.
- Hypotonic Cerebral Palsy: rare. It is characterized by muscular hypotonia with osteotendinous hyperreflexia.
- Mixed Cerebral Palsy: the brain has lesions in more than one structure and, therefore, there are different combinations of symptomatic features.
Prognosis of the disease
The prognosis of infantile cerebral palsy will depend on several factors, taking into account the severity and possible complications. Doctors assure that the prognosis can be more concrete from two years of age, when the nervous system is more developed and, therefore, it will be clearer to observe the child’s behavior, physical development and mobility.
In cases with more severe symptomatology, the child’s life expectancy may be reduced, especially if basic functions such as swallowing and breathing are affected.
If the child has some independence (is able to walk or perform other functions autonomously), his life expectancy will be higher, being able to develop a normal adult life according to the care, treatment and therapies that have been performed.
It is estimated that a child with severe symptoms of CP may reach 30 years of age and in the case of moderate cerebral palsy may have a life expectancy between 60 and 80 years of age.
The prognosis of CP is more specific from the age of 2 years onwards.
Symptoms of infantile cerebral palsy
The symptoms of the pathology will vary according to the degree of affectation presented by the child, so there may be a more severe or milder symptomatology, depending on the case.
Some of the symptoms presented by children with CPI may be the following:
- Variations in muscle tone, too stiff or flaccid.
- Stiff muscles and exaggerated reflexes (spasticity)
- Ataxia: lack of muscle coordination in muscle movements.
- Difficulty in carrying out precious movements (writing, buttoning a shirt, etc.)
- Difficulty swallowing, speaking, or excessive drooling
- Involuntary movements or tremors
- Athetosis: slow and undulating movements.
- It is common to walk using only one foot or dragging a lower limb.
Depending on the affectation it may cause other difficulties such as lack of attention, perception, memory, reasoning or language. Children with these disorders are at increased risk for social difficulties and mental health problems.
Medical tests for infantile cerebral palsy
Early diagnosis is essential but can be very complicated. In general, even in cases with lesions during fetal life, a diagnosis is not made until months, or even a year, after birth.
In addition, information that parents can provide about prenatal, natal and postnatal history can be of great importance to the physician.
For diagnosis, a detailed physical examination should be performed, with special attention to the child’s psychomotor development (which is in accordance with normal for his or her age). In addition, a general neurological examination will also be done. The physician may also perform laboratory tests, neuroimaging studies (such as x-rays, CT scans, etc.), electrophysiological, metabolic and genetic testing if necessary.
What are the causes of infantile cerebral palsy?
CP is due to an alteration or abnormality in the development of the brain, usually before birth. Some of the causes may be:
- Genetic mutations that cause abnormal brain development.
- Prenatal brain attack: an interruption of the blood supply to the brain during development.
- Maternal infections that may affect fetal development.
- Neonatal infections that cause inflammation in or around the brain.
- Traumatic brain injury to the infant.
- Lack of oxygen to the brain, usually related to delivery problems.
Can it be prevented?
There are several risk factors that can be avoided, based on the care of the mother and baby. There are prenatal, natal and postnatal causes that should be assessed as they may influence the development of ICH.
Some of the recommendations to be followed are the following:
- The mother should have adequate medical follow-up, from pregnancy detection to delivery. Also, blood pressure should be monitored and controlled.
- Proper nutrition of the pregnant woman, with dietary supplements, which should include folic acid, iron, among others.
- Not consuming alcohol, tobacco or drugs during pregnancy.
- Prevent intrauterine infectious diseases, rubella, toxoplasmosis, etc.
- Trauma to the mother and, after delivery, to the baby should be prevented.
- Early diagnosis and treatment of hyperbilirubinemia. This occurs when there is an increase in bilirubin levels in the blood of the newborn child.
- Preventing the development of neurological infectious diseases in the baby.
Treatment for infantile cerebral palsy
There is no curative treatment for ICP, but there are various treatments to enable the child to maintain his or her quality of life.
The disorder is treated by a multidisciplinary team of specialists who may work on improving movement, stimulating intellectual development or developing the correct level of communication for the benefit of social relationships.
Some of the treatments may include:
- Occupational and physical therapy
- Physical therapy sessions
- Speech therapy
- Medications to control epileptic symptoms, muscle spasms or pain
- Surgery to correct anatomical alterations
- Use of orthopedic adaptations
What specialist treats it?
Infantile cerebral palsy should be treated by a multidisciplinary team in which we will find specialists in Pediatrics, Neurology, Neurosurgery, Traumatology, Physiotherapy, Speech Therapy and Psychology.