Infantile cerebral palsy, known as ICP, is the most common cause of gross and fine motor and cognitive disability in children. It used to be 2 to 3% of every 1,000 live births, but advances in medicine, the increasing survival of large premature infants, in short, advances in neonatal care and the possibility of later pregnancies have led to an increase in its prevalence, which has not yet been quantified.
What are the causes of ICH?
Generally, it is caused during pregnancy, i.e. prenatally, in 35% of cases (diabetes, hypoxia, maternal infections, placental problems, etc.), at the time of delivery (the most frequent with 55% of cases) by problems that become complicated such as cord twisting, prematurity, complicated deliveries, etc. or in the postnatal phase (only 10%) due to trauma, infections with encephalitis, convulsions, etc.
This problem of motor type is frequently accompanied by alterations of another type since being the lesion at brain level is also affected sensitivity, giving sensory, perception, cognitive, communication problems, sometimes being the cause of epileptic seizures and epilepsy secondary to the injury and giving rise to the problems of increased tone, decreased or dysphonia to difficulties and musculoskeletal problems.
What are the consequences of cerebral palsy in infantile age for the child’s life?
The severity of cerebral palsy depends on the intensity of the brain injury, since, from simply a slightly affected mobility of a limb, slight difficulty in speech, etc.. It can go as far as generalized involvement with complete paraplegia.
This problem is logically accompanied by symptoms and signs secondary to brain lesions and can lead to the appearance of reflex problems, postural dysfunctions, maintenance of archaic reflexes, muscle involvement of minimal type as we have said as light paresis (reduced mobility of a limb or a group of muscles) to involvement of all limbs with paralytic involvement of the trunk, limbs, neck, face with total disconnection. It can result more frequently in hypertonia of the affected muscles (spasticity), sometimes hypotonia, and also mobility problems due to alternating hypo- and hypertonia, dystonia, with movement difficulties.
Infantile cerebral palsy is accompanied with a high frequency of epilepsy in 45% of cases, the more severe the easier. Generally there is also alteration of language and speech in 35-38% of cases, especially in lesions that are bilateral due to the involvement of the left hemisphere, cognitive impairment ranging from a simple ADHD to an IQ impairment with severe decrease of this, especially in those accompanied by epilepsy and in tetraplegia. Ophthalmological defects account for 28% and hearing defects for 12%. The worst thing is that these problems are not alone, but in many occasions they are added in the complication.
How can it be treated?
Patients with this pathology are unique, since each one has its own ICH. There is no one PCI like another. There are patients who only need a little help in their mobility, very simple interventions to patients who need to move from an electric chair and can only speak through a computer. But there are still patients with worse prognosis since they evolve with severe injuries and always remain dependent on another person in order to survive, such as paraplegics with severe epilepsy and lack of connection with the outside world.
PCI was a very serious problem and still is, but new rehabilitation techniques, special education, physiotherapy, reparative surgery techniques at neuromuscular level, etc. have meant that these patients have a better prognosis.