Cerebral Palsy (CP) is a disorder of the brain which is nonprogressive and results in the inability to walk the property and talk. CP also causes problems with the joints, bones, and muscles at a younger age. Patients with CP experience worsening muscle contractures and reduced fitting and range of motion, which develop over time, showing that CP is not a progressive neurological condition. A progressive neurological condition means that the damage to the brain specifically does not continue to get worse throughout life. With cerebral palsy, the muscles are in a continuous state of activation and fluctuations in the stimulus. A person with this level of cerebral palsy has an awareness that something is not right with their muscle activity because of dyskinesia. Dyskinesia means abnormality or impairment to the voluntary muscles and, consequently, to voluntary movement. This applies to cerebral palsy because usually one of the symptoms of Cerebral palsy is dyskinesia movement. Dyskinesia movement is characterized by either unnaturally loose movements or stiffness, or even paralysis.
Process of CP Development
Someone with cerebral palsy can be categorized along several a broad spectrum of movement impairments. There are three main movement areas in the brain that, when damaged or impaired in some way, can cause cerebral palsy. Depending on which movement area is primarily affected, it determines the cerebral palsy that a person has because cerebral palsy is an umbrella term that describes a few different disorders that affect movement. One of the essential movement areas that we will look at to see what type of cerebral palsy generally develops if it is damaged or impaired is the motor cortex. The motor cortex is essential as it helps in planning, controlling, and making voluntary movements. Therefore, when it is affected, it leads to a lack of balance in action.
For the motor cortex to help accomplish a voluntary movement, the motor cortex uses these individual neurons called upper motor neurons, and it uses these to communicate messages to the muscles. The upper motor neurons head off from different parts of the motor cortex, and they come together with neighboring upper motor neurons to form these highways that we call the pyramidal tracks. The neurons go through these structures called the medullary pyramids to reach their destinations in the brain stem or the spinal cord. When the motor cortex itself or these pyramidal tracts are damaged, underdeveloped, or impaired in some way, some of the muscles might not be able to get the right messages from the motor cortex. The signals that control their activity, when this happens, the sort of net result is that the affected muscles get too active, and their muscle tone increases also called muscle stiffness.
This sort of pattern of cerebral palsy distribution that we can see with this stiffness is muscle tone in the arm and the leg on just one side of the body. The person will often still have the same sort of gait problems, like scissor walking and toe walking, but this time it will just be on one side. Some of the muscles become more active than others, and they kind of override the less active muscles in the arm. The most severe version of this stiff type of cerebral palsy happens when the muscles in the arms and the legs on both sides of the body are affected by the stiffness, and often muscles other than the limbs are affected. If the upper motor neurons that are helping to control these affected muscles are not too severely impaired, these people might be able to get around without too much assistance.
Clinical symptoms and signs of CP
The most important point to stress here is that the spectrum of CP is far from linear. Some can walk but may experience great difficulty with balance and speech. On the other hand, there may also be some in wheelchairs who have minimal problems with them. A few other points to be noted: Cerebral palsy is not hereditary as it is a disease that is entirely separate from paralysis or mental retardation. Weak posture, spasticity in the muscles, difficulty talking, all having to do with movement. Another thing you should know is that everything “down there” functions beautifully regardless, and everyone who has it is otherwise totally healthy by nature. Those who were born prematurely with CP may experience some seizures when first being born.
Recent research indicates that a different type of muscle stiffness characterizes cerebral palsy. For instance, someone pulling an arm with the biceps flexed. For this to happen, the muscles in the posterior region of the arm must be relaxed. This is the same excitatory signal that stimulates a muscle inhibits the tissue that would make the opposite movement, and it all happens in the peripheral nervous system. It is some muscular groups always contracted with the different muscles relaxed, an alternation that gives an “average” stiffness, non-regulation of the inhibitory signal, causing both muscular groups to contract.
Cerebral Palsy Motor Vs. Neurone Disease
There a strict difference between cerebral palsy and Motor Neurone Disease (MND), although cerebral palsy is not degenerative. Firstly, CP is not a neurodegenerative disorder, whereas Motor Neurone Disease does get progressively worse over time. Second, MND is a disease of the peripheral nervous system in which lower motor neurons originating in the ventral horn of the spinal cord and synapsing on the muscles. Cerebral Palsy is a condition of the central nervous system. It is motor impairment due to environmental or genetic factors in the early development of the brain. Given the anatomical differences between the two conditions, the presentation is quite different. MND is characterized by progressive weakness and flaccidity of the muscles as the peripheral nerves are unable to synapse on the muscles. Cerebral palsy, however, is characterized by dyskinesia (involuntary movements) and spasticity (increased tone of the flesh) as the brain is unable to regulate the activity of peripheral motor nerves, and their activity is amplified.
Treatments of Cerebral Palsy
The mortality rate of CP is far much low because there are few chances that the person with cerebral palsy could die prematurely as it may become even harder for them when they are old. Physiotherapy is mentioned as a form of treatment to help with stretching and engaging muscles that are typically unused to keep them healthy. However, there are there alternative treatments that do not use medications such as occupational therapy or yoga that would assist with managing CP. If the diagnosis is made within the first 15 days of birth, a specific Early Stimulation treatment for Psychomotor Delay can be initiated with the Mora Technique, and brain damage is reduced by 80 to 90%. Unfortunately, very few doctors (neurologists, pediatricians, gynecologists, rehabilitators, orthopedists, or general practitioners) know to detect this disease in the first month of life. It is a shame to delay the diagnosis for months or years.
The only ones interested in the treatment are the different types of therapists that offer various therapies little or not at all effective. Thousands of parents have found that after 5 or 10 years of up to 10 different treatments, it always seems a slight improvement for the cost, time, and effort invested. If you take a look at adults with PC in all rehabilitation centers, large or small, they will always see them with severe contractures making clear the lack of benefit of therapies. Once children become teenagers and in adults with very powerful muscles, it is impossible to correct with exercises, therapies, massages, heat, Bobath, Vojta, or dozens of therapies that, over time, show their inability to prevent future deformities.
The best option to correct current contractures and prevent future deformities in all types of spasticity (spinal injuries, head and brain injuries, embolisms, cerebral thrombosis, Parkinson’s) and especially in Cerebral Palsy is the lengthening of muscles is through Minimum Invasive Surgery. This can make a child talk and walk if he/she meets all three ideal conditions before surgery. It also improves the quality of life of children and their families in cases of custodial children. If the mother is carrying more than one fetus, the chances of small birth size, placental insufficiency, and premature birth are increased. If two fetuses share an amniotic sack, there is an increased risk of low oxygen during delivery because the cords will be entangled. All these factors increase the risk of cerebral palsy.
Most medications have unwanted side-effects, particularly ones that interact with the brain in some way. The problem with all doctors in Gynecology or Neonatology services is that they deliver the “apparently healthy” child by hanging the medal of heroes. After having been in cardiac and respiratory arrest, stroke, having been intubated with high bilirubins or Syndrome of respiratory distress of prematurity, or any other serious problem or the sum of various. They should deliver the child in their arms and warn them of the risk of Cerebral Palsy and the need for an Early Diagnosis of Psychomotor Delay or neurological manifestations in the first 30 days of life. It is also a shame that nobody cares for children with Cerebral Palsy, doctors in the consultations diagnose them and order them therapies from their desks, without bothering to review them carefully.