Cerebral Palsy

A diagnosis of cerebral palsy can be both confusing and alarming to the parents of an injured child, and many questions certainly spring to mind: What is cerebral palsy? How did this happen to my child? What can be done about it?

The term “cerebral” refers to the brain — cerebral palsy results from damage to or developmental problems in the child’s brain. The term “palsy” refers to the impairment of motor function that forms the most obvious outward sign of the disorder.

Taken together, the medical term “cerebral palsy” describes a set of disorders typically sharing the following characteristics:

  • Impairment of motor function and control;
  • Appearing early in life (usually in the first year); and
  • Generally static (that is, not getting better or worse over time).
  • Beyond these basic characteristics of cerebral palsy, the effects of cerebral palsy can be as individual as your child. Cerebral palsy can be either mild or severe, and cases can be categorized — using medical terms such as spastic, athetoid and ataxic, and quadriplegic, hemiplegic or diplegic — based upon the nature and the degree of impairment present in the individual case.

    In addition to impairment of gross and fine motor control, cerebral palsy may include symptoms such as seizures, cognitive or mental impairment and developmental delay.

    Treatments — such as surgery, medications or physical and occupational therapy — can often assist children afflicted with cerebral palsy to regain some functional use of their bodies. Surgery can loosen tight and constricted muscles and also can be helpful in straightening joints that become misaligned during growth. Correspondingly, physical or occupational therapy sessions can help the child to master ordinary tasks that are made more difficult by their brain injury, thereby improving the child’s overall functional ability and quality of life.

    Cerebral palsy can result from many different causes. However, the most easily preventable cause, and that most associated with obstetrical or neonatal malpractice, is intrapartum asphyxia or hypoxia, resulting in a condition known as hypoxic-ischemic encephalopathy.

    Hypoxic-ischemic encephalopathy refers to a brain injury resulting from asphyxia or hypoxia, or lack of oxygen to the brain, which may occur during the intrapartum period, that is, the time period surrounding the birth or delivery of the baby.

    A hypoxic-ischemic brain injury typically occurs when the baby is deprived of oxygen in utero or during the immediate neonatal period. When the fetus is deprived of oxygen during labor and delivery, changes can often be detected in the fetal heart rate pattern that would signal to a reasonable and careful obstetrician that delivery of the baby should be accomplished expeditiously, in order to avoid serious injury.

    Changes in the fetal heart rate pattern that can signal hypoxia sufficient to cause hypoxic-ischemic encephalopathy include baseline tachycardia, an abnormally fast heart rate, bradycardia, an abnormally slow heart rate and repetitive late decelerations, a periodic slowing of the fetal heart rate, usually in conjunction with uterine contractions.

    Because of the substantial risks and dire consequences associated with intrapartum asphyxia and resulting hypoxic-ischemic encephalopathy, careful and safe medical practitioners are vigilant during labor and delivery and the immediate neonatal period.

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