SC was already 5 years old when his mother decided to take him to a hospital for proper consultation. He was delivered at home by a health assistant. His mother had no form of antenatal care. He could barely make an appreciable sound. He could neither crawl nor feed himself. SC had cerebral palsy.
Cerebral palsy popularly called CP by medical practitioners is a non-progressive and non-communicable neurological disorder. It is the most common cause of disabilities in children worldwide. It affects the developing brain in affected children leading to impairment of motor function such as loss of body movement, muscle control, muscle tone, coordination, balance, posture and reflex. It can also affect vision, speech, and hearing. Poor intellectual ability can also manifest in affected individuals.
Cerebral palsy is not life threatening but it can limit participation in daily activities. It also reduces the quality of life. The damage to the developing brain is permanent and not curable. It is, however, manageable.
The causes or risk factors of cerebral palsy may occur before birth, during labour, or after delivery.
Before birth (pre-natal): The risks involved here include twin or triplet pregnancy, infection during pregnancy, exposure to chemicals during pregnancy, medical conditions in the pregnant woman, and intake of alcohol and cigarettes when pregnant. Placenta problems are also known risk factors or causes.
During labour: Birth asphyxia (resulting from deprivation of the brain of oxygen), complicated labour, breech delivery (delivery with baby presenting with the legs), and prolonged labour are common causes.
After delivery (post-natal): After delivery of a well child, trauma to the head, infections like neonatal meningitis, jaundice, seizure disorder, and diseases affecting the blood vessels can affect the neurological development of the child predisposing also to cerebral palsy.
Evidence of cerebral palsy: In the general population, pointers to cerebral palsy include delayed development of the child such as delayed or absent social smile of the child, delayed neck control, delayed crawling or ability to sit or stand. Among children who can attempt to go to school, poor academic performance is often observed.
Management of cerebral palsy: Multidisciplinary approach is involved in the management of cerebral palsy. Depending on the extent of affectation of the individual, the management team may include pediatrician, surgeon, speech therapist, social workers, psychologist, children educator, and physiotherapist.
Considering the fact that challenge with physical activity is the commonest manifestation in individuals with cerebral palsy, physical therapy aims to achieve the following goals.
1. Facilitation of normal movement pattern.
2. Prevention of abnormal movement pattern.
3. Prevention of deformity.
4. Mastery of supportive devices.
Key emphases: Prevention of cerebral palsy should be ensured. This is achievable through safe lifestyle habits in the lady before or during pregnancy, early registration of pregnancy in the antenatal clinic, adherence to medical counsel, and delivery in registered hospitals. With early consultation and management, the individual with cerebral palsy may live a near-independent life.
Adewumi Adeagbo is a Physiotherapist, researcher and specialist in rehabilitation of neurological conditions in adults and children. He is an expert in identification and maximisation of individual functional ability and potential. He is a Lecturer at Department of Physiotherapy, College of Medicine of the University of Lagos. He can be contacted via firstname.lastname@example.org