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What is Cerebral Palsy?
Cerebral palsy is an incurable disorder affecting children. Defined as "Non-progressive disorders of movement and posture resulting from damage to the brain." The damage to the brain can and usually occurs during fetal development. Damage to the brain can also occur before, during, shortly after birth or during infancy. As one might think, "these disorders are not caused by problems in the muscles or nerves" These disorders are caused by inadequate "Development or damage" to areas of the brain that control movement and posture.

What causes cerebral palsy?
Unlike many other disorders, cerebral palsy has no one single cause. In over 90% of the cases the damage occurs before birth. Hypoxia (lack of oxygen to the brain) while in utero is the most common cause. Other causes include infections spread from mother to the unborn fetus and kernicterus which results from an excess of bilirubin (bile pigment) in babies with hemolytic disease of the newborn. Head trauma during the birthing process leading to decreased oxygen levels in the infant can cause cerebral palsy. Cerebral palsy can also occur after the child is born. Encephalitis or meningitis (infection of the brain or its protective covering) are other causes. These occur after birth.

Can cerebral palsy be prevented?
Yes, like many other disorders there are some preventative measures one can take or do. A measles vaccination for women who are planning to conceive a child can help. Avoiding exposure to x-ray during pregnancy. Regular prenatal visits are encouraged. It is standard care for a mother to be tested for the Rh factor in their blood while pregnant. Phototherapy (light therapy) is available for babies who are jaundiced after birth due to high bilirubin levels in the blood. These are a few programs which are directed toward the prevention of prematurity of an infant. Safeguarding infants after birth is also a preventative measure. All of the measures listed can help to prevent cerebral palsy however, children will be born with cerebral palsy even with all safeguards in place.

Are there different types of cerebral palsy?
Yes. Doctors classify cerebral palsy in three different categories depending in the movement disturbance. the first is known as spastic cerebral palsy. 70-80% of children diagnosed fall under this category. The muscles of children affected by this disorder are "stiffly and permanently contracted." The next category is known as athetoid or diskinetic cerebral palsy. Only 10-20% of children diagnosed fall into this category. Athetoid or diskinetic cerebral palsy is characterized by uncontrolled, slow writhing movements. Although this disorder affects mainly the hands, feet, arms and legs; the muscles of the face and tongue can be affected as well. The third category is called ataxic cerebral palsy. This rare form affects a small 5-10% of children diagnosed. One diagnosed with this form of cerebral palsy will have a poor sense of balance and depth perception. Finally patients with cerebral palsy may also have what is know as mixed forms. This is characterized by a combination of two are more of the three categories.

How do physicians diagnose cerebral palsy?
Cerebral palsy, no matter the category cannot always be diagnosed right away. Clinical signs and symptoms of cerebral palsy do not always appear right away. However, it can be diagnosed by testing the infants motor skills, muscle tone, reflexes and by the infants ability or lack theory to reach various developmental milestones. Ruling out other developmental disorders is also very important. Physicians can also use CT (computerized tomography) scans and MRI (magnetic resonance imaging) scans to detect brain damage or brain underdevelopment. Ultrasonography can also be used on infants before the bones of the skull have time to harden and close. Overall the diagnose of cerebral palsy can be a tricky one.

What are the treatments option for cerebral palsy?
Management is a better word than treatment. Not only are there medications, surgeries, and braces than can be in a treatment regimen, but many other resources can be used as well. Much support will be needed from many outside sources, also i.e., family friends, teachers, therapist, etc. Therapy, whether it be physical, occupational, speech, etc. will all play a very important role in the child achieving his/her highest developmental potential. Contributed by: Bonnie J. Rupke, RN, CLNC Rupke and Associates, LLC P.O. Box 615 Hays, Kansas 67601 P/F 785.625.4464