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Cerebral Palsy (Disabled): Spastic Cerebral Palsy
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Contracture is one of the most common and serious complications of cerebral palsy. Normally, a child whose bones are growing stretches the body's muscles and tendons through running and walking and other daily activities. This ensures that muscles will grow at the same rate. But in children with cerebral palsy, spasticity prevents this stretching and, as a result, muscles do not grow fast enough to keep up with lengthening bones. The resulting contracture can disrupt balance and trigger loss of previous abilities. Physical therapy alone, or in combination with special braces (sometimes called orthotic devices), works to prevent this complication by stretching spastic muscles.
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Observation of slow motor development, abnormal muscle tone, and unusual posture are common initial clues to the diagnosis of cerebral palsy. Assessment of persistent infantile reflexes is important. In infants who do not have cerebral palsy, the Moro reflex is rarely present after six months of age, and hand preference rarely develops earlier than 12 months of age. Hand preference may occur before 12 months of age if spastic hemiplegia is present.
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It may seem surprising that in the definition of cerebral palsy it is said to be a non-progressive disorder. But this means that the damage to the brain is 'done' and it does dot progress. (This is in contrast to some other brain disorders of children.) However, the effect on the body is progressive in that the spasticity of the muscles can have a progressive effect on bones and joints. For example, the stiffness of the muscles in spastic cerebral palsy can gradually lead to permanent fixed contractures of joints in arms and legs. Some joints may eventually become 'fixed' in a flexed position as a child becomes older. A main aim of treatment for spastic cerebral palsy is to keep to a minimum the effects of the muscle stiffness.
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Screening for cerebral palsy should be a regular part of a child's six-month checkup. One should suspect cerebral palsy if an infant has a hard time sucking or keeping a nipple in his or her mouth, tremors or infrequent movements, and legs that are hard to separate. Treatment may include drugs to control seizures and spastic movement. Many children wear leg braces or splints. Exercises, physical therapy, and surgery may improve very-taut muscles. A device provides a valve to help in bladder control.
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The underlying brain damage that causes cerebral palsy can't be fixed. Treatments can... address associated symptoms. For example, physical and occupational therapy help people adapt to balance and motor-control issues. Braces and orthoses help support people with spasticity or low muscle tone. Medication and surgery can help manage spasticity and correct bone and growth issues.
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If muscle tone is too high or too tight, the term spastic is used to describe the type of cerebral palsy. Children with spastic CP have stiff and jerky movements because their muscles are too tight. They often have a hard time moving from one position to another or letting go of something in their hand. This is the most common type of CP. About half of all people with CP have spastic CP.
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Spastic Cerebral Palsy