Cerebral palsy is one of the neurological disorders and mainly affects the motor skills of the child

This type of disease is irreversible but not progressive and is due to changes in brain function before the central nervous system has completed its development.

The causes can be of various kinds as well as the symptoms, which depend on the extent of the brain damage, measurable through special radiological examinations.

There is no possibility of recovery from this pathology, however it is possible to adopt therapeutic countermeasures to improve the symptoms and improve the quality of life of the affected patients.

What is infantile cerebral palsy?

Cerebral palsy is a persistent and non-progressive neurological disorder caused by a lesion of the central nervous system which involves a more or less consistent loss of brain tissue.

The disease mainly, but not exclusively, involves an alteration of motor functions and can also affect the perception of space and the communication skills of the affected child.

The event that causes the lesion can occur in the prenatal, perinatal and postnatal period but, in any case, within the first three years of life, i.e. that period of time in which the phases of growth and development of the brain functions of the ‘human being.

According to World Cerebral Palsy Day, infantile cerebral palsy afflicts 17 million people worldwide and impacts the lives of 360 million people who are closely related to children or adults suffering from PCI.

It is considered the most common physical disability in childhood and is one of the most complex.

The impact on patient health varies from weakness in one hand to almost total lack of voluntary movement.

Again according to Worldcpday data:

• 1 in 4 children with PCI cannot speak
• 1 in 4 children cannot walk
• 1 in 2 children have an intellectual disability
• 1 in 4 children suffer from epilepsy

Let’s see what are the most common causes that lead to infantile cerebral palsy.

What are the causes of the disease?

Cerebral palsy is caused by an insult to the brain that can occur before, during or after birth and block its natural development by damaging part of the nervous structure.

The causes of PCI are generally divided into three groups: pre-natal, peri-natal (from one week before to 4 weeks after delivery) and post-natal.

The most common causes include:

• Genetic mutations affecting one or more genes that are involved in brain development.
• Maternal health disorders during pregnancy affecting the developing fetus. It can be both viral or bacterial infections, thyroid problems or contact with toxic substances.
• Reduced blood supply to the developing baby’s brain, i.e. a fetal stroke which can occur either before or after birth.
• Asphyxia, that is, a severe lack of oxygen to the baby’s brain, which can occur due to a problematic labor or delivery.
• A fetal infection that can affect the newborn after birth or severe jaundice.
• A brain trauma caused, for example, by an accidental fall.
• A premature birth, that is, occurring before the thirty-seventh week of gestation.
• A low birth weight. Babies weighing between 1 and 1.5 kilograms are considered to be at high risk of PCI.
• A breech birth, i.e. a bad positioning of the baby during childbirth that presents itself towards the uterus canal with the feet instead of the head.
• Maternal infections potentially dangerous for the fetus

There are some maternal infections that can increase the risk of cerebral palsy, these include:

• Rubella.
• Chicken pox.
• Cytomegalovirus, which can cause serious harm to an unborn baby.
• Toxoplasmosis, caused by a parasite usually found in contaminated food or feces from infected cats.
• Syphilis, a sexually transmitted bacterial infection.
• Other risk factors that can compromise the health of the fetus are exposure to methylmercury, thyroid problems, high blood pressure and recurrent epileptic attacks.

Diseases that expose the child to cerebral palsy risk

Some morbid states can expose the newborn to the risk of infantile cerebral palsy, among these we mention:

• Bacterial meningitis, an inflammation of the membranes surrounding the brain and spinal cord.
• Viral encephalitis, an inflammation of the brain and spinal cord.
• Severe or untreated jaundice, pathological condition in which an excessive accumulation of bilirubin is observed and which leads to the patient a typical yellow complexion.

What are the symptoms and possible complications?

The symptoms associated with infantile cerebral palsy vary according to the severity and extent of the brain damage caused by the insult.

The more extensive the brain damage, the greater the impairment of brain function.

The most common symptoms of PCI are lack of coordination and impaired command of skeletal muscles; in some cases, moreover, the affected patient may also experience other disorders such as those of learning, vision, swallowing or communication faculties.

Here is a list of disorders that can be included in the symptomatological picture of PCI:

• Reduced muscle tone.
• Muscle spasticity.
• Muscle stiffness.
• Involuntary movements and tremors.
• Lack of motor coordination.
• Slow twisting movements

Delayed motor development:

• Difficulty holding objects, crawling and standing up.
• Difficulty walking. Many affected individuals have the typical “scissors” gait on their toes.
• Difficulty chewing and swallowing, excessive salivation, communication problems.
• Spine malformations and posture problems.
• Impaired depth perception and hearing and vision impairment.
• Mental disorders and poor learning skills.
• Epilepsy.
• Urinary incontinence.

The complications of cerebral palsy can occur in the patient both in childhood and in adulthood

They are mainly due to poor muscle tone, lack of motor coordination and spasticity.

Among the most important ones are muscle contractures which, in the long run, can hinder the physiological bone growth, deforming the joints and causing osteoarthritis.

Other possible complications include malnutrition and scoliosis.

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How is the diagnosis made?

In the event that there is a suspicion that the child may be affected by PCI, the first diagnostic check to be carried out immediately is an accurate objective examination.

Subsequently, it is necessary to make use of a series of instrumental tests to investigate any brain abnormalities and other laboratory tests.

The instrumental tests that can be prescribed to the patient include:

• Nuclear magnetic resonance (MRI).
• Computed tomography (CT) scan.
• Cerebral ultrasound, even if the least reliable, is chosen for its speed of execution, non-invasiveness and for its safety profile.
• Electroencephalogram (EEG).

Blood tests can then be prescribed, starting from routine ones up to genetic tests, which can be useful to the doctor to exclude the possibility that the disorders derive from pathologies of congenital genetics.

Other checks can then be carried out based on the patient’s symptoms to assess the extent of the problem and plan an appropriate treatment.

What are the possible treatments?

As anticipated, the damage to the brain that leads to cerebral palsy is not repairable, so the disease cannot be cured.

However, it is possible to adopt therapeutic countermeasures to soothe the symptoms and slow down the onset of complications.

These countermeasures mainly include pharmacological and physiotherapy treatments even if, in the most serious cases, the use of surgery, occupational therapy and speech therapy cannot be excluded.

Following the diagnosis, parents are advised to rely on a team of health experts in the sector, to guarantee the best care for the child until adulthood.

Is it possible to prevent cerebral palsy?

Cerebral palsy cannot be completely prevented, however it is possible to reduce all those risky situations that could cause the disease.

It is advisable, therefore, that for the woman who wants to have a child:

• Perform all vaccines when possible.
• Take care of her health and live in a healthy environment.
• Have regular medical checkups during pregnancy.

Take precautionary measures to safeguard the health of the newborn, especially in the first years of life, using the appropriate safety devices (safety belt, bike helmet, cot with protection, etc.).

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