Let’s talk about what it means to have Cerebral Palsy

Cerebral palsy (CP) is a loss or impairment of motor function caused by abnormal brain development that most often occurs during pregnancy or labor and delivery. Over 10,000 children are diagnosed with cerebral palsy each year. And, while the condition can be defined, having cerebral palsy does not have to define the child.

Each case of cerebral palsy is different because different areas in the brain are affected. Factors such as the location and severity of the initial brain injury and the level of resulting treatment and therapy will play a role in how a CP diagnosis affects each child.

Range of Problems Associated with Cerebral Palsy

Cerebral palsy can vary from mild to severe. A mild muscular condition might be struggling to talk, whereas a severe muscular condition can be an inability to control one’s legs, resulting in the need to use a wheelchair. One child might have a mild vision issue, while another’s issues might be so severe they need surgery to correct their eye alignment. Problems associated with cerebral palsy can include:

• Movement and coordination issues

  • Variations in muscle tone such as too stiff or too floppy

  • Stiff muscles and exaggerated reflexes (spasticity)

  • Stiff muscles and normal reflexes (rigidity)

  • Lack of muscle coordination (ataxia)

  • Slow, writhing movements (athetosis)

  • Tremors (involuntary movements)

• Delays in reaching developmental milestones like sitting up or crawling

• Favoring one side of the body such as only reaching with one hand or dragging one leg

• Difficulty walking – walking on toes, odd gait

• Pain – 50-75% or those with cerebral palsy report pain associated with this condition

• Cognitive disabilities

• Learning disabilities

• Delays in speech development

• Communication issues, speech and language problems

• Epilepsy and seizures

• Visual impairments, including slow eye movements and low visual acuity

• Hearing impairments

• Hip displacement

• Behavioral disorders

• Incontinence

• Sleep disorders

• Excessive drooling or saliva control issues

• Gastrointestinal disorders, including feeding-tube dependency

• Failure to grow

• Pulmonary disease

• Orthopedic disorders

• Urinary disorders

• Arthritis and tendonitis

• Scoliosis

Treatments for Cerebral Palsy

It is hard to know exactly how a child diagnosed with CP will develop. What we do know is that you will need a host of specialists to assist your child and help your child develop to their fullest potential. The earlier the interventions and therapies are started, the better chance the child has of improving their strength, mobility, and cognition. Most children with cerebral palsy will see at least two of the specialists listed here.

• Pediatrician – The main doctor who will oversee your child’s cerebral palsy treatment plan and medical care.

• Pediatric neurologist – A physician who specializes in treating children with brain and nervous system (neurological) disorders.

• Pediatric orthopedic surgeon – A physician who specializes in treating children with muscle and bone disorders.

• Physical therapist – Specializes in helping improve strength, walking skills, and stretching muscles.

• Occupational therapist – Specializes in assisting your child with daily living skills and teaches them how to use adaptive products.

• Speech-language pathologist – Experts in communication, these doctors and therapists will assist your child if they have difficulty with swallowing or have speech or language issues.

• PM&R (physical medicine and rehabilitation) specialists – Coordinates the care of physical, occupational, and speech-language therapists.

• Developmental therapist – Will help your child develop age-appropriate behaviors, social skills, and interpersonal skills.

• Mental health specialist – Psychologists or psychiatrists may be involved in your child’s care. This specialist may help you and/or your child cope with this lifelong condition.

• Recreational therapist – Assists with sports, cultural and art programming, animal therapy, and art therapy.

• Social worker – Will help your family find services and plan for care transitions.

• Special education teacher – Addresses learning disabilities and helps determine educational needs and resources.

Medication and Drug Therapy for Cerebral Palsy

There are several medications that can lessen the certain symptoms of cerebral palsy. For those suffering from spastic cerebral palsy, which can cause muscle spasms and stiffness, relaxing the muscles can help decrease the stiffness of the muscles. The drug Baclofen suppresses the release of neurotransmitters that cause spasticity, by decreasing the neuron’s excitability or the rate at which the neuron responds to a signal. If your child has severe spasticity, a Baclofen pump might be inserted into your child’s abdomen to slowly and regularly administer the medication. Another medication, Botox, has also been shown to reduce excessive muscle tone and stiffness, thus providing some relief to a child with cerebral palsy. For children with CP who suffer from seizures, there are also medications available to help minimize the frequency of seizures. On the horizon are various stem cell therapies. These therapies are advancing through clinical trials and have shown some promise in treating some of the effects of cerebral palsy.

Hypothermic Treatment for Cerebral Palsy

Hypothermic treatment, also referred to as brain cooling, is a relatively new treatment option for cerebral palsy and is used especially in the newborn. The newborn’s body temperature is lowered in order to reduce neurologic injury. In traumatic births, oxygen flow can be restricted to the baby’s brain, and a brain injury called hypoxic ischemic encephalopathy (HIE) often results. If hypothermic treatment is initiated within six hours of an oxygen-deprived birth, there is the potential to reduce or eliminate neurologic injuries like cerebral palsy.

How does it work? In this treatment, the newborn’s body temperature is lowered to 91° F using a cooling cap or cooling blankets. Reducing the body temperature slows the newborn’s metabolic rate. When brain cells slow their metabolism, they need less oxygen to survive. Cooling also gives the cells more time to recover from injury and can reduce future damage caused when normal oxygen levels are restored in injured brain cells.

Surgery Can Help with Cerebral Palsy

Surgery is an option for some children with cerebral palsy. Most doctors will hold off on surgery until the child has reached a certain age or level of development. Other reasons to postpone surgery is to see if less invasive forms of therapy, like medications and physical therapy, can be successful. However, if surgery is the best option, it can improve the quality of life for the child. Potential surgeries include:

1. Muscle and tendon lengthening – This surgery is usually done to help the child walk and move independently.

2. Selective dorsal rhizotomy (SDR) -- In this surgery, the overactive nerves in the spinal column are cut. This can help the associated muscles relax and provide some pain relief.

3. Tendon release procedures (tenotomy) – In these surgeries, tendons are cut or shortened to improve range of motion. This is usually done to relieve muscle tightening and relax the joints.

4. Eye surgery – Children with cerebral palsy often have a condition called strabismus. Strabismus is characterized by improper eye alignment. Physicians can operate on the eye muscles to correct strabismus.

5. Seizure operations – If seizures cannot be controlled with medicine, surgery might be an option.

6. Baclofen pump insertion – Surgeons can place a pump inside the child’s abdomen that will continuously pump the medication, Baclofen, into the child’s spinal fluid. As noted earlier, Baclofen can help to reduce muscle spasms.

7. Feeding gastrostomy tube insertion (PEG tube) – For children who suffer from swallowing or other eating conditions, a feeding tube can be surgically inserted into the child’s stomach.

Assistive Devices to Help Children with Cerebral Palsy

In addition to specialists, medication, and possible surgeries for treating cerebral palsy, your child most likely will need assistive devices for every stage of growth. Adaptive equipment includes any device that helps a disabled person increase function and independence. There is a large range of adaptive devices but, in general, they can be broken down into these categories:

1. Mobility – These devices help children with cerebral palsy with movement. Examples include wheelchairs, electric scooters, adaptive bicycles, car seats, braces, walkers, lifts, and many more.

2. Communication – These devices help children communicate. Examples includes adaptive writing tools, speech-generating computers, eye-tracking devices, hearing aids, and others.

3. Recreation – These devices help children enjoy the world and make therapy more fun. Examples include specialized art supplies and specialized sporting equipment, like skates, skis, cycles and toys.

In addition to all these treatments for your child, you will most likely need to have accommodations made to your house. As you might imagine, the expenses of dealing with this kind of lifelong medical condition add up quickly.

Cerebral Palsy Law Firm

At The Eisen Law Firm, we help families whose children have been diagnosed with cerebral palsy. We review the medical records to determine if your child’s cerebral palsy is the result of a medical error. We cannot change the fact that your child has cerebral palsy, but we can hold accountable anyone whose carelessness caused the injury, and we can help alleviate the burden of extraordinary medical bills and expenses. At The Eisen Law Firm, we focus exclusively on medical malpractice. We have a successful record of holding medical professionals responsible and accountable for their errors. If you think your child’s cerebral palsy may have been caused by the negligence of a medical professional, contact us at 216-687-0900 or contact us online. You pay nothing -- no expenses, no fees, nothing -- until we win.