What are the Types of Cerebral Palsy?

Cerebral Palsy (CP) is the most common non-genetic cause of physical disability among children. It is defined as a group of permanent, non-progressive disorders resulting in impairment of motor function, cognition, and/or communication due to damage done to the brain during fetal development or early childhood. In this article, we will take a closer look at cerebral palsy. We will examine the types, the challenges it causes, and its management options.

Cerebral refers to the brain, while palsy speaks to issues or weakness affecting the muscles. Cerebral palsy is caused by damage or malformation of the brain’s development and significantly impacts your child’s ability to control their muscles. 

Brain damage leading to cerebral palsy can happen before or during birth. It can also occur within a month of being born or during the first few years after it happens. 

What is the Main Cause of Cerebral Palsy?

The exact cause of cerebral palsy is still under research, the mechanism of nerve damage is not clear, however there is a strong correlation of hypoxia episodes (lack of oxygen in the blood) that damages the sensitive neural pathways. If the neural tissues do not receive a consistent supply of oxygen, their metabolism becomes permanently damaged and causes cell death. 

Hypoxia can occur by events that may have occurred in the womb (toxin exposures, trauma, cord around the neck), during the birth process (difficult prolonged delivery) or immediately in the postnatal period (infections, trauma, toxin exposure, abuse).

What are the Types of Cerebral Palsy?

According to the CDC, your child is affected by one of four main types of cerebral palsy. Each type affects individual children in slightly different ways. These four categories are spastic, athetoid, mixed, and ataxic.

Spastic Cerebral Palsy

If your child falls under this category, it means they display hypertonia (a condition in which there is too much muscle tone, so body parts become stiff and hard to move), which causes their muscles to be overactive and tight. It results in stiff joints, stiffness, or hard muscle tone. About 30-40% of all individuals with cerebral palsy fall into this category, as it is the most common type of CP. 

Spastic CP is classified by the body parts affected: 

• Spastic diplegia/diparesis- muscle stiffness primarily affects the legs.
• Spastic quadriplegia/quadriparesis- the most severe form of spastic CP. It occurs in all four limbs, the trunk, and the face.
• Spastic hemiplegia/hemiparesis- affects only one side of the body.

Dyskinetic Ataxic Cerebral Palsy (athetoid, choreoathetoid & dystonic cerebral palsies)

Dyskinetic CP causes your child to struggle with hand and arm movement. It is also challenging for them to walk or sit. Your child’s movements may appear fast and jerky or slow and writhing. These movements are not easily controlled and can vary from one second to the next, depending on existing conditions. 

Ataxic Cerebral Palsy

Ataxic cerebral palsy causes shaky balance, poor coordination, and a wide range of other symptoms. These can include visual difficulties, cognitive impairment (problems with learning), difficulty communicating, abnormal movements, and problems swallowing or breathing.

Mixed Cerebral Palsy (spastic)

Mixed cerebral palsy is a type of CP that combines spasticity (poor muscle tone), hypertonia (extreme rigidity), and ataxia (lack of muscle control). This combination causes your child to appear stiff, awkward, and unsteady when moving.

Is there a Cure for Cerebral Palsy?

There is no cure for cerebral palsy, but early treatment can improve your child’s quality of life. Treatment for Cerebral Palsy is aimed at managing symptoms and maximizing your child’s quality of life. While no treatment can cure CP, research continues to find ways to slow the effects of the disease.

• There are ongoing research with predictive technologies to identify high risk pregnancies
• Using umbilical stem cell technology to help regenerate the damaged neural tissues
• Artificial prosthesis to aid the child in regaining some degree of mobility

Common Issues in Cerebral Palsy Management

A 2014 study conducted by the University of Bridgeport looked at the challenges of cerebral palsy management. At the end of the study, researchers concluded that the complex nature of CP introduces many challenges to its management process. 

Some of the problems in cerebral palsy management includes:

• The availability and affordability of care- restricts management options.
• Delayed or inaccurate diagnosis- reduces treatment success.
• The risks involved in each treatment option- can delay care as parents take time to determine if the benefits outweigh the risks.
• Unavailability of caregiver to assist with specialized devices and other care- causes deterioration in condition.

Is there a Treatment Plan for Cerebral Palsy?

There is no generic treatment plan for cerebral palsy, as it is a permanent condition. CP treatment is often customized and focuses on managing specific symptoms and helping your child live an enhanced quality of life with the disability. Management is also dependent on your child’s impairment level, type of CP affecting your child, co-occurring conditions, etc. 

Some CP treatment modalities may involve:

• surgery – to help with muscle contractures

• medication – muscle relaxants and anticonvulsants are typically prescribed
• assistive aids – wheelchairs, eyeglasses, walking aids, hearing aids, body braces
• physiotherapy and other forms of therapy and counseling.

These management options target symptoms like spasticity, muscular weakness, and muscle tightness.

What are the Latest Treatment Options for Cerebral Palsy  in 2021?

There is always innovation taking place, and this holds true for healthcare. Over the years, numerous treatment options have been developed and explored for cerebral palsy. At this point, researchers are still looking into and employing different management possibilities for the condition. 

Here are a few new CP treatment options:

EQUINE-ASSISTED THERAPY

Equine-assisted therapy (EAT) is a blanket term for several treatment activities involving horses and other equines. According to ScienceDirect, “Equine Assisted Physiotherapy (EAT) offers children with cerebral palsy (CP) opportunities for new movement experiences, and may influence movement qualities.” 

The study results showed improvements in trunk control and noted that during therapy, children can adopt new movement qualities.

MUSCLE-TRANSFER SURGERY

Another option being explored is a new technique of transfer muscle relating to the muscles with the frontal region of the forearm. It is indicated for upper extremity deformities in spastic cerebral palsy. 

The results portrayed enhanced functional capabilities and cosmetic appearance in all cases in a follow-up over 12 months.

POSTURAL RELEARNING

In the Archives of Rehabilitation Research and Clinical Translation, June 2021, there is a case study of a child who received treatment using a postural relearning system. The investigators reported that the relearning system may improve the static and dynamic standing control ability, fix postural misalignment, and improve motor ability and flexed-knee gait.

SURGERY FOR CEREBRAL PALSY

Surgery usually gets employed as the last option in treating the various cerebral palsy types. However, it cannot be used alone and must be combined with other treatment options for the best results. Because spasticity may lead to muscle tightness, orthopedic surgery and physical therapy are often needed to relieve the stiffness and pain your child is experiencing. 

There are several types of orthopedic surgery that are performed based on the issue your child is having:

SELECTIVE DORSAL RHIZOTOMY

Selective dorsal rhizotomy is used to cut the nerves responsible for spastic muscle movements. It relieves pain and spasticity. Because of how high risk this procedure is, it might not even get recommended for your child. 

ASSISTIVE SURGERIES

The other surgical options for cerebral palsy are used to target specific symptoms. For example, improving hearing abilities using an implant. 

Stem Cell Therapy for Cerebral Palsy 

Stem Cell treatment uses stem cells (cells from which all other cells generate) to restore healthy tissue in your child affected by Cerebral Palsy (CP). Stem cell treatment for Cerebral Palsy has been used to repair and replace damaged brain tissues that are the cause of symptoms experienced by your child. 

While stem cell treatment does not seem to be as efficient in treating sensory, speech, or cognitive defects, it proved highly effective in improving motor symptoms. More research is needed to cement the validation for stem cell therapy as a treatment modality for cerebral palsy.

CONCLUSION

What can a Parent of a Cerebral Palsy Child do? 

As a parent, we understand that you have many concerns and questions regarding your child. As such, we hope this post was able to help you answer some of those questions relating to the type of cerebral palsy affecting your child and the treatment options available. 

The best way to help your special needs child is by equipping yourself and your home with the right knowledge about distinct care strategies according to the pediatrician’s advice, physiotherapy, nutrition, prescriptions and ofcourse their emotional needs as well. 

How can Telemedicine Help in Cerebral Palsy Management?

Telemedicine is an excellent digital health solution for pediatrics, especially specialised child care. Parents of young children face a lot of challenges in accessing convenient pediatric review for minor and complex health issues. 

Parents have to arrange an entire day off work, childcare for unaccompanied siblings, gather their health records, diapers, snacks and other logistic hassles of caring for a sick child in a crowded waiting room for long periods of time.

By using telemedicine, you can have a virtual session with your child’s pediatrician, while you are at home with your child.

Your pediatrician can visually examine your child while both of you are comfortable in a familiar surrounding, with their records at hand and you will not have the hassle of disrupting your daily obligations for a 20-30 min virtual session.

The virtual care session will involve a careful review of the following parameters of an effective and supportive environment for managing cerebral palsy:

• Full birth history
• Assessment of your child’s development milestones
• Dietary and nutritional needs
• Physical therapy methods
• Psychosocial assessment of your child (and even yourself to see if you are getting support)
• Discussion about recent trends in cerebral palsy research
• Practical decisions on future care

How can a VIOS Telemedicine Provider Help my Child with Cerebral Palsy?

VIOS is a Global Telemedicine Platform made up of a specialised network of healthcare experts and consultants, with decades of clinical experience with complex chronic illnesses. Our virtual care platform allows parents from around the world to access a convenient way to select your preferred provider.

This infographic will show you that by choosing a pediatrician with decades of specialised experience in understanding childhood development, you can be assured of a personalised care experience that is specific to your needs.

Most virtual pediatric visits can be cumbersome, hurried and in some cases require a confusing prior authorization process by your insurer. Commonly many healthcare insurers may not even have a skilled pediatrician available for telemedicine visits.

In the VIOS Platform, we place a significant effort in ensuring that all of our specialist telemedicine providers are committed and motivated to provide you the personalised convenient care that you need.

By being in control of your child’s health journey from the very beginning, you can be empowered to learn practical expert guides to better care for your child, and be the prime decision maker for your whole family.