Cerebral Palsy and Pregnancy

Brain damage during pregnancy can have severe effects on a child and can occur for many different reasons. In any case where a child is born with cerebral palsy, there will be an investigation into the cause of that brain damage so that doctors can determine what happened. There may be a range of reasons that a child’s brain was damaged at birth, but some of them are more common than others are.

Brain injuries that occur during pregnancy can have many different causes. Genetics can certainly play a role. In some cases, the genetic factors involved will prevent the brain cells from forming and migrating where they would normally be located, and this can lead to cerebral palsy.

There is also a condition that sometimes causes cerebral palsy that involves the development of nerve cell fibers. These fibers have a protective covering that sometimes fails to form as expected. When this happens, it can cause problems with the nerves being able to transmit signals as they normally.

Illnesses

Sometimes, the mother will contract an infection or other ailment that will end up harming the child while they’re in the womb. This may not be known until the child is born and the condition is actually diagnosed. In such cases, it may be found that the damage could not have been prevented, or conversely, the child may have been damaged due to a lack of appropriate and timely care or due to another medical mistake. It’s important to understand that not all brain damage is the result of a mistake on any medical provider, or most certainly, not because of anything the mother did. Sometimes, people simply fall ill and brain damage is a result of that illness.

Pregnancy Complications

Children sometimes suffer brain damage in the womb due to low amniotic fluid or for other reasons. This is sometimes avoidable, sometimes, not. When a woman has a high-risk pregnancy, doctors may recommend that a Cesarean section is performed to minimize the risk to mother and child. With today’s medical technology, it’s much easier for physicians to detect these issues before they manifest into more serious problems, and because of that, children are oftentimes spared such injuries today when they almost certainly would have suffered them before.

Trauma

Sometimes, trauma that ruptures blood vessels or that causes oxygen deprivation can end up causing CP injuries. This trauma may occur in the womb or it may occur during birth. The trauma can sometimes cause the connections that provide proper communication between the nerves and the brain cells to be severed, as well, and this can lead to cerebral palsy in the newborn.

Cases where trauma could have been prevented are among the most tragic cases when children end up suffering with CP. This is sometimes the result of negligence on the part of a physician, a midwife or a nurse. There are options for the families that have been affected by this type of negligence and it’s not necessary for those families to assume that they’re on their own in these instances.

Negligence

Negligence is sometimes the reason that children suffer brain damage during pregnancy. This may be because the doctor fails to diagnose a condition or because they make a wrong diagnosis. It also may be because the doctor fails to deliver care that the child and mother need, creating a delay during which the child is injured.

In situations where negligence is the issue that caused the injury, the families sometimes sue for compensation. This is one way that they can get financial assistance so that they can support their child. These cases do not always win but, when they do, the jury awards or settlements are sometimes enough to help the family pay for needed medical care.

Growing up with Cerebral Palsy

Children who have cerebral palsy cannot always count on having a “normal” life in many regards. The first thing they always face as a challenge is mobility. Even if they have excellent mobility most of the time, many cerebral palsy sufferers suffer from debilitating muscle spasms from time to time. People with cerebral palsy can live rich, fulfilling lives. Growing up, however, can be difficult for several reasons.

Cerebral Palsy

One of the risks that anybody with mobility impairments has is becoming isolated. It’s simply harder to get around if you have mobility impairment. If your child requires a wheelchair to get around but enjoys spending time with their friends, it’s easy to see how the mobility impairment could become a problem at a certain point. When your child’s friends all start getting driver’s licenses, they may not be able to take your child out with them because of not having room to stash the wheelchair in transit. This is why mobility vans are oftentimes among the first purchases when people have a child with cerebral palsy.

In some cases, people with cerebral palsy need some extra assistance in school. Sometimes, people with cerebral palsy attend normal classes like everyone else. There are quite a few people with cerebral palsy who do very well at school but who have difficulty with one subject or another. You may have to accommodate this by paying for tutors or extra classes. This can be somewhat isolating, as well.

The most severe cases of cerebral palsy are very debilitating. It may be almost impossible for your child to do anything on their own. For people with cerebral palsy, the most difficult tasks are oftentimes those that require the most developed muscle coordination. For example, opening a door can be exceptionally difficult if you can’t get your arms to stop shaking every time you try to grasp the knob. This is an example of what quite a few cerebral palsy sufferers have to deal with in terms of negotiating everyday life.

Cerebral Palsy – Athetoid

What is Athetoid Cerebral Palsy?

Athetoid cerebral palsy (also known as “dyskinetic cerebral palsy”) is a movement disorder caused by damage to the developing brain.

Children with athetoid CP fluctuate between hypertonia and hypotonia. Hypertonia is used to describe unusually high muscle tone, which creates stiffness and tension in the muscles. Hypotonia is used to describe unusually low muscle tone, which causes “floppiness” in the muscles. This inability to regulate muscle tone is what causes CP symptoms.

Athetoid CP can also result in issues surrounding voluntary movement in the hands, arms, feet and legs — making it hard to walk or grasp objects. Treatment for this type of cerebral palsy is centered on various therapies, medications and surgeries that can help to manage symptoms and prevent any future complications.

Types of Athetoid CP

Athetoid cerebral palsy may be given other distinctions to further classify the condition based on the specific type of involuntary movement.

The various types of athetoid CP include:

  • Dystonia – Slow, rotational movement of the torso, arm or leg.
  • Chorea – Sudden involuntary movements, especially in fingers and toes.
  • Athetosis – Sluggish, writhing movements, mainly in fingers and face.
  • Choreoathetoid – A combination of chorea and athetosis.
  • Ataxia – Loss of balance and coordination.
  • Rigidity – High muscle tone due to hypertonia causes restricted movement.
  • Dyskinesia – General term to describe involuntary movements. Athetoid CP is often interchangeably referred to as dyskinetic CP for this reason.

Causes and Risk Factors

Athetoid cerebral palsy is one of several types of movement disorders caused by a brain injury. Each type of cerebral palsy differs based on which part of the brain is damaged. 

Basal ganglia damage

The basal ganglia are a group of nuclei in the brain responsible for coordinating voluntary movement. The basal ganglia are located within the cerebral cortex, a part of the brain that helps control motor function. The basal ganglia also help regulate thinking and learning. Damage to the basal ganglia affects motor function development and causes involuntary movements.

Cerebellum damage

The cerebellum is responsible for regulating coordination and precision of movements — both of which are essential to fine motor skills and balance. When the cerebellum is damaged, balance and coordination become more challenging. The cerebellum is also an important part of cognitive functions, such as communication and attention. A damaged cerebellum can cause co-occurring disorders, such as autism or epilepsy.

Damage to the cerebellum and/or basal ganglia can be caused by:

Certain risk factors increase the chances of brain injuries that cause athetoid cerebral palsy. In general, the risk factors for all types of CP are the same, including: premature birth, severe infantile jaundice and blood clotting in the placenta.

Symptoms of Athetoid Cerebral Palsy

The signs and symptoms of athetoid CP vary based on the severity of the condition and location of movement issues. The symptoms of athetoid cerebral palsy are a result of problems with both high and low muscle tone, which can vary on a daily basis. High muscle tone causes stiffness and jerky movement. Low muscle tone causes floppiness in the muscles, characterized by issues such as trouble sitting up.

The most common symptoms associated with athetoid CP are:

  • Involuntary movement
  • Tremors
  • Poor posture
  • Unsteadiness
  • Twisting of the torso
  • Slow, writhing movements
  • Abrupt movements
  • Grimacing or drooling

The symptoms of athetoid CP depend on whether the damage was solely to the basal ganglia, or if both the cerebellum and basal ganglia were damaged. If both areas are damaged, this will likely cause problems with balance and coordination.

Parents and caregivers usually begin noticing signs of involuntary or jerky movements when their child is around 9 months or older. In many young children, irregular movement may be indicative of a developmental delay, but not necessarily a sign of cerebral palsy.

Athetoid cerebral palsy may be present in a child who:

  • Doesn’t kick legs
  • Seems stiff or rigid
  • Seems limp
  • Doesn’t hold up head at three months old
  • Doesn’t reach for objects
  • Doesn’t smile by three months old
  • Doesn’t roll over

Treatment for Athetoid CP

Although there is no cure for cerebral palsy at this time, children with this condition generally grow up to live healthy, meaningful lives as they transition into adulthood.

Treatment for cerebral palsy helps children with this disorder become more independent and confident in their abilities. Treatment methods such as physical therapy and speech therapy help improve existing symptoms, while also preventing any future complications later in life.

Physical therapy

Physical therapy typically incorporates a series of strength training exercises, resistance bands and machines to help improve low muscle tone. Physical therapists work with children and adults with CP to overcome any sensory impairments, such as touch and depth perception, that make movement more difficult.

Therapy for this type of CP is typically based on improving overall mobility. This includes exercising the face and tongue muscles, as grimacing and drooling is common in children with this type of CP. Athetoid CP can also cause difficulties holding posture or keeping the body in a steady, upright position. Physical therapists will use various exercises to increase the strength in these muscles and prevent any further complications.

Occupational therapy

Occupational therapy is used to enhance a child’s ability to independently play and learn. An occupational therapist will help to make everyday tasks, such as grasping objects, writing or using assistive mobility devices, easier on a child with this type of CP.

Specific exercises used in occupational therapy for athetoid CP include stretching with weights and resistive equipment, as well as incorporating functional and playful activities to keep children interested. Occupational therapy will allow children to form relationships and respond to the demands of daily life with increased mobility and confidence.

Speech therapy

For those diagnosed with CP, speaking, eating or breathing can be a challenge. Speech therapy is used to alleviate these problems, as well as increasing language and vocabulary development, articulation and breathing control.

After working with a speech therapist for a series of sessions, people with CP often begin to have more control over their face and tongue muscles. Speech therapy can also make daily tasks easier on a child with athetoid CP, allowing for increased independence.

Medication

Most of the medications prescribed for athetoid cerebral palsy are used to treat secondary conditions that result from developmental brain damage. For example, anticonvulsants are used to reduce seizures and over-the-counter acid reflux medications, such as Zantac, are prescribed for children with weak gastroesophageal muscles.

Ritalin and other medications treat attention deficit hyperactivity disorder (ADHD), which is diagnosed in up to 20 percent of children with CP. Medications to control drooling and incontinence are also useful for those with athetoid cerebral palsy.

Surgery

Surgery for children with cerebral palsy is used to correct and prevent issues with the joints, muscles and tendons by correctly aligning parts of the body to foster healthy growth. Although it is not common in athetoid CP, surgery can be used to correct joint deformities and dislocations due to high muscle tone.

Embracing A Life with CP

While a cerebral palsy diagnosis may come as a surprise to many families, this is a condition that can be managed effectively through proper treatment and continued care. There are bound to be some challenges along the way, however, maintaining a positive outlook can allow children and adults to embrace life with CP.

To learn more about athetoid cerebral palsy, try downloading our free Cerebral Palsy Guide. This guide includes 60 pages of in-depth information for families affected by cerebral palsy.

Cerebral Palsy in Children

WHAT IS CEREBRAL PALSY?

Cerebral Palsy is a term used to cover several neurological conditions.

These conditions are caused beforeduring or shortly after birth as a result of injury to the brain due to any of the following reasons:Limited or interrupted oxygen supply to the brainA bleed within the baby’s brain
A premature or difficult birth processThe mother catching an infection whilst pregnantChanges in genes which affect the development of the brain 
Cerebral Palsy can affect muscle control, coordination, and tone, reflexes, posture and balance. Often a person with Cerebral Palsy will display signs of the condition, but the effects can vary greatly from person to person
‘Cerebral Palsy’ comes from the Latin words ‘Cerebrum’ and ‘Paralysis’

WHAT ARE THE DIFFERENT TYPES OF CEREBRAL PALSY?

The NHS describes three different categories of Cerebral Palsy, it is also possible to have a combination of categories which is referred to as ‘Mixed Cerebral Palsy’.

Spastic Cerebral Palsy
This affects muscle stiffness or weakness. Click here to learn more.
Athetoid Cerebral Palsy
This affects muscle tone, causing involuntary spasms. Click here to learn more.
Ataxic Cerebral Palsy
This affects balance and coordination. Click here to learn more.

The affect Cerebral Palsy has on individuals ranges from the very mild, to more severe cases that can make it difficult for people to control their limbs.

THE SOCIAL, EMOTIONAL, & PSYCHOLOGICAL EFFECTS OF ADULTS WITH CEREBRAL PALSY


Cerebral palsy (CP) is a cluster of brain disorders that affect an individual’s ability to move, balance, and control posture, muscles, and reflexes. It results from impaired brain development during pregnancy or soon after birth. Those afflicted with cerebral palsy experience its effects and severity differently. Muscles may be weak or stiff. Many cerebral palsy persons experience tremors or unpredictable or uncontrollable reflexes and muscle movements. They may also be visually, hearing, or speech impaired. Severe cases may also have trouble breathing and swallowing, which leads to eating, digestive, and dental problems.

Medical advancements have enabled individuals with cerebral palsy to live well into adulthood. However, there appears to be a limited commitment to help physically disabled adults obtain maximum mental and physical health and well-being. As a result, those with cerebral palsy tend to experience high levels of social and emotional distress as well as physiological challenges.

Social Effects

Cerebral palsy affects one’s mobility and ability to effectively communicate. As a result, cerebral palsy individuals tend to be socially and professionally limited. Employment, marriage, and living independently are viable options only for those with mild cerebral palsy.

Inclusion is important to mitigate feelings of isolationloneliness, and depression. Having a disability does not eliminate the need to be accepted and respected by one’s peers. Cerebral palsy adults may be encouraged to join groups or socialize with individuals their age that have similar disabilities or who do not normally participate in physical activities. Organized crafts, recreational activities, and events aid socialization. Psychologists and behavioral or developmental specialists are often consulted to assist with socialization needs.

Emotional Effects

Aggressiveness, hyperactivity, belligerence, withdrawal, or fearfulness are signs the cerebral palsy individual is having difficulty adjusting to their surroundings or to others. They may act frustrated, mad, or sad. This may be due to painful physical maladies associated with their CP (i.e.: poor sleep, scoliosis, acid-reflux, skin irritations, etc.). This acting-out may also be due to feelings of low self esteem or a negative self-imageAttentiveness to these signs of distressanxiety, and depression provides the impetus for early mental health intervention.

Comprehensive care must include mental health observation and support in addition to customary medical and physical care. Helping the cerebral palsy adult adapt to their disability and/or limitations can help improve mood.

Psychological Effects

Fifty percent of cerebral palsy individuals have a learning disability. The degree of learning disability depends on which area of the brain is damaged. Approximately one-third of individuals with cerebral palsy have moderate-to-severe intellectual impairment (mental retardation). One-third has mild intellectual impairments. One-third shows no signs of cognitive impairment.

More adults with cerebral palsy are furthering their education and entering into the workforce due to advancements in medical treatment, ADA and educational accommodations, and adult cerebral palsy support services. Ensuring physically disabled adults maintain mobility, find inclusion, and have full access to community and adult support services helps ensure they achieve maximum health, well-being, and quality of life.