20 September 2021 Author : Pedro Beleza Cerebral palsy is a heterogeneous group of disorders characterized by non-progressive central motor dysfunction , affecting: Muscle tone; Posture; Movement. Other symptoms are often also present, for example: Cognitive deficit, with reasoning and learning difficulties; Sensory deficit, for example in vision and hearing; Epilepsy; Sensitivity disorders. Cerebral palsy is almost always a congenital problem, that is, is present at birth. However, it can also occur early in the postnatal period. Despite being a static condition, which does not worsen with age, signs and symptoms of cerebral palsy can vary over time , in relation to brain maturation. The severity of symptoms is also variable. Many children who are born with cerebral palsy may not have immediately noticeable signs and the disease may only be diagnosed later , for example following suspicions related to delays in their motor development, such as crawling, sitting or walking. Paralysis is usually classified into three subtypes : Spastic , which can involve all four limbs (tetraparesis), the legs more than the arms (diparesis) or one side of the body (hemiparesis); Dyskinetics ; Ataxic . This classification allows us to consider which causes are most likely to be involved. What causes cerebral palsy? Cerebral palsy occurs when there is inadequate development of areas of the brain that affect movement control. The cause of this inadequate development can occur before or after birth . In most cases, cerebral palsy has prenatal causes; The etiology or cause of cerebral palsy is multifactorial, meaning there is no single cause. The most frequent risk factors are prematurity and/or low birth weight, which are associated with leukomalacia, intraventricular hemorrhage, and bronchopulmonary dysplasia and these may be the cause of cerebral palsy. Cerebral palsy occurs in about 5%-15% of very low birth weight children. Other factors often associated with cerebral palsy are: Congenital anomalies; Multiple pregnancy; Placental pathology; Intrauterine infections. Perinatal hypoxia (oxygen deficit) is probably the cause of a minority of cases of cerebral palsy. Cerebral infarction in the perinatal period typically manifests as spastic hemiparesis. Cerebral palsy does not worsen with age, but related symptoms persist throughout life . Prevention of cerebral palsy Routine prenatal care and surveillance is an important measure to reduce the risk of cerebral palsy. Among these measures are, in particular, those implemented to reduce the risk of prematurity , for example: Administration of magnesium sulphate in pregnant women at risk of preterm birth; Neuroprotective supportive measures in newborns at risk of neurological damage, such as very low birth weight premature newborns and children with perinatal asphyxia. Approach to cerebral palsy Cerebral palsy has no cure. However, there are some treatments that aim to control neurological, orthopedic, or other alterations that are present and, thus, improve the quality of life of patients in aspects related mainly to autonomy to feed, speech, movement and learning. Therefore, the approach and treatment of a child with cerebral palsy is multidisciplinary . It most often involves the medical specialties of orthopedics, physical medicine and rehabilitation and neurology, as well as other health professionals such as physiotherapists and occupational therapists. Family involvement is essential in the treatment of patients with cerebral palsy. Collaboration between health professionals and the family makes it possible to maximize the child social and emotional development, communication, education, nutrition, mobility and independence in daily life activities. Meet the neurology team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
