Cerebral palsy or cerebral palsy is a disease that causes disturbances in body movement and coordination. This disease is caused by impaired brain development, which usually occurs when the child is still in the womb. This brain development disorder can also occur during childbirth or the first two years after birth.
Symptoms of Ccerebral Palso
In affected children or infants ccerebral palsy, the following symptoms may occur:
- Tendency to use one side of the body. For example, dragging one leg while crawling, or reaching for something with only one hand.
- Delayed development of motor skills, such as crawling or sitting.
- Difficulty making precise movements, for example when picking up an object.
- Abnormal gait, such as on tiptoe, crossed like scissors, or with legs wide apart.
- Muscles are stiff or even very limp.
- Tremors.
- uncontrolled writhing movements (athetosis).
- Lack of response to touch or pain.
- Still wetting the bed even though he is older, due to not being able to hold urine (urinary incontinence).
- Intelligence disorders.
- Visual and hearing impairment.
- Speech disorders (dysarthria).
- Difficulty in swallowing (dysphagia).
- Constantly drooling or drooling.
- seizures.
These complaints can be permanent and cause disability.
Reason Cerebral Palsy
Cerebral palsy or what is called cerebral palsy is caused by impaired brain development in children. This condition generally occurs during pregnancy, but can also occur during childbirth, or the first few years after the child is born. It is not known exactly what causes this developmental disorder, but this condition is thought to be triggered by the following factors:
- Changes in genes, which have a role in brain development.
- Infection during pregnancy that is transmitted to the fetus. Examples include chickenpox, rubella, syphilis, toxoplasma infection, and other infections cytomegalovirus.
- Disruption of the blood supply to the fetal brain (fetal stroke).
- Rhesus blood group differences between mother and baby.
- Twins or more. Risk of occurrence cerebral palsy increases in one surviving infant, if the other infant dies at birth.
- Low baby weight at birth, which is less than 2.5 kilograms.
- Lack of oxygen supply to the baby's brain (asphyxia) during labor.
- Premature birth, which is born at a gestational age of less than 37 weeks.
- A breech birth, which is born with the feet out first.
- Inflammation of the baby's brain or membranes.
- Jaundice that poisons the brain (kernicterus).
- Severe head injury, for example from a fall or accident.
Diagnosis Cerebral Palsy
Doctors will suspect a child has cerebral palsy, if there are a number of symptoms that have been described previously. But to be sure, the doctor will suggest further tests, such as:
- Electroencephalography(EEG). EEG aims to see the electrical activity of the brain, using the help of a special instrument that is connected to the scalp.
- Imaging test. Imaging tests are done to see areas of the brain that are damaged or develop abnormally. A number of imaging tests that can be done are MRI, CT scan, and ultrasound.
Neuroscientists can also perform subliminal function tests to detect intellectual impairments, as well as disturbances in speech, hearing, sight, and movement.
Treatment Cerebral Palsy
Treatment can be done to improve the patient's ability to move independently. However, until now there is no treatment that can cure cerebral palsy. Treatment methods that are generally given to people with cerebral palsy are:
Drugs
Medications are used to relieve pain or relax stiff muscles, making it easier for the patient to move. The type of drug used may vary, depending on the extent of the stiff muscle.
In muscle stiffness that only occurs in the local area, the doctor will give Botox injections (botulinum toxin) every 3 months. Botox can also be used to treat drooling.
As for muscle stiffness that occurs throughout the body, the doctor may prescribe diazepam and baclofen.
Therapy
In addition to drugs, various types of therapy are also needed to treat symptoms cerebral palsy, including:
- Physiotherapy.Pediatric physiotherapy aims to improve mobility and muscle strength, as well as prevent contractures (shortening of muscles that restrict movement).
- Occupational therapy. Occupational therapy aims to help patients deal with difficulties with activities, such as bathing or dressing. This therapy will greatly help increase the patient's confidence and independence.
- Talk therapy. As the name implies, this therapy is intended for patients cerebral palsy who have speech disorders.
Operation
Surgery is needed when muscle stiffness causes abnormalities in the bones. The example is:
- Surgery orthopedics. This procedure is performed to return the bones and joints to their correct position. Orthopedic surgery can also lengthen muscles and tendons that are too short due to contractures, so that the patient's mobility is improved.
- Selective dorsal rhizotomy (SDR). SDR will be done if other procedures are not able to overcome the pain and muscle stiffness. This procedure is performed by cutting one of the spinal nerves.
In patients with symptoms of difficulty swallowing (dysphagia), the doctor will suggest giving soft and soft foods, while training the swallowing muscles with physiotherapy. Meanwhile, in severe dysphagia, the doctor will recommend the installation of a feeding tube, either through the nose or directly from the skin of the stomach to the stomach through surgery.
Meanwhile, in patients who are drooling, surgery will be carried out to direct the flow of saliva to the back of the mouth, so that it does not drip out continuously.
Complications Cerebral Palsy
Stiff muscles and movement disorders in patients cerebral palsy, can cause the following complications:
- Lack of nutrition due to difficulty swallowing food
- Stress and depression
- Lung disease
- Low bone density (osteopenia)
- Disease osteoarthritis
- Visual disturbance