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What
to Expect from a Child with Cerebral Palsy?
While
it is possible to diagnose Cerebral Palsy
immediately after birth, it is more commonly
diagnosed when a child is between 15 and
24 months. Predicting the outcome of how
Cerebral Palsy will affect a child is
extremely difficult. By the time a child
is two years old, a physician can determine
whether the child has hemiplegia, diplegia,
or quadriplegia and a rough prognosis
is possible. It should be noted that children
with Cerebral Palsy do not experience
regression (a return to less competent
abilities, motor function, etc.).Early
diagnoses regarding a child's speaking
or mental ability is even more difficult
to predict. Often times, the intellectual
capabilities have more to do with the
degree of mental retardation than with
the severity of Cerebral Palsy.
Available
Cerebral Palsy Treatments
Unfortunately,
no miracle cerebral palsy treatments exists
that can erase the symptoms of Cerebral
Palsy. There are, however, many therapeutic
options that can maximize the physical
and mental potential of an afflicted child.
Physical
therapy usually begins soon after the
diagnosis is made, during the first few
years of life. The programs use specific
sets of exercises to work towards preventing
the weakening or deterioration of muscles
that can result from a lack of use and
to avoid contracture. Contracture, when
muscles become fixed in rigid, abnormal
positions, is one of the most common and
serous complications with Cerebral Palsy.
Spasticity prevents stretching of the
body’s muscles and tendons so muscles
do not grow fast enough to keep up with
lengthening bones. Normally, a child’s
bones that are growing stretches the muscles
and tendons through daily movement and
other activities.
With
Cerebral Palsy the contracture can disrupt
balance and set off loss of previous abilities.
Physical therapy is used to prevent this
complication by stretching spastic muscles.
Some physical therapy programs work to
improve motor development as well. In
addition, behavioral therapy uses psychological
theory and techniques. This can be used
to complement physical, speech, or occupational
therapy.
Drug
therapy is used for those who have seizures
associated with having Cerebral Palsy.
The medication is very effective in preventing
seizures for many of the patients. Drugs
are also used to control spasticity in
some cases. Medications used most often
are diazepam, a general relaxant of the
brain and body, baclofen, blocks signal
sent from the spinal cord to contract
the muscles, and datrolene, interferes
with the process of muscle contraction.
These drugs are used for short periods
but long-term control of spasticity has
not been demonstrated clearly yet.
Athetoid
Cerebral Palsy patients are sometimes
given drugs to help reduce abnormal movements,
usually treated by chemicals called anticholinergics.
This chemical reduces the activity of
acetylcholine, a chemical messenger that
helps some brain cells communicate and
triggers muscle contraction. Physicians
may use injections of alcohol into a muscle
to reduce spasticity for a short period.
By doing this to a muscle that is too
short physicians can work on lengthening
the muscle when it becomes weakened for
weeks from the alcohol.
Surgery
is used when contractures are severe enough
to create problems in movement. The surgeons
lengthen the muscle that is too short.
Lengthening a muscle usually makes it
weaker so surgery for contractures is
usually followed by recovery months. To
reduce spasticity in the legs, surgery
called selective dorsal root rhizotomy
is used. It reduces the amount of stimulation
that reaches leg muscles by the nerves.
The effectiveness of this surgery is continually
being researched.
A
newer device, being the computer, can
make a significant difference in the life
of someone with Cerebral Palsy. Children
can learn to control a computer and communicate
with others. A special light pointer
attaches to a headband, along with the
computer and voice synthesizer.
Treatment
for Erbs Palsy, or Brachial Plexus Injuries,
include exercise and therapy or surgery
plus therapy. Children who do not recover
by 5 months old may benefit from surgery.
Nerve surgery is performed to improve
how well the arm functions. The surgery
is most effective when done when the child
is between the ages of 5 and 12 months.
After one year old, the surgery may not
be as successful. Surgery is not always
recommended and is not always successful.
Daily
exercises can help to keep the muscles
and joints moving normally and prevent
joints from “freezing”. Therapists will
work with the child to do the exercises.
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