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- 26: A Behind-The-Scenes Tour of Life with Cerebral Palsy.
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Multiple births. Twins, triplets, and other multiple births -- even those born at term -- are linked to an increased risk of cerebral palsy. Infections during pregnancy. Infections such as toxoplasmosis, rubella German measles , cytomegalovirus, and herpes, can infect the womb and placenta. Inflammation triggered by infection may then go on to damage the developing nervous system in an unborn baby.
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Maternal fever during pregnancy or delivery can also set off this kind of inflammatory response. Blood type incompatibility between mother and child. Exposure to toxic substances.
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Mothers who have been exposed to toxic substances during pregnancy, such as methyl mercury, are at a heightened risk of having a baby with cerebral palsy. Mothers with thyroid abnormalities, intellectual disability, excess protein in the urine, or seizures. Mothers with any of these conditions are slightly more likely to have a child with CP.
There are also medical conditions during labor and delivery, and immediately after delivery that act as warning signs for an increased risk of CP. However, most of these children will not develop CP. Warning signs include:. Breech presentation. Babies with cerebral palsy are more likely to be in a breech position feet first instead of head first at the beginning of labor. Babies who are unusually floppy as fetuses are more likely to be born in the breech position.
Complicated labor and delivery. A baby who has vascular or respiratory problems during labor and delivery may already have suffered brain damage or abnormalities. Small for gestational age. Babies born smaller than normal for their gestational age are at risk for cerebral palsy because of factors that kept them from growing naturally in the womb. The Apgar score is a numbered rating that reflects a newborn's physical health. Doctors periodically score a baby's heart rate, breathing, muscle tone, reflexes, and skin color during the first minutes after birth.
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A low score at minutes after delivery is often considered an important sign of potential problems such as CP. Severe, untreated jaundice can kill brain cells and can cause deafness and CP. An infant who has seizures faces a higher risk of being diagnosed later in childhood with CP.
Cerebral palsy related to genetic abnormalities cannot be prevented, but a few of the risk factors for congenital cerebral palsy can be managed or avoided. Rh incompatibilities can also be managed early in pregnancy. Acquired cerebral palsy, often due to head injury, is often preventable using common safety tactics, such as using car seats for infants and toddlers. People have stiff muscles and awkward movements. Forms of spastic cerebral palsy include:.
Hyperactivity in the muscles of the face and tongue makes some children grimace or drool. They find it difficult to sit straight or walk.
26: A Behind-the-Scenes Tour of Life with Cerebral Palsy
Intelligence is rarely affected in these forms of cerebral palsy. Children with ataxic CP will often have poor coordination and walk unsteadily with a wide-based gait. They have difficulty with quick or precise movements, such as writing or buttoning a shirt, or a hard time controlling voluntary movement such as reaching for a book. For example, a child with mixed CP may have some muscles that are too tight and others that are too relaxed, creating a mix of stiffness and floppiness. Intellectual disability. Approximately 30 — 50 percent of individuals with CP will be intellectually impaired.
Mental impairment is more common among those with spastic quadriplegia than in those with other types of cerebral palsy. Seizure disorder. As many as half of all children with CP have one or more seizures. Children with both cerebral palsy and epilepsy are more likely to have intellectual disability. Delayed growth and development. Children with moderate to severe CP, especially those with spastic quadriparesis, often lag behind in growth and development. In babies this lag usually takes the form of too little weight gain.
A Behind-The-Scenes Tour of Life with Cerebral Palsy by Stuart Maloney
In young children it can appear as abnormal shortness, and in teenagers it may appear as a combination of shortness and lack of sexual development. The muscles and limbs affected by CP tend to be smaller than normal, especially in children with spastic hemiplegia, whose limbs on the affected side of the body may not grow as quickly or as long as those on the normal side. Spinal deformities and osteoarthritis. Spinal deformities can make sitting, standing, and walking difficult and cause chronic back pain. Pressure on and misalignment of the joints may result in osteoporosis a breakdown of cartilage in the joints and bone enlargement.
Impaired vision. Some children with CP have difficulty understanding and organizing visual information. Other children may have defective vision or blindness that blurs the normal field of vision in one or both eyes. Hearing loss. Impaired hearing is also more frequent among those with CP than in the general population.
Some children have partial or complete hearing loss, particularly as the result of jaundice or lack of oxygen to the developing brain. Speech and language disorders. Speech and language disorders, such as difficulty forming words and speaking clearly, are present in more than a third of persons with CP.
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Poor speech impairs communication and is often interpreted as a sign of cognitive impairment, which can be very frustrating to children with CP, especially the majority who have average to above average intelligence,. Some individuals with CP drool because they have poor control of the muscles of the throat, mouth, and tongue.