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Cerebral Palsy, a neurological developmental disorder

Cerebral Palsy, a neurological developmental disorder

In the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) cerebral palsy (CP) is understood as a neurodevelopmental disorderIt is also known by some health professionals as "central motor dysfunction", it can be mild, moderate, severe or profound and involves a group of conditions that affect the psychomotor skills of the person, characterized by a control of balance, movement and / or posture "different from normal."

This neuropathology is associated with problems during brain development of the fetus, during pregnancy, near the time of delivery, during birth, in the first days of life or due to severe trauma, whether prenatal, perinatal or postnatal, The destruction of nerve cells causes impaired functioning, such as cognitive and sensory difficulties. When the child has communication or motor disorder, the severity must also be evaluated and specified.

Content

  • 1 Etiology of Cerebral Palsy (PC)
  • 2 Incidence of cerebral palsy
  • 3 Types of Cerebral Palsy
  • 4 Cerebral Palsy: Risk Indicators
  • 5 Family of patients with cerebral palsy (PC)

Etiology of Cerebral Palsy (PC)

The causes can be very varied, some of them can be: some infections or diseases during pregnancy, such as encephalitis Y meningitis, intrauterine growth restriction, intrauterine infection, fetal coagulation disorders, multiple pregnancies, hemorrhages during pregnancy, when they are born prematurely, neonatal stroke, hypoxia, trauma, microcephaly at birth, chromosomal and congenital anomalies. Some signs of fetal compromise that are taken into account are: changes in heart rate or meconium passage.

Incidence of cerebral palsy

Damage can occur prenatally, perinatally or postnatally. According to the estimates of the Centers for Disease Control and Prevention (CDC), in the world for every 1,000 births, between 1.5 and more than 4 suffer from PC. It is essential that children with cerebral palsy and their families seek support and guidance from a multidisciplinary health team which includes: neurologist, pediatrician, physiatrists, psychologists, speech therapists, in general require psychopedagogical guidance.

It is estimated that in half of the cases it becomes a childhood motor disability (CDC, 2017), although slightly more than half of children with PC can walk independently, one in ten children affected by this condition use a device that helps them facilitate their movement. The CDC also estimates that approximately four out of ten patients with cerebral palsy have epilepsy and about one in ten presents autism spectrum disorder (TORCH).

Types of Cerebral Palsy

For tone and body posture:

  1. Spastic, arises when there is damage to the cerebral cortex and manifests with muscular rigidity and lack of control of muscle movements, it is estimated that between 70 and 85% of patients with PC, share these characteristics.
  2. Athetoid or dyskinetic. Slow and involuntary movements, muscle tone can change from rigid to lax, especially in the upper and lower limbs, as well as present difficulties in controlling your breathing, your vocal cords and your tongue, so it is often necessary to pay them a lot Attention to understand them.
  3. Ataxic. Due to lesions in the cerebellum, the patient has difficulty controlling balance.
  4. Mixed, the brain shows damage in different structures, so it has clinical manifestations with variants to those previously described.

The classification according to the affected parts of the body or the "topographic criteria" are:

  1. Hemiplegia: Motor difficulties manifest only on the left or right side of the body.
  2. Paraplegia: It affects the lower limbs.
  3. Tetraplegia: Affectation in both arms and both legs.
  4. Monoplegia: Only one part of the body is affected.

You may be interested: The cerebral cortex: motor, association and language areas

Cerebral Palsy: Risk Indicators

There are certain skills or abilities that “average” children develop as they grow. The best results are achieved when the family also receives psychotherapeutic support and health professionals, join forces with teachers and caregivers. Social interaction is important for them, whoever attends school is highly recommended, remember that: “All children have the right to education”, to the extent possible it is beneficial to allow and support to develop their independence.

The way your child develops in areas such as family and academics, his verbal and body language, the way he processes new information, are aspects that you should observe, It is important to be aware of them and their needs, when children have PC they need an extra dose of love, patience, understanding, containment, acceptance and above all inclusion.

The game is an excellent tool to observe in the child several aspects of its development, the way your child does it, as well as his way of learning, speaking and driving offers us key guidelines in his development. It recognizes some indicators of cerebral palsy in the first years of life, the Centers for Disease Control and Prevention (CDC), give us the following tips to observe in infants and young children:

SIGNS OF THE BRAIN PARALYSIS (PC)

AGEPC RISK INDICATORS
2 monthsThe baby does not keep sight of moving objects, does not respond to loud noises, neither smiles nor puts his little hands in his mouth. When you are facing down, you cannot hold your head up when you push your body up.
4 monthsHas difficulty moving one or both eyes in all directions and does not continue to see moving objects, does not smile at people, can't hold head firmly, does not make sounds with his mouth or take his hands to it, does not push with his feet when they rest on a hard surface.
6 monthsHe looks stiff and tense muscles like a doll, does not show affection for those who care for him, does not laugh or emit sounds of pleasure, does not try to grab things that are within his reach, does not react to sounds, does not emit sounds of vowels, has difficulty getting things to his mouth, It doesn't turn in any direction to turn around.
9 monthsHe does not seem to recognize familiar people, does not respond when called by name, does not babble, does not pass toys from one hand to another, You can't sit still with help and it doesn't hold on your legs with support.
1 yearHe doesn't crawl, he can't stand with help, doesn't say simple words as a "mom", she does not learn to use gestures to communicate, how to greet, does not point out things and He loses skills he had acquired.
18 monthsHe can't walk, he doesn't imitate others, He doesn't point out things to show something to other people, they seem indifferent to the fact that his caregiver is present or not. He loses acquired skills and does not know what things are in common use for him.
Do not handle at least 6 words or learn new ones.
2 yearsDo not use phrases with 2 words: "I want milk", does not know how to use common objects, does not copy actions or words, can't follow simple instructions, loses skills he had achieved and does not walk with stability.
3 yearsIt falls more frequently than the babies of its age, it can present problems to go up and down stairs,He doesn't use sentences to speak, or understand simple instructions, drooling or not understood when speaking, can not operate simple toys, does not imitate others, in the playful aspect does not use the imagination in their games, do not want to play with other children or toys, nor look at people to eyes and loses skills he had acquired.
4 yearsCannot jump in the same place, presents difficulties to do scribbles, is not interested in interactive games or imagination, ignores other children or does not respond to people who are not family, refuses to dress, sleep and use the bathroom . He does not understand what they mean "same" and "different", nor is he able to tell his favorite story, does not follow 3-part instructions, does not correctly use the words "I" and "you", speaks with little clarity and loses abilities I had acquired.
5 yearsHe is too withdrawn and passive, trouble concentrating on an activity for more than 5 minutes and easily distracted, has very extreme feelings and emotions eg: too much fear, aggression, shyness or sadness. It does not respond to people or only superficially. Nor can you distinguish fantasy from reality, He doesn't play with a variety of activities, he can't say his first and last name, does not correctly use plurals and the past tense, He doesn't talk about his daily activities or experiences, he doesn't draw, he can't brush his teeth, wash and dry his hands or undress himself without help and lose skills acquired in advance.

Family of patients with cerebral palsy (PC)

The person with cerebral palsy (PC), with the appropriate adaptations, can have a happy life and have great vital achievements. However, they have special attention needs, due to differences in their adaptive functioning. Technology offers new tools, learn about those that can make your life easier, Home adaptations promote children's independence With cerebral palsy, it is advisable to make the necessary ones so that the child can cultivate good habits of personal hygiene and others, ranging from bath chairs, mobility devices, canes, electronic assistance in the home to facilitate functions, among many more.

Without adequate support, your performance in daily living can be limited in terms of independent living in different environments such as school and work. Social participation and inclusion begins in the cell of society: The family! The educational programs and services provided by health professionals represent great support, there are some, which have home care for patients with cerebral palsy (PC), which represents a great relief for parents.

Family dynamics is a core point, many of the warnings and learning can be acquired through play, look for special programs and integrating environments to develop extracurricular activities.

Motivation is one of the "keys" that will open the "door" of persistence and consistency in treatments, both by the patient and the family; Often, the resources may not seem to be necessary for the needs of the child, parents may have doubts and fears about the future of their children, training to manage emotions in patients with PC and parents provides great benefits, some parents struggle Day by day for a better tomorrow for your children:

Many warriors need to heal their wounds, in order to move forward in battle

Sometimes there is a limitation of some resources necessary to give them the attention required by the patient with PC, they can be of all kinds or a combination of them: economic, temporary, when “the time is not enough” to take them to their treatments with different specialists… Therefore, a resource that should not be missing is love, because when there is a strong emotional bond, there is also greater inclusion, because:

"Love, often causes parents to break with their limitations and motivates them to go beyond, even their" abilities ": 'when you have a child with a PC you discover many skills that you did not think you possessed"

Sometimes things get "more than difficult", it is natural that there are certain periods of excessive stress: the labor and social obligations of parents can be many too ... Despite this, when everything looks more "dark", and When they feel that their efforts "will not be worth it", it is necessary to reduce stress levels, seek psychological assistance and move on: Love, can give you that "extra energy" when you feel you can no longer.

Let's fight for a more inclusive society! It is not healthy to use the term PC pejoratively, these people and their families have great challenges, we can learn from them and their value, raise awareness, support, try to understand and be respectful of our verbal, body and language. social networksIt is not inclusive and denotes lack of culture to hang pejorative labels to people with cerebral palsy.

I leave you a poem that I have always loved:

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