Cerebral Palsy Diagnosis & Characteristics
The characteristics of cerebral palsy may vary widely between individuals depending on the degree and location of brain damage. Symptoms may range from mild to severe, and diagnostic techniques can help determine the extent of the condition.
Cerebral Palsy Diagnosis
The diagnosis of cerebral palsy includes the consideration and monitoring of many factors, and may not be made until after the first or second years of development. A child's brain and central nervous system have an amazing ability to recover completely, or partially, following injury - this sometimes leads to a delay in diagnosis. In addition, children develop at different rates, and motor skill difficulties can frequently be signs of other problems - misdirecting diagnosis. In most cases, an interdisciplinary team of medical professionals will be gathered to review the child's strengths and weaknesses, test results, risk factors and medical history. Based on these numerous criteria, a diagnosis of cerebral palsy may be made.
Several tests can be used to assist in the diagnosis, and determine the severity of cerebral palsy:
- Intelligence tests often are administered to a child with CP to evaluate mental impairment;
- An electroencephalogram (EEG) traces electrical activity in the brain and can reveal patterns that suggest a seizure disorder;
- Imaging tests are helpful in diagnosing hydrocephalus, structural abnormalities, and tumors. This information can help the physician assess the child's long-term prognosis;
- Magnetic resonance imaging (MRI) uses a magnetic field and radio waves to create pictures of the internal structures of the brain. This study is performed on older children. It defines abnormalities of white matter and motor cortex more clearly than other methods.
Common Causes of Cerebral Palsy
About 70 percent of cerebral palsy cases result from events occurring before birth that can disrupt normal development of the brain. Contrary to common belief, lack of oxygen reaching the fetus during labor and delivery contributes to only a small minority of cases of cerebral palsy, according to a 2003 report by the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP). A small number of babies also develop brain injuries in the first months or years of life that can result in cerebral palsy. In many cases, the cause of cerebral palsy in a child is not known.
Some of the known causes of cerebral palsy include:
Infections during pregnancy - Certain infections in the mother, including rubella (German measles), cytomegalovirus (a usually mild viral infection) and toxoplasmosis (a usually mild parasitic infection) can cause brain damage and result in cerebral palsy. Recent studies suggest that maternal infections involving the placental membranes (chorioamnionitis) may contribute to cerebral palsy in full-term as well as preterm babies (those born before 37 completed weeks of pregnancy). A 2003 study at the University of California at San Francisco found that full-term babies were four times more likely to develop cerebral palsy if they were exposed to chorioamnionitis in the womb. Reproductive/urinary tract infections also may increase the risk of preterm delivery, another risk factor for cerebral palsy.
Insufficient oxygen reaching the fetus - For example, when the placenta is not functioning properly or it tears away from the wall of the uterus before delivery, the fetus may not receive sufficient oxygen.
Prematurity - Premature babies who weigh less than 3 1/3 pounds are up to 30 times more likely to develop cerebral palsy than full-term babies. Many of these tiny babies suffer from bleeding in the brain, which can damage delicate brain tissue, or develop periventricular leukomalacia, destruction of nerves around the fluid-filled cavities (ventricles) in the brain.
Asphyxia during labor and delivery - Until recently, it was widely believed that asphyxia (lack of oxygen) during a difficult delivery was the cause of most cases of cerebral palsy. The ACOG/AAP report shows that fewer than 10 percent of the type of brain injuries that can result in cerebral palsy are caused by asphyxia.
Blood Diseases - Rh disease, an incompatibility between the blood of the mother and her fetus, can cause severe jaundice and brain damage, resulting in cerebral palsy. Rh disease usually can be prevented by giving an Rh-negative woman an injection of a blood product called Rh immune globulin around the 28th week of pregnancy and again after the birth of an Rh-positive baby. Blood clotting disorders (thrombophilias) in either mother or baby also may increase the risk.
Severe jaundice - Jaundice, yellowing of the skin and the whites of the eyes caused by the build-up of a pigment called bilirubin in the blood, occasionally becomes severe. Without treatment, severe jaundice can pose a risk of permanent brain damage resulting in athetoid cerebral palsy.
Other birth defects - Babies with brain malformations, numerous genetic diseases and other physical birth defects are at increased risk of cerebral palsy.
Acquired cerebral palsy - About 10 percent of children with cerebral palsy acquire it after birth due to brain injuries that occur during the first two years of life. The most common causes of such injuries are brain infections (such as meningitis) and head injuries.
While most doctors, nurses, midwives, and hospital technicians provide a high standard of care for their patients, unfortunately, many families are harmed by medical mistakes. Parents of a child suffering with cerebral palsy should contact an experienced cerebral palsy lawyer to research the cause of their child’s condition. Medical mistakes are responsible for many birth injury cases and it would be impossible for a parent, alone, to determine if medical malpractice caused their child's injury. It is only through the dedicated and thorough efforts of a legal and medical team that the cause can be ascertained.
"After all the information came out, I was bitter. But eventually I put it in my heart to forgive. It's not about the money, but it helps a lot, because brain injury causes a lot of problems that you don't know about early on."
"The saddest moment came when Ken told us that if Lizzy had been born any time between when I came in at 7 a.m. until 10 p.m., she would be fine. The doctor had misread the fetal monitoring strips. She had made a mistake."
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