Everything we do is under the control of the brain. Every muscle in our body is controlled by a different part of the brain. Cerebral the palsy , it has developmental defects or damage in one of the regions of the brain. Cerebral means of the brain. Palsy means the failure or muscle weakness, muscle control is. As a result, cerebral palsy brain is a term describing the muscle control deficiencies caused damage in the region. Cerebral palsy is the term used to describe problems that affect the brain of the developing and emerging in the early stage of life. Cerebral palsy in children weakness, stiffness, slowness, tremors and balance many problems can be seen as disorder.
Problems can vary from mild to severe. Lightweight with cerebral in palsy , children have a vague inexperience in an arm or leg and diagnostic difficulties often experienced. In heavy type experienced serious difficulties during daily activities.
This disease can manifest in different ways.
Spastic Cerebral Palsy
The most frequent type. Spasticity is meant to be stiff and tense muscles. Muscles are faltering because they received improper orders from the damaged area of the brain. A group of muscle contracts during movement of a healthy individual, loose other muscles which move in the opposite direction of this group and thus becomes possible to perform the movement. Cerebral Pals while precludes both groups movement takes place simultaneously struts.
Atetoid Cerebral Palsy
Atetoid (or athetosis ) is a word used to describe the uncontrollable movements. This lack of control is much more pronounced, especially immediately begin to move. Toy or spoon with involuntary movements working to understand the child increases. This type of muscle is very weak and felt like it was child's jelly during transport.
Ataxic cerebral palsy
At least such is seen. Ataxic (or ataxia ) leaper style describes the action. These children have serious problems with balance.
Many children may have multiple types together with related findings.
Results show significant differences from one child to another. Held body is called by different names according to the region:
Hemiplegia: arm and leg on one side of the body is affected.
Diplegia: Both legs were kept more prominently. Usually in the arm and hand function it is also affected by the amount in question.
Quadriplegia: Both arm and leg with the body was kept. The face, the muscles may also be affected on around the mouth and swallowing. About two in every thousand children to be seen. There are many different reasons. Problems may arise in the brain for the following reasons:
- Brain for some reason could not perform the normal growth and development
- The first month of pregnancy, such as rubella spent the mother infection can cause abnormalities or hinder brain development
- During birth, the baby could not get enough oxygen
- In the days following the birth, the baby has experienced serious as meningitis infections has been hampered brain development
- Accidents spent in the first year of life has led to permanent brain damage.
Some children, despite the detailed investigation and examination of cerebral of pulses may not be possible to determine the cause. Advanced MRI and developed some new blood tests with, a greater number of patients can be reached by reason. Today, all cerebral of the palsy causes during pregnancy of about 75%, is due to the difficult birth and discomfort in the newborn period of 10-15%, while the remaining 10% are known to occur due to accidents and diseases in the week early in life.
Cerebral palsy can be formed, it must not affect the body up to the age of five or six problems listed above. After this age it may also develop some neurological problems, but this is typical of cerebral than palsy is different. Premature children are particularly at risk. The time a child born with neurological problems early, did it occur because of premature birth of neurological signs, due to premature birth or developing cerebral of pulses to be responsible for neurological symptoms did you can not always be easily distinguished.
Families, the cause and the problem why the about the doubts and concerns are often continues. This is understandable and natural state. Families often obliged tend to blame someone who has been involved in the process from birth to themselves or pregnancy. However, the event is held responsible for the family to be the real cause of the problem is a very high probability. Even though it is impossible to prevent.
Therefore, there is nothing you can do to prevent the development of family events. Discussing the issue with family, sharing their concerns with the treatment team can facilitate the solution of the problem.
At times children may have added to other difficulties:
- Hearing all blems cerebral palsy children have a hearing therapist ( audiologist ) should be seen by.
- Visually blems cerebral in palsy Strabismus is quite common. Other eye problems may also occur. In the early years of children's lives it should be seen by an ophthalmologist an important part.
- Epilepsy and cerebral palsy develops in about one-third of the children. Different types can be. Some seizures are very rare migrating, in others it may be much more stubborn and may require the intervention of child neurologist.
- Problems with learning and intellectual abilities in these children may show great variability. Unfortunately, in the first year of life, not so possible to assess the true potential. Children with serious physical disabilities normal intelligence may have. The delay in question related to learning at an early stage, in this case mostly "retardation" is called. Development delay statement of a child's development is a concept that describes more slowly than their peers in some ways.
- Perception blems have difficulty in deciding on the size and shape of objects and perceptions of such problems usually can not be recognized until school age.
- In the gastro-oesophageal flooding back ( reflux ) - go up the food into the esophagus is a common state. The most common symptoms are vomiting and restlessness during the meal. It occurs at an irritation of the esophagus if more problems ( esophagitis ) and the situation is very disturbing for children.
- Orthopedic Problems- children grow and develop the muscles tense and length will be shortened and the solid-state form and function disturbances occur in the joints. This problem is most common ankle, knee, hip, elbow and wrist seen. In addition, cerebral palsy carry greater risk for the development of children hip dislocation. Such dislocations are especially more likely to develop the ability to walk independently without children. Periodically monitoring the hip is crucial. Only inspection is not enough, especially when both leg should also be examined by the film children affected by the disease. Curvature of the spine is less a problem encountered.
- Constipation- is very common. Why it is not always clear. Often inaction and inability to consume enough dietary intake of dietary fiber is connected.
- Nutrition-chewing difficulties in some patients with severe involvement, and there are problems with swallowing. This prolongs the process and make it difficult to eat. After all, faced with getting less nutrition status of the children's needs. Another group of cerebral palsy is suffering from unnecessary weight gain, even though they were not active enough since they can be fed faces the risk.
- Saliva control problem of some problems may be permanent early mostly observed saliva flow. Recurrent lung infections - is a relatively small number of issues of concern to the patient. Especially with chewing and swallowing problems are seen in children. Some foods during coughing, the child can escape into the windpipe inadvertently. This situation is reminiscent of an asthma attack. In this case, if frequent happening and continues long, pneumonia may develop. Do not always have such an event in the development of lung problems, other children how lung infection , pneumonia and asthma if having cerebral palsy children are held to the same disease.
Cerebral palsy refers to tell a permanent condition. Problems with this disease (muscle weakness or tension, involuntary movement) continues for a lifetime. However, the child progresses to adapt to these challenges with the support and the appropriate treatment can learn to cope with them.
Treatment of the disease from the root kazıyamas also provides significant improvements.
Life does not get worse in the early stages of developing brain damage over time. The occasional deterioration in the state of the child. The possible causes of this deterioration are listed below:
- Grows child grows expectations. Cerebral palsy is a children's wear, casual jobs such as independent learning takes a long time eating than expected. This developmental delay mistakenly perceived as worsening.
- Thicker than muscles the child's growth. In growing bones grow faster than muscles. This difference between the growth rates, causing the muscles and joints relatively shortening the environment to define the disfigurement. Stiffness of muscles spasitisite to (contraction) or hoarse joints ( contractures ) can be connected. Often in these cases, not very easy to distinguish, just tense muscle is stretched and also must try to distinguish between short-caste. Because these two situations require different treatment approaches.
- Ear or throat affecting child infection of any disease like, you can pause for a while the child's progress.
- Emotional stress. Children, if you feel that much more difficult to develop a skill, can develop resistance to reactive as he does. A pause or slowdown in progress, it does not mean worse. Families can not be diagnosed illnesses like to find an answer to this question. Unfortunately, these questions in the first months or even years may not be able to answer with certainty. Mild to moderate cerebral the palsy often learns to walk. Speech development is dependent on multiple factors. First, children should learn to control the muscles around the mouth; emotionally it should develop, and cognitive (or learn about) the ability should be able to win. Some cerebral palsy no shortage survive in children in learning to speak, others speak of physical therapists need to develop alternative methods of communication or to help.
The goal of treatment is to encourage children to learn as much as possible on their own. Cerebral palsy children a part of any difficulty in gaining independence can not survive, while others fall behind in this process. Some serious involvement may need help in children.
That encouraging children can do on their own should be noted that it is very important. Some cerebral palsy overcome during the development process, children can develop forces of aggression and antisocial behavior. Related to any of the disability, can trigger behavioral changes ( eg available (with severe speech difficulties in children screaming because of the difficulties they face when trying to communicate with others, they begin to cry). The vaccination of such problems, children to give up the fight, causing them to feel free to try to do the shot behavioral difficulties may prevent the country gained independence. Psychologists can help in finding solutions that could solve the problem and define their behavior problems.
Cerebral palsy in children, the vast majority are healthy and have a normal life. Only with a serious illness (eg, recurrent respiratory infections with or prolonged seizures) and a very small group survival in patients with epilepsy may be reduced.
When the treatment team have difficulty answering some questions, all of what is known about the child's been shared with them, they may think that some things are stored. However, this is not true and known to have been shared with family. In this regard, local and accessible to more information from foreign sources.
The implementation of some of the new approach over the last 10 years was possible. Treatments evaluated in three main areas:
- Treatment of movement problems
- Treatment of other concomitant diseases
- Support therapies
Children physiotherapist plays a key role in the treatment of movement problems. Physiotherapy and occupational therapy, the primary task is undertaken in promoting motor development. Treatment also is vital for the success of other applications discussed below.
- Children majority of assistive devices are in certain stages of development ( orthotics ) uses. These devices must be specially manufactured for light weight material and child. Comparison metal rod, when using tensioned with skin, such devices nowadays are seldom preferred.
- Arm splints , move and maintain patency by getting a better grip function of the hand and arm of the business-deal to provide a better view function enables therapists suggested by. These splints are usually made of plastic material and custom made child. In recent years, lycra flexible called rubbery dynamically generated material splints are developed.
- Botulinum toxin ( Botox ) is a treatment method proposed in recent years to tighten and tense muscles. In particular, it is preferable for the tension in the thigh and calf muscles make it difficult to learn to walk. The possibility of adverse developments, except a slight pain at the injection site are very low. Botox reduces muscle tension to the normal muscle growth and development facilities provide, and thus contribute to the development of the child's mobility. Before and after extensive physiotherapy is required program.
- Cut some fibers of the spinal cord / selective dorsal rhizotomy / tension is rarely a preferred surgery to reduce. A debate continues about the benefits still not been finalized. After implementation in the event of a very extensive physiotherapy needs.
- Orthopedic surgery. Often legs, occasionally it is preferable for arms. Some children also due to curvature of the spine can be treated surgically. Post-operative care, physiotherapy is vital. Independent movable or cane / walker to walk with the aid of the children is an important function for the surgical planning of gait analysis program.
Hips: soft tissue interventions in case of recognition in the early stages it is often sufficient (regular hip radiograph importance of withdrawal). Small children just adductor (inner groin) might be enough to stretch the muscles. However, the problem progresses, especially neglected cases, major surgery may be required, including the bones. Not hip replacement surgery treatment in the majority of children, in later years, aiming to keep the site tries to prevent the formation of a dislocated hip may be painful.
Knee: The hamstring of (back thigh muscles) to open the directory with the extension and thus may be able to improve the walk. Sometimes tense muscles around the knee from front to back stiffness reduced by a portion of transportation.
Ankle and foot: a body region where the most need of orthopedic surgery.
Some children may need surgery for multiple regions. With multilevel surgery performed in a hospital admission in the attempt to multiple problems. Multi-level surgery, most children can walk independently or with minimal support work. The aim of surgical deformities fix is to improve the appearance of walking and activity. Success will depend on what the problem is assessed as well as walking and walking laboratory used for this purpose. Well planned extended up to one year intensive physiotherapy surgical benefits expected from the program increased to the highest level.
Other problems that can accompany;
- Epilepsy. Our understanding of epilepsy has increased a lot over the past year. There are many types of epilepsy, and treatment varies according to type. Doctors who best fits prefer to control and minimal side effects with the drug. Anti-seizure drugs usually used in two main groups:
- Gastrointestinal leak ( reflux ). After dinner a time to keep the other children can work.
- Saliva control. Speech therapists play a key role in solving the problem saliva. This application alone does not work, particularly when it comes to the agenda of drug use in children older than 6 years of age. The importance of follow-up in the fight against tooth decay and oral care is important.
- Constipation. Cerebral palsy children often become constipated. Fluid intake of fiber and most of these problems can be solved by increasing the food consumption once. However, a doctor should be consulted in cases where it is not enough.
- Nutrition. Adequate nutrition support dieticians to be taken. Excessive weight gain in children trying to learn to walk is a major problem that must be avoided. The lack of weight gain indicates a problem with nutrition. Oral-motor training in effective nutrition and troubleshoot problems that may occur is very important. You may need feeding tube from a small group. Early intervention programs, not only to improve the mobility of children, the whole development process aims to develop positively. The most commonly used approach from the first two, neurodevelopmental therapy is another treatment while routing.
Neurodevelopmental Treatment ( Bobath known as approach.) Targets, and the direction evaluating the children's mobility. A physiotherapist who Berta Bobath and his wife, neurophysiologist Karel Bobath , neurodevelopmental this approach developed in the 1940s, starting with the treatment of adult patients with neurological principles in the 1960s have begun to use birth movement disorders in infants and children. Today, working with children physiotherapists Cerebral Palsy (CP) in different table causing to be sensory-motor disorders in particular, children have used this approach extensively. Bobath approach, developed by scientific theory and empirical is formatted to include the experiences, it shows a dynamic structure open to development. Until today, starting with the first application developed in this direction and has undergone some changes.
Children physiotherapist by CP children physiotherapy practice in the use of Bobath therapy in today's active-dynamic therapy, education with activities to ensure functionality, improving coordination and balance of movement, to operate in a moving stream of different activities nested gained importance. Tone of regulatory and active movement forward position description for dispensing and sensory-motor activity enhancer stimuli are used.
In connection with the situation in the movement and daily life in a different position and posture while trying to improve control, the planning is done according to the child's personal development. To activate the function of moving and maintaining applications in daily life today Bobath is a basic understanding of the approach.
Bobath approach different to achieve these goals physiotherapy practices, orthotic and adaptive araçgereç Includes use. Bobath within the approach CP children in the fundamental problems of postural control, although considered to be defects in movement and coordination, neuromuscular problems, personality traits, genetics, motivation , perception engine experience, environmental requirements and neural are said to be closely associated with the level of improvement. All these expressions, BOBATH of whether a method or technique, rigid shows that it is not variable and is still developing.
To sum up today Bobath approach, firstly, CP existing observation of the child's performance, analyze and interpret, then aims at ensuring a maximum level of independence in the child's assessment and ultimately the potential limitations.
Orientation training ( conductive education ) to educate children home with adult problems Movement is a system developed by the Hungarians. In 1940, Andras Peto , it tried to avoid the problems and treatment of learning disabilities, recognizing the problems can not be treated in case of vaccination of these challenges have brought this approach to the agenda. Child, family / caregiver and a group that included maintaining all aspects of life on the physical, social, emotional, cognitive and communicative skills are always aiming to improve the system together.
No problem should never be taken lightly put the family distress. Families themselves angry, rundown, may feel lonely and non-believers. These feelings are most intense during the time of diagnosis may subside. Severe cerebral palsy children have the day many need help and support during this activity and jobs considerable stress on family creates counted.
Each family has its own needs. However, often you need the following:
- Finding answers to questions. Answer the questions sought to mind arrive a paper sorting and debate as to the addressee is a good idea.
- Support the meaning of the problems of the child. The feelings, hopes and fears must be prepared to share in the atmosphere. Support from family, friends, may this purpose the support of other parents and experts in this field who have similar problems.
- Access to information about Associates.
- Support and assistance in finding the best way to help the child.
- Give it a break. It is very important for many families. This is very important, especially for very heavy and very serious problems that require children to help their families. Break the family for a while to rest and enables other things to take your time.
All events are often recommended to apply the letter of the daily hustle and bustle impossible . Families they feel guilty because they do not spend enough time with their children. On the other hand, other family members and other children not to spare time is a very important challenge. Taking the time to problem child, it does not mean to neglect other children. This may cause serious jealousy.
Sometimes annoying comments and cerebral palsy can be a problem for both children brother and other family members. For example, the word spastic very good idea in the minds of people in general are being told association hopeless situation. However, doctors or physical therapists use to describe the tension and stiffness of muscles that word only. This comprehensive information programs should be implemented to resolve the misunderstanding. Despite everything, things are not so easy. However, parents should be able to feel you're not alone, they should contact their families facing similar issues and family support groups.
Cerebral palsy There are many people and organizations to help the child and family. Some children may need to settle a number of support while some limited support. Various professional groups engaged in different times:
- Family. Mothers are the most important person to father children. All children need the love and protection of their parents. Over time, teachers and sometimes parents, sometimes the therapist will.
- Pediatrician. It directs the experts when necessary to evaluate the overall health problems of children.
- Neurology specialist. Especially to diagnose and other neurological problems that may develop in the process (such as epilepsy) should be taken to help overcome.
- Physiotherapist. It works with the child and family. First, the best children should be taught the family how they can help. General physiotherapy approaches beyond speech and occupational therapy is also required.
- Psychologist. Get help with emotional situations and problems with behavior.
- Special education teacher
- Orthotics maker
- Hearing treatment specialist
Source:Cerebral Palsy : An Information Guide for Parents ( Royal Children ` s Hospital of Melbourne)