Cerebral Palsy - Treatment

Cerebral palsy cannot be cured. However, the physical and other problems it causes can usually be managed through planning and timely care. Treatment plans depend on the type of impairment as well as associated problems the child may have, such as learning disabilities. Many CP patients require the help of physical and occupational therapists only. These professionals help the child learn to deal with loss of muscle control. Other specialists, such as speech-language therapists, special education teachers, nutritionists, and neurosurgeons (nerve specialists) may be needed to help with problems related to CP.

Ultrasound is a method by which doctors can study organs and tissues inside the human body. The technique was developed during World War II (1939–45) when scientists used very high pitched sound waves (ultrasound) to search for submarines under the water. The sound waves were sent out from a ship. They traveled through the water and bounced off objects, such as submarines and fish. The reflect sound waves formed characteristic patterns, depending on the objects from which they rebounded. By the 1950s scientists began to realize that ultrasound had many other uses and could be especially helpful in the field of medicine.

A problem doctors face is that they cannot see through the body to find out what organs and tissues look like. They can shine X rays through the body, which does produce photographs. However, only teeth, bone, and other hard substances can be seen. Ultrasound is an ideal method for taking pictures of organs and tissues. It is reflected off these objects in much the same way it reflect off submarines, and it does not harm the organs and tissues it strikes. Today, ultrasound is widely used for many medical purposes, such as diagnosing cerebral palsy.

While cerebral palsy does not become worse over time, the needs of a CP child do change and new treatment plans may have to be developed as the child grows older. Most parents do not have the knowledge and skills to provide a CP child with all the care he or she needs. Medical professionals then become essential. Other parents who have CP children are also an important resource. They can provide both practical advice and emotional support for parents of newly-diagnosed CP children. These support groups exist throughout the United States. They can be contacted with the help of the United Cerebral Palsy Association or a local hospital or social service agency.

Posture and Mobility

Cerebral palsy affects both posture and one's ability to move about. Physical therapists work with a child to develop good posture, to move affected arms and legs, and to develop normal body movements. Special equipment, such as wheelchairs, crutches, braces, and walkers, may be needed to achieve this goal.

SPASTICITY. Spasticity is a condition in which muscles become tight and stiff. It can cause muscles to shorten, joints to tighten, and posture to change. It can also affect the ability to walk, use a wheelchair, or sit unaided. Spasticity can prevent a person from being able to feed, dress, or care for himself or herself.

Treatments for spasticity depend on its severity. Mild spasticity is treated with regular stretching exercises. Moderate spasticity may require braces or casts to keep a limb in its normal position. More serious cases of spasticity may require more aggressive treatments. For example, spasticity can be treated with muscle-relaxing drugs, such as diazepam (pronounced di-AZE-uh-pam, trade name Valium) or dantrolene (pronounced DAN-tro-leen, trade name Dantrium). Surgery can also be used. Tendons in the affected muscle are cut. The limb is then placed into a cast until the tendons grow back in a normal position.

SCOLIOSIS. Scoliosis, or curvature of the spine, can develop when back muscles become weak or spastic. When that happens, the vertebrae (bones that make up the spinal column) may be pulled out of alignment. Scoliosis causes pain, changes in posture, and possible damage to internal organs. Scoliosis is usually treated with a brace that holds the back in a normal position. Surgery can also be used to join the vertebrae in a normal position.

Ataxia and Coordination

Ataxia (pronounced uh-TAK-see-uh) is a loss of balance control. It impairs a person's ability to move normally. Physical therapy can help a child with CP regain the sense of balance.

Seizures

Seizures (see epilepsy entry) occur in 30 to 50 percent of children with cerebral palsy. The seizures may occur only in one arm or leg, or throughout the body. They can be treated with various drugs, such as carbamazepine (pronounced KAHR-buh-MAZ-uh-peen, trade name Tegretol) or ethosuximide (pronounced ETH-o-SUK-sih-mide, trade name Zarontin). Some children need antiseizure drugs for a limited time only, while others must continue to use them throughout their lives. Careful control of one's diet can also reduce the risk of having seizures.

Strabismus

Strabismus (cross-eye, pronounced struh-BIZ-muss) is treated with eye patches and corrective lenses. If these treatments do not work, injections of botulinum toxin or surgery on eye muscles may help relieve the disorder.

Nutrition

People with cerebral palsy may have trouble eating because they cannot control the tongue and mouth muscles. They may also have difficulty holding eating utensils. As a result, they may not get enough of the foods needed for normal, healthy development. In such cases, the symptoms of CP may actually become worse.

Twenty-month-old Ashley Neisis who suffers from cerebral palsy, with her service dog, BJ. The dog has warned Ashley's parents when she was having trouble breathing. (Reproduced by permission of

AP/Wide World Photos

)

Nutritionists can help children with CP learn what foods they should eat. Nutritional supplements, such as vitamins and minerals, may also be needed. Speech-language therapists can teach people with CP more effective ways to use their throat and mouth muscles, reducing the risk of aspiration. Aspiration is the inhaling of food and saliva into the airways, causing choking and suffocation. In severe cases, a tube can be inserted through the abdomen and into the stomach to carry food directly into the digestive system.

Communication

Poor coordination of tongue and mouth muscles can cause speech problems in people with CP. Problems with speaking can retard a child's mental development. Picture boards can help with speech problems. They allow the CP child to point to objects rather than naming them. A number of mechanical devices are available for school-age children with communication problems. These include typing programs and computer-assisted speech devices. Speech-language therapists can offer valuable advice on the types of equipment available.

Education

Children with mild symptoms of cerebral palsy can often be placed in a regular school classroom. This practice is known as inclusion or mainstreaming. Inclusion has the advantage of making CP children feel less different from other children.

Children with more severe forms of CP may be placed in separate classrooms with teachers trained to work with special education problems. On the federal level, such schools operate under and are financed by the Individuals with Disabilities Education Act (IDEA). Most states have legislation similar to IDEA. Educational specialists can help parents understand the options and opportunities provided for their CP children by these acts.

Behavioral and Mental Health Services

Children with cerebral palsy sometimes develop behavioral or emotional problems. These problems may require special treatments, such as behavioral modification (structured programs for changing behavior) and/or individual and family counseling.

Alternative Treatment

Some alternative treatments that have been effective with some CP individuals include massage therapy, vitamin supplements, herbal medicine, and acupuncture (a Chinese therapy technique where fine needles puncture the body).

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