What is cerebral palsy?

Cerebral palsy (CP) refers to a group of disorders that affect muscle movement and coordination. In many cases, vision, hearing, and sensation are also affected.

The word “cerebral” means having to do with the brain. The word “palsy” means weakness or problems with body movement.

CP is the most common cause of motor disabilities in childhood. According to the Centers for Disease Control and Prevention (CDC), it affects at least 1.5 to 4 out of every 1,000 children worldwide.
What are the symptoms of cerebral palsy?

The symptoms of CP vary from person-to-person and range from mild to severe. Some people with CP may have difficulty walking and sitting. Other people with CP can have trouble grasping objects.

The symptoms can become more severe or less severe over time. They also vary depending on the part of the brain that was affected.

Some of the more common signs include:

delays in reaching motor skill milestones, such as rolling over, sitting up alone, or crawling
variations in muscle tone, such as being too floppy or too stiff
delays in speech development and difficulty speaking
spasticity, or stiff muscles and exaggerated reflexes
ataxia, or a lack of muscle coordination
tremors or involuntary movements
excessive drooling and problems with swallowing
difficulty walking
favoring one side of the body, such as reaching with one hand
neurological problems, such as seizures, intellectual disabilities, and blindness

Most children are born with CP, but they may not show signs of a disorder until months or years later. Symptoms usually appear before a child reaches age 3 or 4.

Call your doctor if you suspect your child has CP. Early diagnosis and treatment are very important.
What causes cerebral palsy?

Abnormal brain development or injury to the developing brain can cause CP. The damage affects the part of the brain that controls body movement, coordination, and posture.

The brain damage usually occurs before birth, but it can also happen during birth or the first years of life. In most cases, the exact cause of CP isn’t known. Some of the possible causes include:

asphyxia neonatorum, or a lack of oxygen to the brain during labor and delivery
gene mutations that result in abnormal brain development
severe jaundice in the infant
maternal infections, such German measles and herpes simplex
brain infections, such as encephalitis and meningitis
intracranial hemorrhage, or bleeding into the brain
head injuries as a result of a car accident, a fall, or child abuse

Who’s at risk for cerebral palsy?

Certain factors put babies at an increased risk for CP. These include:

premature birth
low birth weight
being a twin or triplet
a low Apgar score, which is used to assess the physical health of babies at birth
breech birth, which occurs when your baby’s buttocks or feet come out first
Rh incompatibility, which occurs when a mother’s blood Rh type is incompatible with her baby’s blood Rh type
maternal exposure to toxic substances, such as methylmercury, while pregnant

What are the different types of cerebral palsy?

There are different types of CP that affect various parts of the brain. Each type causes specific movement disorders. The types of CP are:
Spastic cerebral palsy

Spastic CP is the most common type of CP, affecting approximately 80 percent of people with CP. It causes stiff muscles and exaggerated reflexes, making it difficult to walk.

Many people with spastic CP have walking abnormalities, such as crossing their knees or making scissorlike movements with their legs while walking. Muscle weakness and paralysis may also be present.

The symptoms can affect the entire body or just one side of the body.
Dyskinetic cerebral palsy

People with dyskinetic CP have trouble controlling their body movements. The disorder causes involuntary, abnormal movements in the arms, legs, and hands.

In some cases, the face and tongue are also affected. The movements can be slow and writhing or rapid and jerky. They can make it difficult for the affected person to walk, sit, swallow, or talk.
Hypotonic cerebral palsy

Hypotonic CP causes diminished muscle tone and overly relaxed muscles. The arms and legs move very easily and appear floppy, like a rag doll.

Babies with this type of CP have little control over their head and may have trouble breathing. As they grow older, they may struggle to sit up straight as a result of their weakened muscles. They can also have difficulty speaking, poor reflexes, and walking abnormalities.
Ataxic cerebral palsy

Ataxic CP is the least common type of CP. Ataxic CP is characterized by voluntary muscle movements that often appear disorganized, clumsy, or jerky.

People with this form of CP usually have problems with balance and coordination. They may have difficulty walking and performing fine motor functions, such as grasping objects and writing.
Mixed cerebral palsy

Some people have a combination of symptoms from the different types of CP. This is called mixed CP.

In most cases of mixed CP, people experience a mix of spastic and dyskinetic CP.


What is cerebral palsy?

Cerebral palsy (CP) refers to a group of disorders that affect muscle movement and coordination. In many cases, vision, hearing, and sensation are also affected.

The word “cerebral” means having to do with the brain. The word “palsy” means weakness or problems with body movement.

CP is the most common cause of motor disabilities in childhood. According to the Centers for Disease Control and Prevention (CDC), it affects at least 1.5 to 4 out of every 1,000 children worldwide.
What are the symptoms of cerebral palsy?

The symptoms of CP vary from person-to-person and range from mild to severe. Some people with CP may have difficulty walking and sitting. Other people with CP can have trouble grasping objects.

The symptoms can become more severe or less severe over time. They also vary depending on the part of the brain that was affected.

Some of the more common signs include:

delays in reaching motor skill milestones, such as rolling over, sitting up alone, or crawling
variations in muscle tone, such as being too floppy or too stiff
delays in speech development and difficulty speaking
spasticity, or stiff muscles and exaggerated reflexes
ataxia, or a lack of muscle coordination
tremors or involuntary movements
excessive drooling and problems with swallowing
difficulty walking
favoring one side of the body, such as reaching with one hand
neurological problems, such as seizures, intellectual disabilities, and blindness

Most children are born with CP, but they may not show signs of a disorder until months or years later. Symptoms usually appear before a child reaches age 3 or 4.

Call your doctor if you suspect your child has CP. Early diagnosis and treatment are very important.
What causes cerebral palsy?

Abnormal brain development or injury to the developing brain can cause CP. The damage affects the part of the brain that controls body movement, coordination, and posture.

The brain damage usually occurs before birth, but it can also happen during birth or the first years of life. In most cases, the exact cause of CP isn’t known. Some of the possible causes include:

asphyxia neonatorum, or a lack of oxygen to the brain during labor and delivery
gene mutations that result in abnormal brain development
severe jaundice in the infant
maternal infections, such German measles and herpes simplex
brain infections, such as encephalitis and meningitis
intracranial hemorrhage, or bleeding into the brain
head injuries as a result of a car accident, a fall, or child abuse

Who’s at risk for cerebral palsy?

Certain factors put babies at an increased risk for CP. These include:

premature birth
low birth weight
being a twin or triplet
a low Apgar score, which is used to assess the physical health of babies at birth
breech birth, which occurs when your baby’s buttocks or feet come out first
Rh incompatibility, which occurs when a mother’s blood Rh type is incompatible with her baby’s blood Rh type
maternal exposure to toxic substances, such as methylmercury, while pregnant

What are the different types of cerebral palsy?

There are different types of CP that affect various parts of the brain. Each type causes specific movement disorders. The types of CP are:
Spastic cerebral palsy

Spastic CP is the most common type of CP, affecting approximately 80 percent of people with CP. It causes stiff muscles and exaggerated reflexes, making it difficult to walk.

Many people with spastic CP have walking abnormalities, such as crossing their knees or making scissorlike movements with their legs while walking. Muscle weakness and paralysis may also be present.

The symptoms can affect the entire body or just one side of the body.
Dyskinetic cerebral palsy

People with dyskinetic CP have trouble controlling their body movements. The disorder causes involuntary, abnormal movements in the arms, legs, and hands.

In some cases, the face and tongue are also affected. The movements can be slow and writhing or rapid and jerky. They can make it difficult for the affected person to walk, sit, swallow, or talk.
Hypotonic cerebral palsy

Hypotonic CP causes diminished muscle tone and overly relaxed muscles. The arms and legs move very easily and appear floppy, like a rag doll.

Babies with this type of CP have little control over their head and may have trouble breathing. As they grow older, they may struggle to sit up straight as a result of their weakened muscles. They can also have difficulty speaking, poor reflexes, and walking abnormalities.
Ataxic cerebral palsy

Ataxic CP is the least common type of CP. Ataxic CP is characterized by voluntary muscle movements that often appear disorganized, clumsy, or jerky.

People with this form of CP usually have problems with balance and coordination. They may have difficulty walking and performing fine motor functions, such as grasping objects and writing.
Mixed cerebral palsy

सेरेब्रल पाल्सी या शब्दाची फोड सेरेब्रल म्हणजे मेंदूशी संबंधित आणि पाल्सी म्हणजे अर्धांगवायू अशी होते. सेरेब्रल पाल्सी हा विकार हालचालींशी संबंधित असून यात स्नायूंची शक्ती, त्याचे नियमन आणि अतिरिक्त ताठरतेमुळे हालचालींवर मर्यादा येतात. ही लक्षणे स्नायूंच्या झिजेमुळे नाही तर मेंदूला होणाऱ्या हानीमुळे होतात.

सेरेब्रल पाल्सी होण्याच्या मागे अनेक बाबी कारणीभूत आहेत. सेरेब्रल पाल्सी होण्याची काही कारणे अशी आहेत प्रसुती दरम्यान आईला झालेला संसर्ग, काही औषधांचे सेवन, गंभीर जखमा ही प्राथमिक कारणे असू शकतात. त्याचबरोबर मुदतीआधी जन्मलेले अपत्य, जन्माच्यावेळी अपत्याचे वजन कमी असणे, मूल उशिरा रडणे, जन्मताना झालेल्या जखमा, एकावेळी अनेक मुलांचा जन्मही सेरेब्रल पाल्सीची कारणे असू शकतात. प्राणवायूची कमतरता, कावीळ, सीझर किंवा मेंदूत पाणी जमा होणे यामुळेही सेरेब्रल पाल्सी होऊ शकतो.
सेरेब्रल पाल्सी असणारे मूल स्नायूंच्या हालचालींवर नियंत्रण ठेवू शकत नाही. तसेच त्यांच्या हाताच्या तसेच पायांच्या स्नायूंमध्ये ताठरता वाढते. जरी हा प्राथमिकदृष्ट्या हालचालींवर मर्यादा आणणारा विकार असला तरी मेंदूतील ज्या भागावर हा परिणाम घडवतो, त्यानुसार रुग्णाच्या आकलनक्षमता, शिकणे, बुद्धी, स्वभाव, संवाद, वाचा, संवेदना, श्रवण तसेच दृष्टीवर परिणाम घडवतो.

सेरेब्रल पाल्सी हा आयुष्यावर कायमस्वरुपी परिणाम घडवतो. विकारात मेंदूला होणारी इजा ही कायमची असते. मेंदूला एकदा हानी झाली की ती अधिक वाढत नाही पण बरीही करता येत नाही परंतु या लक्षणांमध्ये सुधार किंवा बिघाड ही रुग्णाच्या घेतल्या जाणाऱ्या काळजीवर अवलंबून असते. त्यामुळे सेरेब्रल पाल्सी म्हणजे काय हे समजून घेताना त्याची लक्षणे, त्याचे परिणाम याविषयी माहिती करून घेणे मोलाचे ठरते. जेणेकरून त्या रुग्णाचे योग्य व्यवस्थापन करून रुग्णाच्या त्रासात भर पडणार नाही.

गर्भधारणेच्या कालावधीत आईला काही इन्फेक्शन झाल्यास, रक्तदाब, मधुमेह असल्यास, श्वास घेण्यास किंवा थायरॉईड ग्रंथीचा त्रास असल्यास, वेळे आधीच प्रसूती झाल्यास, फार कमी वजनाचे बाळ असल्यास व इतरही काही कारणांमुळे जन्माला येणारे बाळ हे ‘सेरेब्रल पाल्सी’ (गतीमंद) राहू शकते. विशेष म्हणजे, अलीकडे अयोग्य जीवनशैलीमुळे ही लक्षणे बºयाच महिलांमध्ये दिसून येऊ लागली आहे. मात्र या रुग्णांची कुठेही नोंद घेतली जात नसल्याने ‘सेरेब्रल पाल्सी’ वाढत आहे किंवा नाही हा प्रश्न आहे. मात्र, गेल्या पाच वर्षांत उपचारासाठी येणाºया रुग्णांची संख्या वाढल्याचे डॉक्टरांचे म्हणणे आहे.

३ आॅक्टोबर हा दिवस ‘राष्टीय सेरेब्रल पाल्सी दिन’ म्हणून पाळला जातो. यासंदर्भात रविवारी ‘नागपूर पेडियाट्रिक थेरेपीस्ट असोसिएशन’ने रविवारी पत्रपरिषद घेतली. यावेळी उपस्थित डॉक्टरांनी रुग्ण वाढल्याचे कबूल केले. पत्रपरिषदेत, डॉ. भाग्यश्री हजारे, डॉ. निलम शर्मा, डॉ. अल्पना मुळे, डॉ. तेजल तुराळे, डॉ. प्रेरणा वाहने, डॉ. पल्लवी भाईक, डॉ. अश्विनी हजारे, डॉ. रेणुका नाईक व डॉ. राखी यांनीही सेलेब्रर पाल्सीशी निगडित विषयांवर प्रकाश टाकला.

ही एक मेंदूची स्थिती
डॉ. मीनाक्षी वानखेडे या म्हणाल्या, ही एक मेंदूची स्थिती आहे. हा रोग नाही. यामध्ये शरीराचा काही भाग किंवा संपूर्ण शरीराच्या हालचालीमध्ये संतुलन किंवा सुसूत्रता नसते. सुमारे सात-आठ वर्षांपूर्वी जागतिक आरोग्य संघटनेने (डब्ल्यूएचओ) जारी केलेल्या आकडेवारीनुसार ‘सेरेब्रल पाल्सी’चे (सीपी) हजारात तीन मुले दिसतात. भारतात २५ लाख नागरिक सेरेब्रल पाल्सीने पीडित आहे. शासनाने सेरेब्रल पाल्सीची नोंदणी सुरू केल्यास संशोधनात मदत होईल, असेही त्या म्हणाल्या.

सीपीची कारणे
डॉ. प्राजक्ता ठाकरे म्हणाल्या, बाळ पोटात असताना प्रसूती होईपर्यंत गर्भधारणेच्या काळात आईला काही इन्फेक्शन झाल्यास, आईला रक्तदाब, मधुमेह असल्यास, श्वास घेण्यास किंवा थायरॉईड ग्रंथीचा त्रास असल्यास, प्रसूतीच्या वेळी नाळ बाळाच्या गळ्याभोवती आवळल्यास, खूप कमी वजनाचे बाळ, लवकर न रडणारे बाळ, जन्मानंतर लगेच बाळाला होणारे इन्फेक्शन, डोक्याला मार, कावीळ आदी कारणांमुळे जन्मलेले बाळ ‘सेरेब्रल पाल्सी’ राहूूू शकते.
लक्षणे दिसताच डॉक्टरांचा सल्ला घ्या

डॉ. संपदा लाभे म्हणाल्या, बाळ जन्माला आल्यानंतर अति चिडचिड करीत असेल, फिट्स येत असतील, दूध ओढायला जमत नसेल, शरीरात अति कडकपणा किंवा अति शिथिल असेल, शरीराची एकच बाजू काम करीत असेल तर डॉक्टरांचा सल्ला घेणे महत्त्वाचे ठरते.

लवकर उपचार फायद्याचे
डॉ. अभिजित देशमुख म्हणाले, सेरेब्रल पाल्सीमध्ये लवकर उपचार सुरू होणे अत्यंत फायदाचे ठरते. कारण बालवयात मेंदूची लवचिकता व शिकण्याची क्षमता फार चांगली असल्यामुळे त्याचा फायदा होतो. या उपचारपद्धतीचे मुख्य उद्दिष्ट हे बहुविकलांग मुलांना स्वावलंबी बनविणे हा असतो. सेरेब्रल पाल्सीसाठी बालरोगतज्ज्ञ, मेंदूरोगतज्ज्ञ, अस्थिरोगतज्ज्ञ, फिजिओथेरॅपिस्ट, अ‍ॅक्युपेश्नल थेरॅपिस्ट, सायकोलॉजीस्ट आदींची गरज पडते, असेही ते म्हणाले.