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Cerebral palsy is a condition
involving a group of disorders that affects the child's ability to control
his or her own movement. "Cerebral" refers to the brain and "palsy"
refers to muscle weakness and lack of control. The effects, depending on which
areas of the brain have been damaged, may include:
Mental
Retardation;
Seizures;
Impairment of Speech, Hearing or Sight;
Abnormal Perception and Sensation;
Problems in Gait and Mobility;
Involuntary Movement; and
Muscle Spasm or Tightness.
In most cases, cerebral
palsy is a lifelong disability.
A child may be affected
by any of the following types of Cerebral palsy:
Spastic
Cerebral Palsy which causes difficult and stiff movements;
Ataxic Cerebral Palsy which causes loss of depth perception
and sense of balance;
Athetoid Cerebral Palsy which causes uncontrolled and involuntary
movements; and
Mixed Cerebral Palsy which causes symptoms of more than one
of the above three types.
Cerebral palsy results
from injury to the cerebrum (the largest portion of the brain, involved with
higher mental faculties, sensations, and voluntary muscle activities). It
can be caused by injury to the brain before, during, or after birth. Any condition
that impedes a child's breathing could lead to Cerebral Palsy. The most significant
birthing complication related to Cerebral Palsy is severe asphyxia. Asphyxia
is the lack of oxygen to the brain. This can occur when:
The child's
breathing is restricted by the umbilical cord.
The baby
becomes stuck in the birth canal and the placenta being prematurely sheared.
When this happens, a doctor must make an immediate decision to order a C-section
in order to prevent conditions that could lead to Cerebral Palsy.
The baby
does not begin breathing immediately after birth. Without oxygen, the baby's
brain cells start to die causing brain damage. Half of the infants who suffered
severe asphyxia during birth develop Cerebral Palsy. Thus, it is critical
for doctors to prevent asphyxia and make sure that an infant's breathing
is normal.
Other complications that
can result in cerebral palsy include:
Infection
during pregnancy, including measles, rubella, cytomegalovirus and toxoplasmosis;
Jaundice in the infant that can damage the infant's brain cells;
and
Rh incompatibility that can lead to the production of antibodies
by the mother's body that destroy the fetus's blood cells, and can lead
to a form of jaundice in the newborn
Approximately 10 to 20
percent of children who have cerebral palsy acquire the disorder after birth.
Cerebral palsy may occur during early infancy as a result of cerebral injury
caused by such factors as:
illnesses,
including encephalitis, meningitis, and herpes simplex infections;
head injury
during birth resulting in subdural hematoma; and
blood vessel injuries.
Cerebral palsy can also
be caused later in life by head injury following an accident.
There are certain risk
factors that, if present, indicate an increased likelihood that the child
will later be diagnosed with cerebral palsy. These risk factors include:
Fetal Distress
- Complications during labor and delivery, such as vascular or respiratory
problems of the baby during labor and delivery may result in brain damage
causing permanent brain damage that results in cerebral palsy.
Breech
presentation - Babies that present feet first, instead of head first,
at the beginning of labor are at a higher risk of developing cerebral
palsy.
Multiple births - Twins, triplets, and other multiple births
have an increased risk of cerebral palsy.
Maternal bleeding or severe proteinuria (the presence of excess
proteins in the urine)late in pregnancy result in a higher risk of having
a baby with cerebral palsy.
Maternal hyperthyroidism, mental retardation, or seizures increase
the risk for cerebral palsy.
When these or other warning
signs are present, doctors and health care providers should take immediate
steps to properly monitor the unborn baby, to treat the cause of any complication
that has arisen, and, where necessary, to deliver the baby (usually by cesarean).
Once the baby is born,
there are additional risk factors that indicate the baby is at risk of having
or developing cerebral palsy and should be closely monitored and treated.
These include
A Low Apgar
score.
The Apgar score is a numbered rating that reflects a newborn's condition.
To determine an Apgar score, doctors periodically check the baby's heart
rate, breathing, muscle tone, reflexes, and skin color in the first minutes
after birth. They then assign points; the higher the score, the more normal
the baby's condition. A low score at 10-20 minutes after delivery is often
considered an important sign of potential problems.
Low
birthweight and premature birth.
The risk of cerebral palsy is higher among babies who weigh less than 2500
grams (5 lbs., 7 1/2 oz.) at birth and among babies who are born less than
37 weeks into pregnancy. This risk increases as birthweight falls.
Nervous system malformations.
Some babies born with cerebral palsy have visible signs of nervous system
malformation, such as an abnormally small head (microcephaly). This suggests
that problems occurred in the development of the nervous system while the
baby was in the womb.
Seizures
in the newborn.
An infant who has seizures faces a higher risk of being diagnosed, later
in childhood, with cerebral palsy.
Cerebral palsy continues
to occur at a disturbing rate, with
Approximately
2 to 4 out of every 1000 new births having Cerebral Palsy;
At least 5000 infants and toddlers being diagnosed with cerebral
palsy each year;
At least 1,200 - 1,500 preschoolers being diagnosed with cerebral
palsy each year; and
Approximately 50,000 people in Canada have cerebral palsy.
There are many indicators
that, if present, can suggest the injury occurred as a result of improper
medical care, or trauma to the baby's brain during the birthing process:
The baby
receives a low score on the Apgar test
The baby develops seizures within 24 to 48 hours
The baby demonstrates poor sucking and swallowing after birth
The baby shows signs of weakness or abnormal muscle tone
The baby's skin is blue or dusky at birth
The baby needs resuscitation at, or shortly, after birth
because he/she is not breathing
The baby shows signs of apnea (breath holding)
The baby shows decreased signs of arousability
There was no indication of trauma or infection during the pregnancy
There is no history in the family of brain damage
The infant has problems maintaining temperature after birth
The cordPH is low indicating the presence of metabolic acidosis
The bag of waters was ruptured for over 24 hours
There was meconium (fecal) staining on the baby at the time
of delivery.
If your son or daughter
has cerebral palsy and you suspect that the cerebral palsy resulted because
a doctor, nurse, or other health care provider failed to provide adequate
care during the pregnancy, during labor and delivery, or after the delivery
of your baby, you should immediately contact a competent lawyer. The lawyer
will be able to help you understand whether your son's or daughter's cerebral
palsy was the result of a health care provider's negligence, in which
case the lawyer will also be able to assist you in recovering compensation
that can be used for your child's care and education. |