Cerebral Palsy and Its Treatments

Cerebral palsy (CP) is a non-progressive neurological disorder in the brain that results in abnormal muscle tone, poor balance, poor muscle control, and limitation in the performance and participation of the individual in activities. The insult of the developing brain is static and permanent. However, the consequent symptoms are variable and its clinical manifestation may change over time. Motor impairments may be accompanied by secondary musculoskeletal complications and disturbances of sensation, cognition, perception or behavior. Patients may have a range of comorbidities, which are likely to impact outcomes and costs of care. Thus CP remains the world’s most common childhood physical disability. Children with CP need assessments of other conditions often associated with the disorder. These tests include evaluating the presence of vision or hearing impairment, speech delays or impairments, intellectual disabilities and other developmental delays. The focus of intervention programs is reducing existing deficiencies and increasing the ability to perform daily activities independently. Children with CP require long-term care presented as individualized program by a team. Physical and occupational therapist by using muscle training and exercises may help child’s strength, flexibility, balance, motor development, independent participation in daily activities and routines in the home, school, and community. Speech and language pathologists can improve child’s ability to speak clearly or to communicate using sign language, computer and voice synthesizer and also working with picture boards of items and activities that child may see in daily life. They may also address difficulties with eating and swallowing. Braces or splints and adaptive equipment may support function, such as improved walking. Others may stretchstiff muscles to help prevent contractures. Some children may benefit from recreational therapies, such as therapeutic horseback riding that can help improve child’s motor skills, speech, and emotional well-being. Medications that can lessen the tightness of muscles may be used to improve functional abilities, treat pain and manage complications related to spasticity or other cerebral palsy symptoms. Drugs selection depends on whether the problem affects only certain muscles (isolated) or the whole body (generalized) and may include botulinum toxin A, diazepam (Valium), dantrolene (Dantrium)and baclofen (Gablofen). There may need to use medications to reduce drooling. Depending on the child’s situation, surgical intervention may be needed to lessen muscle tightness or correct bone abnormalities caused by spasticity. These includesurgery on bones or joints to place their arms, hips or legs in their correct positions or lengthen muscles and tendons that are proportionally too short because of severecontractures. Sometimes the patient may benefit from selective dorsal rhizotomy that relaxes the muscle and reduces pain, but can also cause numbness. Theintervention protocol should be individualized for each patient and by considering the child’s situation, parents’ time and attitudes and also social resources.

کلیدواژه ها:

CP ، Symptoms ، Intervention