AnikaMeyer, CC BY-SA 4.0, via Wikimedia Commons
A healthy child should be able to control their neck at 3 months, sit without support at 6 to 8 months, and walk by one year and above. However, diseases affecting the brain and muscle control can delay or prevent all these from happening. Cerebral is one such disease.
What is cerebral palsy?
Cerebral palsy is a group of disorders affecting a child’s ability to move, coordinate, or maintain balance and posture. It results from a problem in the brain that occurs during pregnancy, delivery, or soon after birth.
How common is cerebral palsy in Nigeria?
The exact number of children living with cerebral palsy is not known. However, some research estimates that about 3 out of 1,000 children in Nigeria have cerebral palsy. Parents often discover the condition when the child is about 6 to 16 months old, affecting males slightly more often than females.
What are the symptoms of cerebral palsy?
Cerebral palsy symptoms emerge as soon as a child is born, but they are often not noticeable until the child ages. After the child’s first few weeks of life, the parents may notice symptoms such as:
- Delayed motor development, such as sitting, crawling, standing, and walking
- Muscle stiffness and rigidity
- Floppiness
- Weak arms and legs
- Difficulty with speech and swallowing
- Seizures
- Muscle paralysis
- Intellectual disabilities
- Behavioral and emotional problems
- Uncontrolled jerky movements
The symptoms vary according to the severity of the condition. Some children with cerebral palsy may have minor difficulties with movement, while others could be severely impaired.
When to see the doctor
The symptoms above are not exclusive to cerebral palsy. While they are typical of brain diseases, they are not necessarily signs of trouble.
However, you should watch out for the early signs of cerebral palsy and visit a doctor if you have concerns about your child’s health and development.
The doctor will help you understand your child’s condition and, if necessary, refer you to a specialist.
What are the causes of cerebral palsy?
Cerebral palsy is caused by abnormal brain development or injury to the developing brain. The brain starts developing in the fetus and completes development at mid-age. Abnormality or injury to the developing brain, whether inside or outside the fetus, can make it difficult for a child to control their muscles.
Some of the causes responsible for the abnormality include:
- Genetic disorders
- Enzyme deficiencies
- Hormone disorders
- Maternal infections such as gonorrhoea, urinary tract infections, etc.
- Maternal diabetes
These factors are thought to cause an abnormality or damage the brain before a child is born. Hence, they are called congenital factors. More than 80% of cerebral palsy cases are thought to be congenital.
Other abnormalities occur after birth, and they are linked to conditions such as:
- Severe perinatal asphyxia
- Bilirubin encephalopathy
- Intracranial infections like meningitis
- Prematurity
- Prolonged labour
- Traumatic birth
- Brain injury or bleeding
In some cases, the exact cause of cerebral palsy is not known.
How to prevent cerebral palsy
While complete prevention is not possible, expectant mothers can reduce the risk of their children having cerebral palsy by:
- Getting adequate antenatal care
- Avoiding exposure to non-vaccine preventable infections
- Receiving vaccination against common infections
- Treating any underlying infection or disease
- Avoiding smoking, alcohol, and psychoactive drugs
These steps manage the risk factors and lessen the chance of developing cerebral palsy.
Doctors can also help prevent cerebral palsy by:
- Monitoring fetal health
- Monitoring the heart rate of mother and child
- Screening for Rhesus compatibility between mother and child
- Ensuring timely delivery
- Ensuring adequate oxygenation at birth
- Resuscitating baby as appropriate
Diagnosis of cerebral palsy
Diagnosing cerebral palsy can be challenging because the symptoms can be similar to those of other conditions that affect movement and posture. However, early diagnosis is important because it allows for early intervention, which can improve outcomes for children with CP.
Here are some of the methods used to diagnose cerebral palsy:
- Medical history containing detailed information about a child’s pregnancy, delivery, and the developmental milestones helps to evaluate symptoms to aid diagnosis
- Physical examination of muscle tone, reflexes, posture, and movement that may reveal abnormalities to suggest cerebral palsy
- Neurological examination can help detect underlying brain problems such as seizures or abnormal brain activity
- Imaging tests such as MRI or CT scans can help identify any brain abnormalities that may be causing cerebral palsy. These tests can also help identify the type and severity of cerebral palsy.
- Developmental monitoring helps to identify any delays or abnormalities in the child's development, such as motor or cognitive development delays.
- Genetic screening is useful in detecting mutations or chromosomal disorders that are associated with cerebral palsy.
- An electromyography (EMG) measures the electrical activity in muscles; it detects any abnormalities in muscle function that may indicate cerebral palsy.
Treatment for Cerebral Palsy
There’s no cure for cerebral palsy. However, treatments are available to manage the symptoms and improve outcomes for children with cerebral palsy. The treatments are tailored to the needs of the person and may include the following:
- Physical therapy to improve movement, flexibility, and muscle strength
- Occupational therapy to help develop fine motor skills or learn new ways to perform daily tasks.
- Speech therapy to improve a child’s the ability to speak and swallow
- Medications to relieve the symptoms such as seizures and contractions
- Surgery may be recommended to correct skeletal abnormalities, such as scoliosis or hip dislocation.
- Assistive devices, such as braces, walkers, or wheelchairs, can help individuals with CP improve their mobility and independence
Caring for a Child with Cerebral Palsy
It can be challenging caring for a child with cerebral palsy, but with the right resources and support, parents can give a child the care and attention they need without burning out.
Here are some tips for caring for a child with cerebral palsy:
- Build a strong support system of family, friends, support groups, and other caregivers to help you through the process
- Understand a child’s physical, emotional, and cognitive needs so you can provide the appropriate care and support
- Find alternative ways to communicate, such as using pictures, gestures, or assistive technology, especially for children with speaking difficulties
- Make sure the child's environment is safe and accessible, with plenty of space for them to move around and play
- Encourage the child to participate therapy exercises or adapted sports; you can join in too
- Make their food ease to chew and swallow
- Advocate for their needs within your community and help to empower other families
Bottom Line
Cerebral palsy affects a number of children in Nigeria, and it limits their chances of living high quality lives or living to the best of their potentials. Many of them dropout of treatment due to the cost and difficulty in accessing care. Thankfully, the situation is improving, as more hospitals have specialists to manage the cases, and families get better informed to take care of their child. Knowing the risk factors and prevention options can help parents reduce the risks of having a child with cerebral palsy.
