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Cerebral Palsy

Cerebral Palsy is "an umbrella term for a group of non-progressive, but often changing, motor impairment syndromes secondary to lesions or anomalies of the brain arising in the early stages of its development" (Kuban and Leviton, 1994). Congenital cerebral palsy (90% of cases) may be caused by inadequate blood or oxygen supply to the fetus, illness during pregnancy, premature birth, birth trauma, etc. Acquired cerebral palsy (10% of cases) may be caused in the first few months after birth by head trauma, infections (encephalitis, meningitis, herpes simplex, cytomegalovirus), exposure to toxic substances, severe malnutrition, child abuse, etc.

A wide variety of associated conditions may or may not exist for persons with cerebral palsy, but several of the most common include:

  • Seizure disorders
  • Vision impairment
  • Speech impairment
  • Hearing impairment
  • Scoliosis
  • Tonal problems
  • Bladder problems (urinary tract infection)
  • Excessive drooling
  • Poor nutrition
  • Depression
  • Joint contractures
  • Hip dislocation
  • Joint, muscle or other pain
  • Skin breakdown
  • Gastrointestinal problems (oral motor dysfunction, gastroesophageal reflux, esophagitis, gastritis, ulcers, constipation and bowel obstruction)
  • Pneumonia
  • Osteoporosis

Developmental disabilities: Resources for healthcare providers. (n.d.). Retrieved November 2002, from the Developmental Disabilities Health Information Network Web site: http://www.ddhealthinfo.org/ggrc/doc2.asp?ParentID=2850

Several things are of primary consideration when treating individuals with cerebral palsy. First is that while many individuals with cerebral palsy also have mental retardation, the majority do not. It is important to recognize that an individual may have normal, or above normal intelligence even if he or she is unable to speak or communicate that level of intelligence in a more conventional way. Second is that persons with cerebral palsy often have various levels of speech impairment and may use augmentative communication devices, nonverbal communication, slow or difficult to understand speech, or a combination thereof. Third, cerebral palsy is often accompanied by various levels of mobility impairment. The person may require the use of a wheelchair, braces or other adaptive equipment. Being aware of these considerations beforehand and preparing appropriately will lessen the chance for awkward or inaccessible office situations.

Both speech and mobility considerations will be elaborated upon later. Remaining cognizant of both the potential for and possible severity of speech and mobility impairment in persons with cerebral palsy will help the physician in addressing these issues.

For more information about cerebral palsy:

General reading:
http://gait.aidi.udel.edu/res695/homepage/pd_ortho/clinics/c_palsy/cpweb.htm

Aging and cerebral palsy:
http://www.cpconnection.com/Aging/index.htm

Reference

Kuban, K., & Leviton, A. (1994). Cerebral palsy. New England Journal of Medicine, 330(3), 188-195.