OMIM Entry

Cerebral palsy is a disorder of movement, muscle tone or posture that is caused by damage that occurs to the immature, developing brain, most often before birth. In the largest medical malpractice jury verdict in the state of Massachusetts, a baby was awarded $40,000,000 in compensation after suffering severe brain damage due to medical negligence. Literature Review: There are epidemiological, clinical and review studies about management of spasticity in children with cerebral palsy.

Treatments for spastic cerebral palsy vary depending on the severity of the symptoms in the individual. Approximately, 500,000 children and adults of all ages in this country have cerebral palsy. As muscles become increasingly stiff, the range of movement in the joints becomes more and more limited.

The signs and symptoms of spastic cerebral palsy are different for every child. Although it was long considered that the main causes of cerebral palsy occurred during the perinatal period, it is now considered that perinatal causes account for less than 10% of people with cerebral palsy.

According to the St. Louis Children's Hospital, muscles need enough tone in them to maintain correct posture, to help someone walk correctly, and to maintain speed and flexibility. Figure 1. SEFs evoked by the tactile stimulation of the right (left panels) and left (right panels) D1 from TD2, HCP1, and DCP3 children from −100 to 400 ms after the stimulus onset.

Fascicle length is especially important when analyzing muscle architecture because it is highly related to secondary musculoskeletal contracture development, which can severely limit the initial length of muscle contraction and excursion 9 , 28 , 40 , 46 , 47 In this study, we show that the fascicle length in the affected calf was shorter than that observed in both TD peers and the unaffected side of children with hemiplegic CP. This alteration could contribute to the tip-toe gait, decreased range of motion, and decreased gait speed observed in CP. The results of previous reports regarding the changes that occur in fascicle length in children with spastic CP have been inconsistent 18 - 21 Because fascicle length changes as muscles contract, studies have yielded conflicting results.

The team of parents, caregivers, and health practitioners has the responsibility to help the child with cerebral palsy achieve this goal. Although symptoms may change over time, cerebral palsy by definition is not progressive, so if increased impairment occurs, the problem may be something other than cerebral palsy.

Cerebral Palsy is often classified by severity level as mild, moderate, severe, or no CP. These are broad generalizations that lack a specific set of criteria. These movements can be quite debilitating and greatly limit the child's ability to perform many motor tasks.

We conclude that motor and sensory pathways could both be important in the clinical outcome of children with CP and that the diminished connectivity in these pathways in the affected hemisphere, especially of children with HCP, could be indicative of a pathophysiological mechanism responsible for motor dysfunction ( Yoshida et al., 2010 ; Lee et al., 2011 ). These results have important implications for the diagnosis and the rehabilitation of patients with CP. Such interventions should be applied early in life when the brain demonstrates the ability to explanation plasticity, allowing it to readily reorganize in the face of injury ( Johnston, 2009 ). Therefore, new approaches using innovative technologies that will identify early functional and structural deficits in the brain of children with PVL are needed.

The symptoms can become more severe or less severe over time. Unfortunately, at the present time there are very few medical services that are oriented to treat adults with cerebral palsy. A child with spastic cerebral palsy may experience episodes of clonus when trying to walk or navigating stairs.

The thickness of the tibialis anterior and lateral gastrocnemius muscles and the fascicle length of all of the targeted muscles were significantly smaller in the DCP group than on the unaffected side of the HCP group (p<0.05, Table 2 , Fig 3 ). Children with severe spastic cerebral palsy may also be at increased risk of aspiration pneumonia and scoliosis.

In fact, cerebral palsy (CP) refers to a family of related conditions, all stemming from injuries to or congenital malformations in the brain. This type of cerebral palsy is caused by brain damage to the cerebellum, located towards the base of the brain. Spastic cerebral palsy has varying forms depending on the areas of the body it affects, whether its one side of the body or just the legs.

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