Cerebral Palsy Overview
Cerebral palsy (CP) is a disorders affecting body movement, balance, and posture. Loosely translated, cerebral palsy means “brain paralysis.” Cerebral palsy is caused by abnormal development or damage in one or more parts of the brain that control muscle tone and motor activity (movement). The resulting impairments first appear early in life, usually in infancy or early childhood. Infants with cerebral palsy are usually slow to reach developmental milestones such as rolling over, sitting, crawling, and walking.
Common to all individuals with cerebral palsy is difficulty controlling and coordinating muscles. This makes even very simple movements difficult.
Cerebral palsy may involve muscle stiffness, poor muscle tone, uncontrolled movements, and problems with posture, balance, coordination, walking, speech, swallowing, and many other functions.
Mental retardation, seizures, breathing problems, learning disabilities, bladder and bowel control problems, skeletal deformities, eating difficulties, dental problems, digestive problems, and hearing and vision problems are often linked to cerebral palsy.
The severity of these problems varies widely, from very mild and subtle to very profound.
Although the magnitude of the problems may wax and wane over time, the condition does not get worse over time.
Types of cerebral palsy are as follows:
- Spastic (pyramidal): Increased muscle tone is the defining characteristic of this type. The muscles are stiff and movements are jerky or awkward. This type is classified by which part of the body is affected.
- Dyskinetic (extrapyramidal): This includes types that affect coordination of movements. There are 2 subtypes.
- Athetoid: The person has uncontrolled movements that are slow and writhing. The movements can affect any part of the body, including the face, mouth, and tongue. About 10-20% of cerebral palsy cases are of this type.
- Ataxic: This type affects balance and coordination. Depth perception is usually affected. He or she has difficulty with movements that are quick or require a great deal of control, such as writing.
Many individuals with cerebral palsy have normal or above average intelligence. Their ability to express their intelligence may be limited by difficulties in communicating. All children with cerebral palsy, regardless of intelligence level, are able to improve their abilities substantially with appropriate interventions. Most children with cerebral palsy require significant medical and physical care, including physical, occupational, and speech/swallowing therapy.
Despite advances in medical care, cerebral palsy remains a significant health problem. The number of people affected by cerebral palsy has increased over time. This may be because more and more premature infants are surviving.
Cerebral palsy results from damage to certain parts of the developing brain.
This damage can occur early in pregnancy when the brain is just starting to form, during the birth process as the child passes through the birth canal, or after birth in the first few years of life.
In many cases, the exact cause of the brain damage is never known.
At one time, problems during birth, usually inadequate oxygen, were blamed for cerebral palsy.
In fact, current thinking is that at least 70-80% of cases of cerebral palsy begin before birth (prenatal). Some cases begin after birth (postnatal).
Risk factors linked with cerebral palsy include the following:
- Infection, seizure disorder, thyroid disorder, and/or other medical problems in the mother
- Birth defects,especially those affecting the brain, spinal cord, head, face, lungs, or metabolism
- Rh factor incompatibility,a difference in the blood between mother and fetus that can cause brain damage in the fetus (Fortunately, this is almost always detected and treated in women who receive proper prenatal medical care.)
- Certain hereditary and genetic conditions
- Complications during labor and delivery
- Premature birth
- Low birth weight (especially if less than 2 pounds at birth)
- Severe jaundice after birth
- Multiple births (twins, triplets)
- Lack of oxygen (hypoxia) reaching the brain before, during, or after birth
- Brain damage early in life, due to infection (such as meningitis), head injury, lack of oxygen, or bleeding
Cerebral Palsy Symptoms
The signs of cerebral palsy are usually not noticeable in early infancy but become more obvious as the child’s nervous system matures. Early signs include the following:
- Delayed milestones such as controlling head, rolling over, reaching with one hand, sitting without support, crawling, or walking.
- Persistence of “infantile” or “primitive” reflexes, which normally disappear 3-6 months after birth.
- Developing handedness before age 18 months: This indicates weakness or abnormal muscle tone on one side, which may be an early sign of CP.
- Problems and disabilities related to CP range from very mild to very severe. Their severity is related to the severity of the brain damage. They may be very subtle, noticeable only to medical professionals, or may be obvious to the parents and other caregivers.
- Abnormal muscle tone: Muscles may be very stiff (spastic) or unusually relaxed and floppy.” Limbs may be held in unusual or awkward positions. For example, spastic leg muscles may cause legs to cross in a scissor-like position.
- Abnormal movements: Movements may be unusually jerky or abrupt, or slow and writhing. They may appear uncontrolled or without purpose.
- Skeletal deformities: People who have cerebral palsy on only one side may have shortened limbs on the affected side. If not corrected by surgery or a device, this can lead to tilting of the pelvic bones and scoliosis (curvature of the spine).
- Joint contractures: People with spastic cerebral palsy may develop severe stiffening of the joints because of unequal pressures on the joints exerted by muscles of differing tone or strength.
- Mental retardation: Some, although not all, children with cerebral palsy are affected by mental retardation. Generally, the more severe the retardation, the more severe the disability overall.
- Seizures: About one third of people with cerebral palsy have seizures. Seizures may appear early in life or years after the brain damage that causes cerebral palsy. The physical signs of a seizure may be partly masked by the abnormal movements of a person with cerebral palsy.
- Speech problems: Speech is partly controlled by movements of muscles of the tongue, mouth, and throat. Some individuals with cerebral palsy are unable to control these muscles and thus cannot speak normally.
- Swallowing problems: Swallowing is a very complex function that requires precise interaction of many groups of muscles. People with cerebral palsy who are unable to control these muscles will have problems sucking, eating, drinking, and controlling their saliva. They may drool. An even greater risk is aspiration, the inhalation into the lungs of food or fluids from the mouth or nose. This can cause infection or even suffocation.
- Hearing loss: Partial hearing loss is not unusual in people with cerebral palsy. The child may not respond to sounds or may have delayed speech.
- Vision problems: Three quarters of people with cerebral palsy have strabismus, which is the turning in or out of one eye. This is due to weakness of the muscles that control eye movement. These people are often nearsighted. If not corrected, strabismus can lead to more severe vision problems over time.
- Dental problems: People with cerebral palsy tend to have more cavities than usual. This results from both defects in tooth enamel and difficulties brushing the teeth.
- Bowel and/or bladder control problems: These are caused by lack of muscle control.
Cerebral Palsy - Ayurvedic Herbal Treatment
The Ayurvedic treatment of cerebral palsy focuses on treating the presenting symptoms and attempting to reverse the brain damage. A group of herbal medicines called 'Medhya' are very useful in improving the functional capacity of the brain and may also help in regeneration of damaged brain cells. These medicines include: Brahmi (Bacopa monnieri), Mandukparni (Centella asiatica), Shankhpushpi (Convolvulus pluricaulis), Jyotishmati (Celastrus panniculatus), Kushmand (Benincasa hispida), Ustukhudoos (Lavendula stoechas), Yashtimadhuk (Glycerrhiza glabra), Ashwagandha (Withania somnifera), Shatavari (Asparagus racemosus), Guduchi (Tinospora cordifolia), Vacha (Acorus calamus), Haritaki (Terminalia chebula), Abhrak-Bhasma and Suvarna-Bhasma. Some of these medicines are also useful in preventing or reducing convulsions.
Medicines which act on the 'Majja' dhatu (tissue) are useful in this condition and include Guduchi, Amalaki (Emblica officinalis), Musta (Cyperus rotundus), Panch-Tikta-Ghruta, Panch-Tikta-Ghrut-Guggulu, Brahmi-Ghruta and Pancha-Gavya-Ghruta. In addition, other medicines are used which improve nerve conduction and muscular co-ordination. These medicines include Kaishor-Guggulu, Yograj-Guggulu, Vatagajankush-Ras, Mahavat- Vidhwans-Ras, Tapyadi-Loh-Ras and Vish-Tinduk-Vati.
Massage of the entire body with medicated oils like Maha-Narayan oil, Maha- Mash-oil and Maha-Saindhav-oil are very useful. Specialized Panchkarma procedures like Shiro-Basti, Shiro-Dhara as well as prolonged courses of Basti (medicated enemas) are also very useful in this condition.
Though cerebral palsy may not be fully cured, Ayurvedic treatment can definitely help to reduce disability and improve the functioning of the affected individual to a great extent.