The 7th October is World Cerebral Palsy Day. This is a day set aside to create awareness and support for the 17 million people worldwide who live with cerebral palsy.
There is need for more people to be aware of this life-long and life-altering condition. As a Paediatrician who is also a subspecialist in care of children with physical and mental disabilities (Neurodevelopmental Paediatrician), I want to do just that today in honour of the World CP Day.
Cerebral palsy often abbreviated as CP is a group of disorders that affect a person’s ability to move and maintain balance and posture. “Cerebral” means having to do with the brain. “Palsy” means weakness or problems with using the muscles. The problem in CP is actually caused by abnormal brain development or damage to the developing brain (early childhood) that affects a person’s ability to control his or her muscles.CP is the most common motor disability in childhood. The prevalence of CP is 2–3 per 1000 live births. It is especially much more common (100 per 1000 live births) in children who were born extremely premature. Although the abnormality in the brain remains unchanged (non-progressive), the clinical picture of CP may change or be modified with age.
All people with CP have problems with movement and posture. However, these are not the only problems with CP. Many also have other conditions such as intellectual disability; seizures, problems with vision, hearing, or speech, changes in the spine (such as scoliosis), or joint problems (such as contractures). The associated problems may even be more limiting to the lifestyles of individuals with CP than the posture or movement problems which primarily characterized CP.The symptoms of CP vary from person to person. A person with severe CP might need to use special equipment to be able to walk, or might not be able to walk at all and might need lifelong care. A person with mild CP, on the other hand, might walk a little awkwardly, but might not need any special help. CP does not get worse over time, though the exact symptoms can change over a person’s lifetime.
Most of the time the cause of a child’s CP is not known, because it is difficult to tell exactly when the damage to the brain happened. However common causes of CP in our own environment are delayed cry at birth (perinatal asphyxia) due to anything going wrong before and during delivery, prematurity (especially below 32 weeks and weight less than 1.5kg), severe neonatal jaundice (often requiring exchanged blood transfusions), infections in the brain (meningitis), bleeding in the brain, severe convulsions after birth and head injuries in very young children. There are many more but perhaps not so common causes.
The signs of CP vary greatly because there are many different types and levels of disability. The main sign that a child might have CP is a delay reaching motor or movement milestones (such as rolling over, sitting, standing, or walking).
Some other early signs of possible CP in children younger than 6 months include head lag, stiffness of the body though sometimes the baby feels floppy, over-extension of the back and neck, and at times child’s legs get stiff and they cross or form a scissor.
In children older than 6 months of age, features suggestive of CP include: the child doesn’t roll over in either direction, he/she
cannot bring her hands together ; he/she has difficulty bringing her hands to her mouth and he/she reaches out with only one hand while keeping the other fisted.
In children older than 10 months of age, the child may crawl in a lopsided manner, pushing off with one hand and leg while dragging the opposite hand and leg. At times most children with CP are not diagnosed until they are 2 years old when parents seek help because the children are not walking.
There is no cure for CP, but treatment can improve the lives of those who have the condition. It is important to begin a treatment program as early as possible. After a CP diagnosis is made, a team of health professionals works with the child and family to develop a plan to help the child reach his or her full potential.
Common treatments include medicines, surgery, braces, and physical, occupational, and speech therapies. No single treatment is the best one for all children with CP, most children get combination of therapies. Before deciding on a treatment plan, it is important to talk with the child’s doctor to understand all the risks and benefits.
Prevention of CP is a major challenge because at times we do not know why a child has CP.
Some strategies that can prevent some causes of CP include
- Good and prompt antenatal care. This may help reduce chances of preterm delivery by recognition and proper management of high risk pregnancies.
- Supervised delivery by skilled healthcare workers and prompt management of complicated deliveries is another useful strategy.
- Childhood immunizations may prevent meningitis and CP due to brain infections.
- Early detection and treatment of neonatal jaundice will also prevent CP due to brain damage from severe jaundice.
- It is also important to avoid head injury in children by using car seats.
- Where primary prevention is impossible early diagnosis and treatment will help prevent more complications and allow the children to maximize their potential and live a good quality life.
In conclusion, CP is life-long. A child will always have CP and it will not go away. The earlier the diagnosis is made and therapies commenced, the better the outcome for the child.
If you observe any of the early signs mentioned in your child, please go to the hospital and see a Paediatrician who is trained in managing children with developmental problems (Neurodevlopmental Paediatrician) or a Paediatric Neurologist, usually at the Teaching Hospitals.
Although we cannot cure CP, all children have the potential to change. With early and right therapies, people with CP can live good quality lives acheiving their maximum potential.
If you have questions, please ask by commenting on the post. I love to read your questions and comments. Show love to someone who has CP today-Share!
Dr Gbemisola Boyede
I ve a four plus with cp. we r on physo but the problem i ve now is that his neck is yet to be controlled. I need vitamin that can at least help the brain. Recently he was sick ,cries endlessly at night,i dont no what to do and stife his body. please let me know if there is any vitamin
You need to see a Paediatrician preferably a Paediatric neurologist at the Paeditric Neurology Clinic of the Teaching Hospitals. It appears that the child is havng seizures as well (the stiffness) and may need to be on medications for the seizures or convulsions. There is no special vitamins per se but the child can take regular multivitamins available for you to buy over the counter.
I am a teacher and I have a child with cp in my class, his own is not that severe as he uses the toilet alone, performs thoughtful actions and feeds himself. He is so friendly and sweet but his main challenges are in his speed and movement, he can’t talk, can you suggest ways he can be helped to have a better life
Thank you for being so concerned. Is the child seeing a Paediatrician? Please ensure the child sees one. Ask the parents to take him there. The child will need speech therapy too. In terms of education, you need to be patient with him and may need some adaptation tools and techniques. The therapists usually the Physiotherapist and occupational therapists can advise or support him with this.
I have a 15 months old with cerebral palsy, we are on physiotherapy as well, he got sick when he was only 3 weeks old, he had jaundice and he was put on phototherapy for 1 month and he had an opening in his heart, so he was also on oxygen for 1 month, the only problem we are having is that he does not sleep a lot, he sleeps only 3 to 4 hours then he can be awake for 8 hours, any remedies apart from physiotherapy…..please help.
Hello Susan! You need to take him to see a Paediatric Neurologist for further evaluation. Sleep difficulties are some of the challenges children with cerebral palsy can have. There are medications for that which the Paediatric Neurologist can prescribe for him to regulatehis sleep. All the best.
Hi, I have a child who is 5 years old. He had jaundice on the third day after birth. I have tried taking him to teaching hospital which CT scan was made and results came through that his brain looked okay. How do I from this stage help the boy? He walks but has challenged in talking and learning some things.
Kindly see a Paediatrician preferably a Paediatric Neurologist or Developmental Paediatrician for further management. They will advise you further. Also read our posts here on child with special needs
My baby is now 14month he can’t sit and stand on his own, but we have been taking to physioteraphy and he has jaundice and seizures, the pediatrician has given him drug to take for 2yrs.will my baby walk
Hi Bukola….It appears your baby has Cerebral palsy due to the severe jaundice. There is no medication for the walking just for the seizures. Continue with the physiotherapy and hope for the best. What can he do now? Always hope for the best as long as he is progressing no matter how gradually!
Good morning doctor, pls my girl is 4 months and 2days. 3days after she was born we went for bcg and was advised by the nurse to do a jaundice test before the injection be administered to her which we did and the result came out as severe. The number was about 25. and the pead advised we place her on phototherapy immediately and that was done for 3days and another test was done and it down to 13.6 we were discharged and asked to checkback after a week. Another test was carried out and it went down to 8. And the pead said she is ok. Reading this now i became worried, though she has gain neck control, eat and sleep very well. Pls is there anything to look out for?
There is no need to worry since your baby is fine now.
Good evening, pls what are the signs that will show that a child will ever walk,e.g if a child is only rolling over at one year and 3 months,not standing ,sitting nor walking is there hope that d child will walk tnx for Ur response
Hi Chinaza….There is no definitive sign but as we monitor the child and track progress usually with what we call Gross Motor Function Classification System, we are able to fairly predict. Basically a child who is making progress each time will eventually walk unlike a child who reamins static at the same position for a long time.
Hi,
My son will be 12months old next week. He had seizures when he was 2daya old but stopped on same day as he was treated. It never came back. He was able to keep his head steady at 5months, he started sitting unsupported at 8months, he also started army crawling on his belly at 8months. Started to roll over at 10months. Getting into sitting position from lying down on his own at 11months. He can climb thened on his own, he holds on to furniture and stands and walks for a while holding on the something. He isn’t crawling on his knees yet but moves around crawling on his tummy and buttocks. He only says ‘papa’ he understands some commands like come, give me, up, give me five…should I be worried?
Not really…the development is still within average and the most important thing is that the child is making progress all the time!
My son is 14 months old he is vision impaired,he can sit unsupported on his own from 6mnth, he can control his neck from 3months, he never convulse nor had seizures he bagan to crawls backwards and rollover when he began therapy by 9 months but can’t stand upright, can’t talk but blabs and very playful,he has been to teaching hsptl and has been on therapy, visits neurologists , Opthalmologist including ENT,He is so strong am always moved by the way he’s responding to his therapies,am I have hope that he will be fine, he is on supplements like Neurovite, Omega 3 DHA, is there other multivitamins I can add to it,
Just continue with the therapies and follow up with the specialists as I can see that you are seeing many already. Well done!
Good morning doctor, my daughter didn’t cry immediately after birth but she was admitted, she is almost ten months now, she has started standing on her own but she is crawling with her bum bum, am worried what do I need to do?
You don’t need to be worried as her development appears to be on point so far. You can keep checking with your paediatricians if you have any concerns.
The baby is weak on the leg and arm and has shown improvement on therapy and can now stand with things a little .what else can be done to help her? And is there hope that she can recover fully?
Just continue with therapies and discuss with your Paediatrician and therapists managing her.
My baby is 16month, he can walk by him self, he can say some few words like Daddy, mummy, byby, but he cannot get up from the bed by him self or get up from the floor went seated, but he can walk parfectly well should I be worried, thank you ma
I am curious as to how he is able to walk but cannot get up by himself…that is not usual…do you mean walking when you hold his hands or walking without you holding his hands?
I will recommend you seeing a Paediatrician preferably a Paediatric neurologist for further evaluation. You can Book Consultation to see one of our specialist online.
The epilim am using for my daughter is making the seizure get worst..is there anything I can do
Kindly book an appointment with one of our Paediatric neurologist at ATP Clinics.
Good morning doctor, pls my girl is 4 months and 2days. 3days after she was born we went for bcg and was advised by the nurse to do a jaundice test before the injection be administered to her which we did and the result came out as severe. The number was about 25. and the pead advised we place her on phototherapy immediately and that was done for 3days and another test was done and it down to 13.6 we were discharged and asked to checkback after a week. Another test was carried out and it went down to 8. And the pead said she is ok. Reading this now i became worried, though she has gain neck control, eat and sleep very well. Pls is there anything to look out for?
If your baby is fine, there is no need to worry.
Thank Doctor, I have read through. My son didn’t carry at birth but later cried, he started having seizure at 6months and now he is 5years. He is strong, can hold something and move round, can come down from bed/chair. But yet to establish talking and walking. Upth have been managing with no permanent doctor, I feel if one doctor’s sees him always he will improve better. Can you recommend a physiotherapist? I’m in Port Harcourt
You can go to the University of Port Harcourt Teaching Hospital to see the Paediatric neurologist. For urgent questions and answers, please post your questions directly to our Facebook group
My baby is 6months and her weight is 11kg , she started having seizure right from her 3 months and she had jundice when she was born but it was treated,she can hold her neck,stand on my leg and she is trying to roll but she can not sit on her own yet except if she is sitting with surport.we went to pediatric hospital an do EEG and it came out that nothing happens to her brain and they also gave us syr carbamazepin for the seizure, but am also worried because of her sitting and her weight I don’t know if her not sitting by herself is because of the seizure she always have or her weight
Normal EEG does not mean nothing happened to the brain. That is not what EEG is for. The child’s problem may have to do with the severe jaundice or other brain injury that is causing the seizures from age 3 months. Please see a Paediatric neurologist. It is too early to worry about sitting at 6 months. Most children are still learning to sit at this age. The child is also overweight and that has to be addressed as well.
Hello ma’am
My 15 months old boy sleeps well at night and feeds well..its just that his hands are always fist and no.neck control yet but he moves the neck to any direction you are when his name is called..
He also sits aided but not straight yet for about 20 minutes.. sometimes,he refuses to sit and cries. I give him lots of home made meal and fruits especially avocado, applea and banana..
Can I do away with the suppliments since he takes lots of fruits or continue with them?
Also, other supplements be given to help stop his shaky legs.
There is no need to give any supplements. You should be seeing a Paediatric neurologist for the management of your child’s condition.
I have a 11months old daughter who at birth did not cry but after been placed on oxygen for days she got over it. We had a transfontanelle scan which the resultsl show everything was okay.We noticed her hand preference of her right hand at 6months and she gained neck control at 6-7months. She is just trying bit by bit to be using her left hand even though she hasn’t still been able to. She has not been sitting unsupported, not standing, not yet walking and not yet blabbing. Although we have started going for physiotherapy since she was 7months.
Please, what else could we do…could it be CP or what could that be.
She is developing cerebral palsy. Transfontanelle scan does not exclude brain injury. You should see a Paediatric neurologist or Developmental paediatrician for further evaluation and management
Pls doctor
Is it possible for a boy of 19 yrs old to start having seizures which he never had since birth?
Yes it is possible and it is even more significant so you should see a doctor preferably a neurologist urgently.