Cerebral palsy (MPD).

Cerebral palsy is a form of physical disability that lasts a lifetime and affects movement and posture. It results from permanent, nonprogressive brain damage in the early stages of a child's development. It can intensify with age, take different forms and affect different parts of the body. Therefore, each person struggling with MPD presents a different form of it. In people with infantile cerebral palsy gait, sitting and often manual dexterity are impaired. Other physical and cognitive problems. It is the most common childhood motor disability, affecting 17 million people worldwide.

Cerebral palsy - symptoms

Cerebral palsy, due to its symptoms is divided into 4 forms. These classifications reflect the areas of the brain that are damaged. The most common form is the spastic form (80-90%). It results from injury to the motor cortex and is characterized by stiffness and tension in the muscles. The atactic form is characterized by wobbly movements. It affects balance and sense of placement in space, and arises from damage to the cerebellum. Unintentional movements, such as dystonia, athetosis and/or chorea, occur in the dyskinetic form and result from damage to the basal ganglia. Last in the classification is the mixed type, which combines two types of muscle tone disorders, such as spasticity and dystonia.

Cerebral palsy can affect various parts of the body. There are distinctions:

1. Quadriplegia - spastic/obstructive quadriplegia - the legs and arms are paralyzed, and often the muscles of the trunk, face or mouth;
2. Diplegia - spastic/obstructive paralysis of the lower extremities - both legs are paralyzed, and the arms to a lesser degree;
3. Hemiplegia - spastic/unilateral hemiplegia - one side of the body (leg or arm) is paralyzed.

Large motor skills (such as sitting or walking) in children and adolescents with cerebral palsy can be divided into 5 different levelsusing a tool called Gross Motor Function Classification System (GMFCS - Gross Motor Function Classification System) developed by CanChild in Canada:

- Levels I - the child walks without restrictions,

- Level II - the child walks with limitations,

- Level III - the child walks with a handheld instrument,

- Level IV - the child moves independently with limitations, can use an electrical device,

- Level V - the child is wheeled in a manual wheelchair.

Taking into account the current level of large motor skills allows the selection of the method of treatment best for a particular person with cerebral palsy and application of rehabilitation.

MPD is accompanied by many disorders. Among people with this disorder:

- 1 of 3 people with MPD do not walk,
- 1 of 4 people with MPD do not speak,
- 1 of 4 people with MPD have behavioral disorders,
- 1 of 10 people with MPD have visual impairment,
- 1 of 5 people with MPD have drooling problems,
- 1 of 2 people with MPD have intellectual disabilities,
- 2 of 4 people with MPD have continence problems,
- 1 of 4 people with MPD have epilepsy,
- 3 of 4 people with MPD experience pain,
- 1 of 5 people with MPD have a sleep disorder.

When diagnosing cerebral palsy, ask the following questions.

Are there risk factors for MPD?

Among the factors that increase the risk of childhood cerebral palsy include:

1. thyroid disorders,
2. Pregnancy poisoning/pre-eclampsia,
3. bleeding,
4. infections,
5. IUGR,
6. bearing irregularities,
7. multiple pregnancy,
8. prematurity,
9. perinatal encephalopathies.

Is motor development abnormal in an infant?

• Wiek: < 20 tyg. (skorygowany) – wykonuje się ocenę globalnych wzorców ruchowych Prechtl’a (95% przewidywalności); nasilenie zaburzenia pomaga przewidzieć
Hammersmith Neonatal Neurological Examination (HNNE).
• Wiek: 6-12 miesiąc – wykonuje się Developmental Assesment of Young Children (DAYC) (83% przewidywalności), a także Hammersmith Infant Neurological Examination (HINE) (90% przewidywalności).

Is neuroimaging abnormal in a newborn?

% of all people who have MPD and show abnormal neuroimaging:

- periventricular leukomalacia - 19%,
- brain malformations - 11%,
- stroke - 11%,
- damage to the gray matter - 22%,
- intracranial hemorrhage - 3%,
- infection - 2%,
- unspecified - 19%,
- normal - 13%.

Cerebral palsy without treatment multidisciplinary Can contribute to physical deterioration. MPD is almost always accompanied by a number of other conditions, which can lead to disability as much as the physical condition. Therefore, it is important to recognize and treat them early, such as regular hip x-rays to spot dislocation, early initiation of speech support or appropriate pain control methods. At Paley European Institute our specialty is pediatric orthopedics and physiotherapy, so we offer a comprehensivee treatment of people with cerebral palsy cerebral palsy.