Spastic cerebral palsy

definition

Spastic cerebral palsy is paresis, i.e. muscle relaxation caused by damage to the brain (hence the "Cerebral“) Is caused. Spastic cerebral palsy is also often referred to as "infantile cerebral palsy". Most of the time, brain damage is detected in the newborn.

It manifests itself through various disorders of the skeletal muscles in the extremities, i.e. the muscles that are required for active movements. These include muscle weakness and problems standing and walking.

causes

In about half of all spastic cerebral palsy, this can be assigned to a clear cause by a disruption in brain development before or during birth. Mostly there is a lack of oxygen, which the nerve cells in the brain need to survive. As a result of this deficiency, the nerve cells die and certain areas in the brain fail.

Possible causes include infections. The infectious diseases toxoplasmosis, rubella and the cytomegaly caused by the CMV virus are particularly common during pregnancy. Another possible cause is bleeding in the brain, which can result from damage to the head during childbirth.

In addition, certain drugs or alcohol can damage the child's brain during pregnancy and lead to spastic cerebral palsy. If there is a defective development of the mother cake, the child's brain is also not supplied with sufficient oxygen during pregnancy and can be damaged. Heredity of spastic cerebral palsy is extremely rare.

diagnosis

The diagnosis of spastic cerebral palsy is largely based on the anamnesis, i.e. the consultation with the doctor, of the parents of the affected baby. Specific questions are asked about the symptoms that have occurred. So that the cause of the spastic cerebral palsy can be found, the blood and urine as well as the cerebral fluid should always be examined using a lumbar puncture.

To make sure that there is damage to the brain, an MRI image of the head is also taken.

Concomitant symptoms

Unfortunately, the symptoms of spastic cerebral palsy delay and restrict development in newborns. In spastic cerebral palsy, there are many different symptoms of the muscles, which are particularly evident when moving. This leads to a so-called spastic paralysis, i.e. a rigidity of certain muscles, which makes them difficult or impossible to move.

Furthermore, there is an ataxia, i.e. a disturbance of movements. These are particularly evident when standing and walking. The affected person has problems executing movements correctly due to the difficult control of the muscles.

Numerous other symptoms can also occur. About half of all those affected also suffer from epileptic seizures and have a reduced or slowed development of intelligence. In some cases, behavior, speech or hearing disorders occur.

Read more on the subject below: Seizure in baby

therapy

It is important that therapy is started as early as possible in spastic cerebral palsy. Unfortunately, there is no form of treatment that can cure this disease, as the diagnosis of spastic cerebral palsy has already resulted in damage to the brain.

Physiotherapy plays a central role in therapy due to the movement restrictions of those affected. The therapy concepts according to Bobath and Vojta play a role here. Both are about using targeted physiotherapy to show the person concerned supportive methods for posture and gait problems.

Various medications can be used to try to reduce the excessive tension in the muscles, which is the cause of many symptoms. These include, for example, benzodiazepines or botox. Orthopedics also play a role in the treatment of spastic cerebral palsy. The movement of the person affected can be adequately supported by various rails or walking and sitting aids.

Since the disease can lead to a curvature of the spine due to the movement disorders, a corset is also useful in some cases. Surgical treatment options focus on the muscles. In this case, excessive tension in the muscle can be counteracted, for example, by lengthening a muscle tendon.

You may also be interested in this topic: What possibilities are there to solve a spasticity?

Life expectancy

Life expectancy with spastic cerebral palsy depends on the severity of the disease. Unfortunately, this is usually very restrictive for the person concerned, which leads to an inability to stand or walk properly. This creates many other problems, such as curvature of the spine (see also: Scoliosis), which can be life-shortening if the thoracic spine is impaired.

However, many people with spastic cerebral palsy still reach adulthood with appropriate therapy.

forecast

A spastic cerebral palsy has a different prognosis depending on the severity. For some of those affected, a relatively normal life can be led with supporting walking and grasping aids. The impairment of intelligence is also not very pronounced in some cases. What is certain, however, is that those affected usually need support in order to cope with everyday life.

In severe cases, those suffering from spastic cerebral palsy can be treated as care cases.

What is bilateral spastic cerebral palsy?

Bilateral spastic cerebral palsy is a specific form of spastic cerebral palsy. This also results in movement disorders and spastic paralysis, but on both sides. Most often, bilateral spastic cerebral palsy affects both legs. Excessive tension in the leg muscles occurs, which makes it difficult to move the legs.

This has a very great impact on the locomotion of the person suffering from bilateral spastic cerebral palsy. The legs can no longer be alternately lifted off the ground and put down again in an appropriate manner. In addition, the movements are random and slow. This creates great insecurity for those affected when walking and standing. Therefore, a detailed and consistent physical and occupational therapy as support is very important here. The sick are often so limited that they have to rely on outside help.

Bilateral spastic cerebral palsy is the most common form of cerebral palsy with around 60%.

What is tetraspastic cerebral palsy?

Tetraspastic cerebral palsy is a form of spastic cerebral palsy in which all four extremities, i.e. both arms and both legs, are affected. The resulting motor disorders create an interplay of various symptoms in the legs, which leads to pronounced movement disorders. In addition, there are the symptoms in the arms, which means that those affected can hardly walk with a pronounced form of tetraspastic cerebral palsy and are completely dependent on the help of others in everyday life.