Cerebral palsy and its impact on the body’s systems

By Shaima AlHosani & Ebtihal Mohsin Saleh

SCHS Nurse Unit

Introduction

Cerebral palsy is a disorder that affects muscle tone, movement, and motor skills. This disease is caused by damage that occurs to the immature brain that might affect a person’s abnormal brain development or might result in injuries. Usually, the injury can occur during birth, even if there is no obvious sign of the injury that would affect the baby. Cerebral palsy might also occur within the first three to five years of a child’s life while their brain is still developing. Another way that a child might develop cerebral palsy is if they have a life-threatening disease such as bacterial meningitis or viral encephalitis. Even though many individuals, including the child’s mother, may have experienced these diseases, it remains a possibility and warrants consideration. Finally, head injuries can lead to cerebral palsy. Head injuries are the most common way that children and adolescents obtain cerebral palsy. Often, people have the assumption that an injury to the head must be severe to obtain cerebral palsy; however, this is untrue. Cerebral palsy is a disease that is non-progressive, yet it is permanent. This disease occurs in the area of the brain responsible for development, as well as the areas of the brain that control movement and posture. As a result, it will affect a person for the rest of their life. Now, the ways that this disease affects body structures have been studied a lot more in depth. While it is known that an injury to the brain can result in paralysis and that the more brain damage, the more severe the paralysis, many more correlations between cerebral palsy and paralysis are being discovered. One such study discovered that when a child develops spastic cerebral palsy, it is common that their symptoms will not grow in number or severity over time. This was discovered by analyzing a child’s motor skills from the age of 2–4. There is still no explanation for this. (Sadowska et al., 2021) (Visco et al., 2021) (Paul et al., 2022). (Lear et al., 2022).

Effects on the Musculoskeletal System

Treatment usually again involves soft tissue and bone surgery; however, patients are now tending away from hip fusion due to the associated late pelvic issues. The Dega osteotomy, a more recent operative approach, can offer a good acetabulum cover. Bilateral hip reconstruction can improve sitting and perineal function; however, the future effects of arthritic change and pelvic deformity are still relatively unknown. Any form of surgery will involve postoperative care and physiotherapy, and throughout, pain control is an important issue. Frequent reviews and a long-term plan are necessary, taking into account the patient’s level of function and future needs. (Jóźwiak et al., 2023) (Woźniak et al., 2023)

اقرأ ايضا: متلازمة ميلر فيشر ودور العلاج الوظيفي

Up to 64% of ambulatory children with cerebral palsy may develop hip displacement. The degree of displacement can range from subluxation, which is an incomplete dislocation with maintained contact between the ball and the socket, to a fixed dislocation, which is easy to detect. Disorders of sensation, pain, and discomfort do not necessarily offer any warning signs when associated with hip displacement. This is problematic, as a high proportion of cognitive impairment in cerebral palsy patients may mean that a patient is unable to detect a problem. If detected early enough, preventative maintenance of the hip(s) in a reduced position can minimize pain and maximize function. Symptoms of hip displacement can be observed in changes in sitting posture and walking pattern. A Galeazzi sign may be present when a child is laid supine and the knees are held flexed. There will be a significant difference in level between the knees; that is, one knee will appear further away from the midline. (Howard et al., 2023) (Ulusaloglu et al., 2023)

Spasticity makes movements difficult and causes fatigue. It may lead to the permanent shortening of muscles. In some instances, where the three main types of cerebral palsy are involved (spastic, athetoid, and ataxic), incoordination or imbalance will be present. This can make simple tasks difficult and have nonspecific effects, such as on bone growth. Each of these types of cerebral palsy can have a variety of effects on the developing child and their future musculoskeletal system. This often results in a variety of problems that are noticed at different stages of childhood and adolescent growth. (Keles & Ates, 2022) (Kaya Keles & Ates, 2022)

Cerebral palsy affects muscle tone, reflexes, bone development, and motor skills. Often, muscles are either too tight or too loose. This can cause joints to become dislocated. (Giannoni and Zerbino, 2022).

Effects on the Nervous System

I. Mental subnormality Almost one-half of all cases of cerebral palsy suffer from mental subnormality. This is especially true in the cases of spastic children who have suffered from the effects of neonatal jaundice or kernicterus. In these cases, the brain damage site has a site-specific aspect. In kernicterus, the basal ganglia and thalamus suffer relatively severe damage, leading to athetoid cerebral palsy. Whereas in spastic diplegia due to premature birth, the damage is often in the germinal layer of the cerebral ventricles, resulting in damage to various parts of the efferent and afferent fibers with motor and sensory defects. (Tawfik et al., 2024) (Ayyangar et al., 2020)

The effects of cerebral palsy on the nervous system depend on the cause of the damage and the site of the lesion. It may affect any part of the nervous system, with varied consequences with respect to the motor and other defects that result. To some extent, the effects may be different for the various types of cerebral palsy. The following is a summary of the main consequences for nervous system function in cerebral palsy. (Paul et al., 2022).

The nervous system plays a crucial role in the development and functioning of the human body. It is responsible for transmitting signals between different parts of the body, allowing us to move, think, and feel. Cerebral palsy, a neurological condition, affects the brain and the nervous system, leading to impaired muscle control and coordination. Individuals with cerebral palsy may experience difficulties with movement, balance, speech, and even cognitive function. Early intervention and rehabilitative therapies can help manage the symptoms and improve the quality of life for those with cerebral palsy. (Paul et al., 2022). (Handsfield et al., 2022).

Associated Diseases and Conditions

Gastrointestinal problems can become a significant issue for some children with cerebral palsy, particularly as they get older. Problems can include difficulty swallowing, prolonged feeding times, high levels of stress during mealtimes, inadequate intake of food, and unhealthy mealtime patterns. This can lead to undernutrition in some instances. Drooling, which occurs due to poor muscle control, can result in excoriation of the skin around the mouth, embarrassment, and social isolation. North American society has described the primary dental care management of children and adults with cerebral palsy and other developmental disabilities as a “silent epidemic”. High rates of oral disease can be attributed to the limited access to oral health services provided for this segment of the population. (Vinkel et al., 2022). (Verhofste et al., 2021).

Due to the motor disability previously discussed, a child with cerebral palsy may be susceptible to a variety of health conditions. Impairment of muscle control, coordination, and movement often leads to related musculoskeletal problems, including joint contractures, hip dislocation, and scoliosis. Management of these conditions may require surgical intervention and can cause further functional limitations. Children with cerebral palsy are also at higher risk for hip dislocations, other orthopedic deformities, and osteoarthritis. The occurrence of these conditions increases with the severity of the child’s impairment. Children with cerebral palsy can also have the following associated oral health conditions: drooling, teeth grinding, chronic tooth decay, malformed or displaced teeth, and chronic traumatic injuries to the teeth, mouth, or jaw. (Wang et al., 2023) (Minaie et al., 2022).

Conclusion

After reading my essay, I hope you understand how cerebral palsy affects the body’s systems. You can conclude that an injured or immature brain makes it unlikely for an individual to grow up with normal movement and posture. We also know that 80% of individuals with cerebral palsy have spastic cerebral palsy. Of that group, 41% will lose the ability to walk by the time they are adults. That’s quite a high percentage of people who will have to rely on assistive devices or wheelchairs. With the knowledge that abnormal movement patterns occur as the brain-damaged individual grows, it can be expected that musculoskeletal problems will become more severe throughout their lives. Knowing the role the brain plays in movement and posture and the impact CP has on that revealed in this essay, surgical intervention on the muscle tendon or bones to improve the alignment of the lower limbs is unlikely to succeed in anyone with CP. At the moment, there is no cure for cerebral palsy. What I hope you take from this essay is a better understanding of the effects of cerebral palsy on the body’s systems, in particular the musculoskeletal and neurological systems. With this knowledge, people affected by cerebral palsy can manage and improve their condition through effective treatment. This essay reveals an understanding of CP that can aid in its prevention. Because cerebral palsy is not a disease but an injury to the brain, it is preventable, and efforts to prevent CP are of the utmost importance. The effects of cerebral palsy on the musculoskeletal and neurological systems demonstrate the importance of early intervention in brain development during the first two years of life. With CP being a common condition in motor disorders today, the more we understand it, the better we can help those with CP, and the more chance there is for prevention. (Paul et al., 2022). (Evensen et al., 2023) (Cantero et al., 2021).

References:

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