| |
 |
|
| Medical Edge |
|
|
|
Medical Edge Newspaper Column from Mayo Clinic
CEREBRAL PALSY: DIAGNOSIS AND PROSPECTS
DEAR MAYO CLINIC: My son and daughter-in-law, who live in Singapore, have a 2-year-old daughter who was born about six weeks prematurely. She weighed 3 pounds, 3 ounces. Today, she looks perfectly normal, sits up with support, rolls over to reach what she wants, but does not yet crawl or stand. Last week, doctors there said they wanted to operate on her legs because her muscles were too tight. This week they say she may have cerebral palsy. I am frantic. Can you give me any information? — Tucson, Ariz.
ANSWER: I’m glad to hear that your granddaughter looks normal and healthy. However, your description of her physical abilities at age 2 indicates delayed motor development. And she has tight leg muscles. These signs, together with her premature birth, have prompted her doctors to suspect that cerebral palsy is the cause.
Cerebral palsy — a general term applied to a group of disorders that affect a child’s ability to coordinate body movements — results from injury to the area of the brain that controls voluntary movement. Such damage could have occurred during fetal development, the birth process, or the first few months after birth.
Doctors should reach a diagnosis of cerebral palsy only after examining the child, reviewing her test results and monitoring her motor development for several months. Because cerebral palsy is nonprogressive — it does not worsen with age — any further loss of motor abilities would suggest a progressive problem and therefore other possible causes of the motor delays.
In some children, cerebral palsy affects only one side of the body, but in others it can affect virtually all muscles and movements. The condition’s seriousness depends on the intensity of the muscle tightness and which muscles are involved. Because eating, swallowing and talking require fine muscle control, they too can be a problem for some children with cerebral palsy, and some children can have coexisting learning problems or a seizure disorder.
I’d emphasize, however, that children with cerebral palsy exhibit a wide variety of signs and symptoms, ranging from mild to severe. Some people might need a wheelchair and extensive lifelong care, but others require little or no special assistance. With proper medical care, it’s often possible for children with cerebral palsy to enjoy near-normal lives.
I would encourage your son and daughter-in-law to discuss their daughter’s current situation with her health-care provider, making sure to ask questions about recommended treatments or proposed surgeries. A number of straightforward surgical interventions, such as lengthening the Achilles tendon (behind the heel), can improve a child’s ability to progress toward walking independently. Medications, braces, adaptive devices and other types of orthopedic surgery may help normalize muscle tone and motor development.
Treatment of cerebral palsy is best done by an experienced team that includes pediatric specialists trained in neurology, physical medicine and rehabilitation, and orthopedics, working closely with physical and occupational therapists, speech pathologists and nutritionists. Therapists in particular can often give excellent guidance to families for stimulating and assisting children as they develop independent motor skills, often during their play.
— Nancy L. Kuntz, M.D., Neurology, Mayo Clinic, Rochester, Minn.
Additional Resources:
Cerebral Palsy
Appointment Information
More Information on Cerebral Palsy
- - -
Medical Edge from Mayo Clinic is an educational resource and doesn’t
replace regular medical care. To e-mail a question, go to www.mayoclinic.org,
or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave.,
Suite 114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.
© 2005 TRIBUNE MEDIA SERVICES, INC.
|
|
