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Cerebral palsy: pathophysiology?

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Cerebral palsy is caused by brain injury or abnormality before birth or in childhood, leading to difficulties with muscle control, posture, and movement. Risk factors include premature birth, low birth weight, maternal illness, and childhood injuries. Symptoms vary, including delays in fine motor skills, problems with muscle tone and coordination, and deficits in other areas such as language and senses. There is no known cure, but physical therapy, medication, and surgery can help manage symptoms.

The pathophysiology of cerebral palsy begins before birth. The cause of cerebral palsy is usually a brain injury or abnormality that occurs before birth or in childhood. This disease causes problems with the brain’s control of muscles, leading to difficulties with posture, muscle tone, and movement.
A baby born prematurely or with a low birth weight is at increased risk for cerebral palsy. Maternal illness is another risk factor, as are injuries or illnesses in the child’s childhood.

Symptoms can vary widely, but the condition is usually evident from a young age. Often, delays in the development of fine motor skills are the first sign. A person with cerebral palsy may exhibit problems with muscle tone, resulting in muscles that are either too tight or too floppy. There may also be a lack of coordination, which can cause difficulty walking or a struggle with fine motor movements. Some babies have difficulty eating, sucking and swallowing.

Brain damage, which is part of the pathophysiology of cerebral palsy, is not limited to muscle control, so people with this disorder will show deficits in other areas, such as language. There may also be problems with the senses, especially vision and hearing. Some people may suffer from mental retardation or seizures.

Maternal diseases, especially infections, can lead to this condition, as can genetic mutations affecting the brain. A prenatal stroke that prevents blood flow to part of the brain can also cause cerebral palsy. Another possible cause is a head injury to an infant, whether caused by a car accident, abuse, or other trauma.

Because muscles can be overstretched for long periods of time, normally elastic tissue can be replaced by tissue that doesn’t stretch, called contracture. This causes the muscles to shorten as well. Constant pressure on the joints due to stiff muscles can lead to osteoarthritis, which can be very painful. If a person with cerebral palsy has difficulty eating or swallowing, he or she may be suffering from malnutrition. Cerebral palsy can severely interfere with a person’s ability to function normally and thus can lead to depression.

There is no known cure for cerebral palsy. If a person is experiencing muscle spasms, certain medications may be used to keep it under control. Physical therapy to exercise and stretch muscles can help a person walk normally and prevent contractures. If you have severe contractures or joint abnormalities, you may need surgery.

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