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Cerebral Palsy
SUBMITTED TO Dr. RABIYA EJAZ

SUBMITTED BY AIMAN RAANA

ROLL# 2010146019

COURSE TITLE DEVELOPMENTAL BIOLOGY

COURSE CODE ZOO-409

SEMESTER 8th A

DEPARTMENT ZOOLOGY

SUBMISSION DATE March 18 , 2024

Contents:
 Cerebral Palsy .............................................................................03
 Types of cerebral pulsy ............................ ..................................03-04

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 Causes of cerebral palsy .............................................................04-05
 Symptoms ...................................................................................05-06
 Diagnosis and screening ……………………….………………06-07
 Treatment ………………………........…………………………07-08
 References.

Cerebral Palsy

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Cerebral palsy (CP) refers to a group of neurological disorders that appear in infancy or early
childhood and permanently affect body movement and muscle coordination. CP is caused by
damage to or abnormalities inside the developing brain that disrupt the brain’s ability to control
movement and maintain posture and balance. The term cerebral refers to the brain; palsy refers
to the loss or impairment of motor function.

In some cases, the areas of the brain involved in muscle movement do not develop as expected
during fetal growth. In others, the damage is a result of injury to the brain either before, during,
or after birth. In either case, the damage is not reversible and the disabilities that result are
permanent

Fig. 01 cerebral palsy

Types of Cerebral Palsy

Doctors classify CP according to the main type of movement disorder involved. Depending on
which areas of the brain are affected, one or more of the following movement disorders can
occur:
 Stiff muscles (spasticity)
 Uncontrollable movements (dyskinesia)
 Poor balance and coordination (ataxia)

There are four main types of CP:

1. Spastic Cerebral Palsy
The most common type of CP is spastic CP. Spastic CP affects about 80% of people with
cerebral palsy. People with spastic CP have increased muscle tone. This means their muscles are
stiff and, as a result, their movements can be awkward. Spastic CP usually is described by what
parts of the body are affected:
a) Spastic diplegia/diparesis
In this type of CP, muscle stiffness is mainly in the legs, with the arms less affected or not
affected at all. People with spastic diplegia might have difficulty walking because tight hip and

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leg muscles cause their legs to pull together, turn inward, and cross at the knees (also known as
scissoring).
b) Spastic hemiplegia/hemiparesis
This type of CP affects only one side of a person’s body; usually the arm is more affected than
the leg.
c) Spastic quadriplegia/quadriparesis
Spastic quadriplegia is the most severe form of spastic CP and affects all four limbs, the trunk,
and the face. People with spastic quadriparesis usually cannot walk and often have other
developmental disabilities such as intellectual disability; seizures; or problems with vision,
hearing, or speech.
2. Dyskinetic Cerebral Palsy
People with dyskinetic CP have problems controlling the movement of their hands, arms, feet,
and legs, making it difficult to sit and walk. The movements are uncontrollable and can be slow
and writhing or rapid and jerky. Sometimes the face and tongue are affected and the person has a
hard time sucking, swallowing, and talking. A person with dyskinetic CP has muscle tone that
can change (varying from too tight to too loose) not only from day to day, but even during a
single day.
3. Ataxic Cerebral Palsy
People with ataxic CP have problems with balance and coordination. They might be unsteady
when they walk. They might have a hard time with quick movements or movements that need a
lot of control, like writing. They might have a hard time controlling their hands or arms when
they reach for something.
4. Mixed Cerebral Palsy
Some people have symptoms of more than one type of CP. The most common type of mixed CP
is spastic-dyskinetic CP.

Fig. 02 Types of cerebral palsy

Causes of cerebral palsy

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 Cerebral palsy is caused by abnormal development of part of the brain or by damage to parts of
the brain that control movement. The majority of people have congenital cerebral palsy (they
were born with it), although it may not be detected until months or years later. Possible causes of
congenital CP include genetic abnormalities, congenital brain malformations, maternal infections
or fevers, or fetal injury. This damage can happen at different times, including before, during and
after birth. Damage before birth makes up about 80% of the causes. After birth, it makes up
about 10% of causes.
Causes before and during birth
Examples of the causes include:
 Preterm (premature) birth.
 Congenital malformations due to disruptions in fetal brain development.
 Infections in the central nervous system (brain or spinal cord).
 Strokes that affect the developing brain.
 Genetic issues affecting fetal development.
 Lack of blood flow or oxygen to the fetal brain.
 Kernicterus (brain damage from toxic buildup of bilirubin, a chemical made in your
liver).
 Meconium aspiration.
 Newborn hypoglycemia.
Causes after birth
Babies can develop CP after birth due to other events. These are often injury-related, but there
are other possible causes, too, including:
 Accidental injuries.
 Physical abuse.
 Asphyxiation.
 Infection, strokes or bleeding in and around their brain.
 Jaundice and kernicterus.

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 Fig.Causes of Cerebral palsy

Symptoms
Cerebral palsy can have several different signs and symptoms. Some affect movement, while
others affect certain body parts, appearance and behavior.
Examples of non movement signs and symptoms
 Head size differences:
These can include an unusually small head (microcephaly) or an unusually large head
(macrocephaly).
 Irritability:
Babies with CP may seem fussy or irritable frequently.
Lack of interaction: Babies and children with CP may not react to people around them.
 Hypotonia:
This means a lack of muscle tone, giving affected body parts a “floppy” appearance (this usually
happens early on and later becomes spasticity or dystonia).
 Delayed development:
Children with CP often have delays in reaching some expected developmental milestones. Many
of these involve movement but can involve other abilities, too.
Examples of movement symptoms related to cerebral palsy
 Stiffness in your arms and legs that makes them hard to bend or use (spasticity).
 Uncoordinated movements.
 Movements that look like they’re slow and writhing or twisting.
 Movements that look like you’re flinging or throwing or fidgeting or dancing.
 Spasms or contractions might cause you to hold an uncomfortable or painful pose
(dystonia).

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Risk factors of cerebral pulsy

There are certain circumstances or factors that can contribute to cerebral palsy or make it more
likely to happen. They include:

 Premature birth (babies born before 28 weeks of gestation have the highest risk overall).
 Low birth weight (under 3.3 pounds, or 1.5 kilograms).
 Substance use by a pregnant person.
 Conditions affecting the pregnancy, such as preeclampsia.
 Multiple fetuses (twins, triplets, etc.).
 Infections affecting the placenta or amniotic fluid.
Screening & Diagnosis
Diagnosing cerebral palsy (CP) at an early age is important to the well-being of children and
their families. Diagnosing CP can take several steps:
 Developmental Monitoring
 Developmental Screening
 Developmental and Medical Evaluations

1. Developmental Monitoring
Developmental monitoring (also called surveillance) means tracking a child’s growth and
development over time. At each well-child office visit, the doctor monitors the child’s
development. The doctor does this by asking parents if they have any concerns about their
child’s development, taking or updating the child’s developmental history, and watching the
child during the exam to see how he or she moves.
2. Developmental screening
During developmental screening a short test is given to see if the child has specific
developmental delays, such as motor or movement delays. Some developmental screening tests
are in the form of interviews or questionnaires completed by parents, others are tests that the
doctor gives to the child. The American Academy of Pediatrics recommends that all children be
screened for developmental delays during regular well-child office visits at:
 9 months
 18 months
 24 or 30 months
When a child is 9 months of age, many issues involving movement can be seen easily. However,
mild movement delays that were not found at the 9-month screening might be easier to see when
the child is 18 months of age. By the time the child is 30 months of age, most movement delays
can be found.
3. Developmental and Medical Evaluations
The goal of a developmental evaluation is to diagnose the specific type of disorder that affects a
child. To evaluate movement or motor delays, the doctor will look closely at the child’s motor

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skills, muscle tone, reflexes, and posture, and take a careful medical history from the parents.
The doctor will try to rule out other disorders that could cause similar problems.
In addition to the developmental evaluation, additional tests can be done to look for a cause
of CP. Specialists might suggest brain imaging tests, such as x-ray computed tomography (CT
scan) or magnetic resonance imaging (MRI). An electroencephalogram (EEG), genetic testing,
or metabolic testing, or a combination of these, also might be done.
CP generally is diagnosed during the first or second year after birth. But if a child’s
symptoms are mild, it is sometimes difficult to make a diagnosis until the child is a few years
older.
Treatment
There is no cure for cerebral palsy. However, there are many treatment options that may help
improve your child’s daily functioning. Selecting care depends on your child’s specific
symptoms and needs, which may change over time. Early intervention can improve outcomes.
Treatment options can include medicines, therapies, surgical procedures and other treatments as
needed.
1. Physical therapy and rehabilitation
A child with cerebral palsy usually starts these therapies in the first few years of life or soon
after being diagnosed. Physical therapy is one of the most important parts of treatment. It
involves exercises and activities that can maintain or improve muscle strength, balance, and
movement. A physical therapist helps the child learn skills such as sitting, walking, or using a
wheelchair. Other types of therapy include:
Occupational therapy :
This type of therapy helps a child learn to do everyday activities such as dressing and going to
school.
Recreational therapy :
Participating in art programs, cultural activities, and sports can help improve a child’s physical
and intellectual skills.
Speech and language therapy :
A speech therapist can help a child learn to speak more clearly, help with swallowing problems,
and teach new ways to communicate, such as by using sign language or a special communication
device.
2. Orthotic devices.
Braces, splints, and casts can be placed on the affected limbs and can improve movement and
balance. Other devices that can help with movement and posture include wheelchairs, rolling
walkers, and powered scooters.
3. Assistive devices and technologies.
These include special computer-based communication machines, Velcro-fastened shoes, or
crutches, which can help make daily life easier.
4. Medication
Certain medications can relax stiff or overactive muscles and reduce abnormal movement. They
may be taken by mouth, injected into affected muscles, or infused into the fluid surrounding the
spinal cord through a pump implanted near the spinal cord. For children who have cerebral palsy

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and epilepsy (seizures), standard epileptic medications should be considered, but these
medications may also have negative effects on the developing brain.
5. Surgery :
A child may need surgery if symptoms are severe. For instance, surgery can lengthen stiff,
tightly contracted muscles. A surgeon can also place arms or legs in better positions or correct or
improve an abnormally curved spine. Sometimes, if other treatments have not worked, a surgeon
can cut certain nerves to treat abnormal, spastic movements. Before conducting surgery, it is
important for a health care provider to assess the procedure’s benefits by carefully analyzing
biomechanics of the joints and muscles.

References
 https://www.ninds.nih.gov/health-information/disorders/cerebral-palsy
 https://www.cdc.gov/ncbddd/cp/diagnosis.html#:~:text=An
%20electroencephalogram%20(EEG)%2C%20genetic,is%20a%20few%20years
%20older.
 https://www.mayoclinic.org/diseases-conditions/cerebral-palsy/diagnosis-
treatment/drc-20354005
 https://my.clevelandclinic.org/health/diseases/8717-cerebral-palsy