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Submitted by PatientsEngage on 16 April 2015

As we wait for Kalki Koechlin’s portrayal of a gutsy girl with Cerebral Palsy in the award-winning film Margarita with a Straw, we find out more about the condition from rehabilitation specialist Lakshmi Gopalakrishnan. The film releases on 17th April 2015. 

Cerebral Palsy is a birth-related disorder that affects the brain and nervous system. The nerve damage causes difficulties in the child’s movement, coordination, posture and ability to walk. It can also affect speech, cognitive ability, vision, and cause epilepsy. 

What causes Cerebral Palsy (CP)?

Cerebral palsy results from damage to certain parts of the developing brain. This damage can occur early in pregnancy when the brain is just starting to form/ during the birth process as the child passes through the birth canal / after birth in the first few years of life. 

In many cases, the exact cause of the brain damage is never known.

Prenatal (before birth): At least 70-80% of cases of cerebral palsy begin before birth. 

It can be caused by:

• Infections in the mother -German measles, other infections

• Accident /trauma

• Smoking, alchohol, drugs 

• Amniotic fluid disorders (less than 300 ml or more than 2 litres of amniotic fluid are known to cause disorders)

• Umbilical cord around neck

• Insufficient placenta

• Multiple pregnancy

Perinatal (during birth)

• Premature birth

• Prolonged labour

• Forceps delivery

• Lack of oxygen

Post natal (after birth) 

• Severe jaundice

• Seizures

• Meningitis/Encephalitis 

• Low sugar

• Head injury

Cerebral Palsy is NOT 

• Contagious

• Progressive

• Usually hereditary

• Primary cause of death

Types of CP

Muscle tone is the amount of tension or resistance-to-movement in a muscle. Muscle tone is what helps us to keep our bodies in a certain position or posture. Changes in muscle tone are what enable us to move. The brain damage in CP directly affects the muscle tone.

According to the effect on the child’s muscle tone, CP can be classified as follows:

 Spastic-Tense, tight muscles (most common type of C.P). High muscle tone.

  Hypotonic-Floppy; low muscle tone.

  Athetoid - Constant, uncontrolled (involuntary) motion of limbs, head, eyes. Muscle tone fluctuates from high to low. 

 Ataxia - Poor balance, often causing falls and stumbles. Walks with wide based gait. (Low muscle tone)

  Mixed – Spastic-athetoid. 

What is the treatment for children with CP? Can CP be cured?

Drugs and surgery cannot cure this condition. A child with CP will become an adult with CP.

Early detection and training is vital. Early intervention of a child with cerebral palsy focuses on speech, movement and education. This is carried out by Physiotherapists, Occupational and Speech Therapists and Special Educators. 

Medication is used sometimes to treat very spastic muscles (anti-spastic drugs) and to treat seizures (anti-epileptic drugs).

If the muscles get contracted (fixed in a position), surgery is performed to release the muscle, followed by physiotherapy.

Walking aids, mobility aids and orthoses are often used. Ex: Wheel chairs, walkers, sticks, knee and arm braces, special shoes, special furniture etc.

Life with CP

With the right kind of support from family, professionals and the community, a person with CP can lead a fulfilling life; he can attend a mainstream school, college and take a suitable job in an office/pursue a profession; he can learn a skill and use it professionally; he can have as many choices as any other person without Cerebral Palsy.

The Rights of Persons with Cerebral Palsy are the same as that of any other person. 

For example Right to Life with Dignity, Right to Information & Communication, Right to recreation, Right to Education, Right to Mobility, Right to Health, Right to Family Life and so on. 

For stories of young people with CP, who attended Vidya Sagar, an NGO in Chennai working with people with neurological impairments, visit http://www.vidyasagar.co.in/alumni/#/Profile

Pic of Lakshmi with Abhishek who now works for an NGO raising funds for people with communicable diseases

Lakshmi Gopalakrishnan is a Special Educator and Rehabilitation specialist with 17 years of experience in the field of disability. She worked at Vidya Sagar, an NGO that provides services for people with neurological impairments, Public Health Centre and Children's Hospital, Chennai. She lectures on disability and psychology.

 

Condition

Stories

  • Empowered families encourage better development in the child
    Tamahar not only tries to develop the children with various activities, it also brings the family, the primary caregivers, into its fold to help them grow and learn with the children. Vaishali Pai is a visionary and an experienced occupational therapist who set up the Tamahar Trust in 2009 to help children with special needs find their own little spaces in this world. She shares how she would like Tamahar to reach out to more children in future. Tell us briefly the thoughts behind forming…
  • Early Detection Key to Managing Cerebral Palsy
    On World Cerebral Palsy Day, we speak to Joyeeta Sen, a senior special educator and Priti Salunkhe, a senior neurodevelopment therapist with Ummeed Child Development Center regarding child development and learning for children with the condition. What is the average age of a child with CP when first brought in? At Ummeed children with Cerebral Palsy varies anywhere from 3 years to 10 years but the average age would be between 3-4years. However, as part of early detection and early intervention…
  • Bhavna is person with cerebral palsy in a red and white dress on a wheelchair
    I follow my heart
    Bhavna Botta, a young serial entrepreneur with cerebral palsy, had her dream project, Saahaagika, an exclusive boutique for ahimsa silk, washed away in the recent rains and floods in Chennai. Broken but not beaten, she looks for strength, motivation and new avenues to start afresh. Could you tell us a bit about your journey and how you became an entrepreneur? I finished my high school from Vidya Sagar and went on to do higher secondary from Lady Andal Matriculation School, Chennai and then…
  • Accessibility For All at Vaccess Expo
    By  Lakshmi Gopalakrishnan, a Special Educator and Rehabilitation Specialist Vaccess, a two day Expo, represents Vidya Sagar, a Chennai centre for the disabled, and its constant and persistent efforts towards Accessibility for people with disabilities. As the founder Poonam Natarajan put it so crisply, “In the past, this was understood only as the need for physical access. It meant building ramps, railings and pathways for people with visual impairments, special features in toilets,…
  • Do not assume a person with a disability needs your help
    Says Hans Dalal, who has not let cerebal palsy get in the way of his independence and dreams. The tiger conservationist and founder of PROWL (Preservation of Wild Landscapes) talks about social attitudes, self-reliance and what it takes to bring up confident kids with disability. In conversation with Dr Shital Raval. You have said that human ignorance is the toughest to beat. Society is unaware of cerebral palsy and hence more than often mistake it for mental retardation and consider me dumb or…
  • Prevention of Cerebral Palsy
    In cases where the cause of cerebral palsy is unknown, nothing can be done to prevent it. However some cases relate to pregnancy complications and brain injuries. Pregnancy Complications Try and minimise these by ensuring appropriate prenatal care, trying to stay healthy during a pregnancy, avoid low birth weight, premature birth,  Brain Injury Try and ensure that the baby does not have head injuries at very early stages.  Make sure you take the baby to a doctor after a fall …
  • Management of Cerebral Palsy
    Cerebral palsy affects each person differently. The person may lead a fairly normal life with little assistance or need help with everyday activities. For instance, they may suffer from an inability to control body movements, have problems with balance and seizures, may have trouble swallowing or speaking, or may be intellectually impaired. You will need to tailor the care to the needs of the person. You may need to consider some of the following: Understand the patient's communication style.…
  • Cerebral Palsy Treatment
    Treatment includes: Treatment to improve movements Drugs for medical problems Surgical approach  Treatment to improve movements: Physiotherapy The child may need physiotherapy, sometimes throughout his life. The aim of physical therapy is to: Encourage motor development Improve the ability to move all parts of the body Promote, maintain and restore physical, psychological and social wellbeing. Equipment used to improve movements include: Devices to maintain normal posture of the child…
  • Cerebral Palsy Diagnosis and Tests
    Cerebral palsy is diagnosed based on the child’s medical history and physical examination, like the infant’s motor skill and symptoms. Brain imaging technologies can reveal areas of damage or abnormal development in the brain. The tests include: Radiographic tests: Magnetic resonance imaging (MRI): An MRI uses radio waves and a magnetic field to produce detailed 3-D or cross-sectional images ofthe brain. An MRI can often identify any lesions or abnormalities in the brain. Cranial…
  • Types of Cerebral Palsy
    Types of cerebral palsy Based on severity: Categorised into mild, moderate and severe Mild:  Daily activities are not affected and child can move without assistance Moderate: Child needs assistance like medication and adaptive technology to accomplish daily activities Severe: Child requires support and will have significant challenges in accomplishing daily activities Based on topographical distribution they are classified as: Monoplegia: One limb is affected Diplegia: Two limbs are…