Cerebral palsy (CP) is the diagnosis given to a collection of symptoms caused by an injury to the brain that impacts (among other things) muscle control. CP has many causes (including hypoxia during labour and delivery), a wide range of manifestations, and no known cure.
If your child has been diagnosed with CP what type of treatment will they need?
Every Child is Different
Because the symptoms of CP can be different in every person, treatment must be individually tailored, incorporating a series of therapies, assistive devices, medications, and sometimes even surgery to help improve physical function and raise the quality of life for child with CP.
Cerebral palsy often occurs when the brain is damaged before or during birth. This type of newborn brain injury is called hypoxic-ischemic encephalopathy (HIE). Not all HIE injuries cause cerebral palsy, but it is among the most well-known causes of this type of injury. A lack of oxygen to the brain during labour and delivery is one of the common causes of HIE. The lack of oxygen can happen when your baby gets stuck during delivery (shoulder dystocia), it can be caused by umbilical cord compression which prevents blood flow to the fetus’s brain, or it can happen if the mother suffers a ruptured uterus or other trauma.
Some cases of CP are caused by injuries that happen after the child is born. This is called acquired cerebral palsy.
A Team of Specialists is Required
No matter the cause or type of cerebral palsy, treatment often requires a collaborative effort among medical specialists, therapists, family members, and the patient. While outward physical symptoms may receive the most attention, internal ailments, and emotional health cannot be forgotten in any treatment plan.
Physical impairments — including muscle weakness or stiffness, spasms, poor motor skills, and problems swallowing or focusing — are considered the early signs of a cerebral palsy diagnosis. As such, physical therapy is the centerpiece of most treatment plans. A physical therapist can help a child to control pain while improving strength, flexibility, and mobility.
Depending on the way in which CP impacts someone, the physical symptoms can have a series of related effects that can also be mitigated with physical and occupational therapy. For example, if a child struggles with chewing and swallowing, therapy can help the child eat and digest food, improving overall health and energy levels.
Related therapies can further enhance independence. Speech therapy and occupational therapy may improve communication skills and the ability to perform basic tasks that can lead to self-sufficiency and even employment.
Ongoing therapeutic treatment is just one piece of the puzzle. Other approaches include:
- Assistive devices;
- Complementary and alternative medicine;
- Medication; and
- Surgery
Assistive devices may be technological — hearing aids, communication boards, and eye tracking devices, for example — or analog, including braces, orthotics, bathing benches, and even adaptive sports equipment.
Complementary and alternative medicine are similar, in that they have not been fully tested or approved by Health Canada or other recognized governing bodies. They are seen as complementary when they support traditional methods, and as an alternative when they replace those methods. These treatments include massage, acupuncture, energy work, aqua-therapy, and almost any other non-traditional modality.
Medication only treats cerebral palsy symptoms and cannot reverse the brain injury. Different classes of commonly prescribed drugs target muscle control, muscle spasms, stomach discomfort, and seizures. Antidepressants may also be used to support cerebral palsy patients as they cope with the limitations brought about by their condition.
Like medication, surgery treats symptoms and not the cause of cerebral palsy. Orthopedic surgery, especially on the lower extremities, is most common, but vision correction, hearing correction, and gastrointestinal relief are other goals of surgical treatment of cerebral palsy patients. An important consideration when opting for surgery is the ability to provide ongoing support to the patient during recovery and rehabilitation from any procedure.
Types of Cerebral Palsy Treatment
When thinking about treatments for cerebral palsy (CP), it is first important to understand that no two children are alike. The specific type of treatment that your child will need will depend on factors such as their type of cerebral palsy, level of impairment, the location of their movement problems, and whether they have any co-occurring conditions. Below, we have listed some of the more common CP treatments, and what you can expect from each.
Occupational Therapy for Cerebral Palsy
Occupational therapy is a specialized type of therapy that helps a person with a disability or medical condition improve their ability to perform everyday tasks.
At the start of treatment, an occupational therapist will evaluate a child’s perception, oral motor skills, and fine motor skills. This information is used to create a treatment plan, which may include help learning things like:
- Picking up small objects
- Brushing teeth
- Using pencils, pens, and crayons
- Writing
- Using scissors
- Fastening buttons and zippers
- Opening jars
- Brushing hair
During therapy sessions, a child may work on a range of skills, including grasping, reaching positioning, and releasing. These skills are often practiced through the use of play, which can make it more fun and motivating for kids. By practicing these movements, children with cerebral palsy may be able to live more independently.
Physical Therapy for Cerebral Palsy
Because CP is a movement disorder, children with cerebral palsy usually go to some form of physical therapy. The goal of this type of therapy is to improve independent motor function as well as muscle tone. The exact type of physical therapy utilized will depend on a child’s symptoms and diagnosis but may include work on balance, flexibility, posture, mobility, and strength.
At the start of any physical therapy program, the therapist will assess the child’s motor skills and mobility to develop a treatment plan. This plan will usually include a combination of stretching, muscle-relaxing techniques, and strength training. A child may use different types of equipment during sessions, such as weights, balance balls, and resistance bands to improve muscle tone, and hot and cold packs to relax and heal muscles.
As spastic cerebral palsy is often associated with complications such as scoliosis and contractures, physical therapists will work to address symptoms as they arise to avoid these issues worsening. For children with “loose” muscles and hypotonia (low muscle tone) due to dyskinetic cerebral palsy, strength training is often emphasized.
Orthotics
Orthotics are often an important part of treating cerebral palsy. They can include a number of assistive devices, such as splits, braces, and casts. These types of devices can encourage mobility, proper physical growth, and balance.
Speech and Language Therapy
Many children with cerebral palsy have difficulties with speech, as the part of their brains that controls speech and the oral muscles may have been impacted. Speech therapy can help children with CP communicate more effectively by improving language and oral skills.
At the same time, speech therapy can address other issues related to the mouth and oral muscles. Some types of brain damage can make it more difficult for a child to eat, particularly when it comes to chewing and swallowing food. A speech therapy program can help to manage these issues.
Recreational Therapy
Recreational therapy can provide social, emotional, and physical benefits. It can include any type of adaptive recreational therapy, such as therapeutic horseback riding or swimming. These and other types of exercises can be incredibly helpful for overall well-being.
Medications
For children with cerebral palsy, medications may help to reduce muscle tightness, treat pain, and manage complications associated with CP. The exact medication will depend on your child’s condition and symptoms. It may include:
- Muscle relaxants to ease spasticity, are taken either orally or through a pump that has been surgically implanted.
- Medicine to reduce drooling
- Muscle or nerve injections to treat the tightening of a specific muscle
Medications can be used to control a range of symptoms, including acid reflux, incontinence, involuntary movements, seizures, tremors, spasticity, and respiratory disorders.
Surgery
Not every child with cerebral palsy will be a good candidate for surgical procedures. However, particularly for children who suffer from spasticity, surgery may be helpful to lessen muscle tightness or correct bone changes.
Surgical treatments may include orthopedic surgery to lengthen muscles, lengthen or reposition tendons, or to place bones or joints in the correct positions. This type of surgery can reduce pain and improve mobility.
Another type of surgery known as selective dorsal rhizotomy involves cutting nerve fibers for spastic muscles. This procedure then relaxes the muscles in the affected area, which can make it easier to walk or move and can reduce pain.
Alternative Therapies
Because each person with cerebral palsy is different, there is no one-size-fits-all approach to treatment. Depending on your child’s situation, they may benefit from other therapies, such as acupuncture, music therapy, hippotherapy (horse or equine therapy), or aquatic therapy. A cerebral palsy specialist can work with you to find complementary therapies that can help to improve fine motor skills and mobility while reducing pain and spasticity.
Treatment for Co-Existing Conditions
Many children with cerebral palsy have co-occurring conditions as a result of their brain injury. They may receive a number of different treatments designed to address these specific conditions.
For example, epilepsy is incredibly common among children with CP. If your child suffers from epilepsy or another seizure disorder, they may be prescribed medicine or even have surgery to manage or reduce seizures.
Many children with CP also have intellectual disabilities due to brain damage. This is often treated with educational support as well as behavioral therapy and medication.
Other common co-occurring conditions include:
- Hydrocephalus, or a buildup of cerebrospinal fluid in the skull. This is usually treated by implanting valves to drain the excess fluid.
- Urinary tract infections, commonly occur due to issues with bladder control and constipation because of a lack of muscle control. Frequent baths and diaper changes can reduce the frequency of these issues.
- Gastrointestinal issues, such as acid reflux, can be controlled with medication and special eating techniques.
- Dental issues, including underbites, overbites, enamel defects, and tooth decay are often a problem for children with CP due to an inability to control muscle movement in the mouth. Oral surgeons and orthodontists can often help.
- Hearing and/or vision impairment, caused by brain damage before, during, or after birth can be treated with surgical procedures, glasses, hearing aids and/or cochlear implants.
How the Birth Injury Lawyers Alliance Can Help
Cerebral palsy is not always caused by medical negligence. However, if a medical professional fails to meet the standard of care during pregnancy, labour and delivery, and/or after birth, then they may be held responsible for any injuries that result – including cerebral palsy.
If you believe that your baby may have cerebral palsy from a preventable birth injury, a birth injury lawyer can advise you of your legal options. Call the Birth Injury Lawyers Alliance (BILA) today at 1-800-300-BILA or fill out our online contact form to schedule a free initial consultation with a lawyer in your province.
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