Cerebral palsy (CP) is a disorder that permanently affects the brain’s ability to control movement. We’ve all heard of it, but did you know that, according to the Centers for Disease Control and Prevention, it is the most common motor disability in childhood?
CP is seen in approximately 1/100 to 1/250 live births. It is non-progressive, meaning that once a child is born with the symptoms, they will not become worse; however, it is typically a life-long disorder with distinct impacts on a variety of aspects of one’s life.
The term cerebral refers to the brain’s cerebral cortex, which is the part of the brain that controls movement and balance. Palsy refers to complete or partial muscle paralysis. CP occurs when the brain does not develop normally during fetal development. The prevailing medical view is that most cases of CP are caused by injuries occurring before, during, or after birth. More recent discoveries, however, have pointed to genetics playing a more significant role in CP than previously thought.
Types of cerebral palsy
There are three types of CP: spastic, dyskinetic, and ataxic. The most common form, spastic CP, is characterized by muscle stiffness and is caused by damage to the brain’s motor cortex. Dyskinetic CP is characterized by abnormal movements and is caused by damage to the basal ganglia of the brain.
The least common form comprising CP is classified as ataxic. Ataxic CP is caused by damage to the cerebellum, the balance center of the brain. Approximately 5-10% of all cases of cerebral palsy are classified as ataxic cerebral palsy.
What does ataxic cerebral palsy look like?
Just from the name, one can infer that CP could cause problems with the brain and muscles. The extremities, speech, eye movement, and even swallowing can be limited by ataxic CP. An individual whose upper limbs are affected may have difficulty clapping due to shakiness in the arms and hands. Daily tasks such as writing or typing also may prove to be difficult.
When the lower limbs are affected, walking can become a special challenge. A child with ataxic CP may walk later than his or her peers and have other delays in motor development. Once walking is achieved, it is typically unstable due to poor balance.
What have we learned recently about the causes of CP?
Twenty to thirty years ago, only a small percentage of CP was thought to have a genetic component; however, within the last few years, research in genetics has continued to reveal that individuals diagnosed with CP may have an underlying genetic diagnosis.
In 2015, scientists even learned that up to 14% of individuals with clinically diagnosed CP had a potentially disease-causing gene variant. Their work is published in the Nature journal Molecular Psychiatry. While prematurity, low birth weight, infections, and hypoglycemia have been considered risk factors for ataxic CP, studies have suggested that more than 50% of ataxic cerebral palsy cases have a genetic origin.
More recently, research has pointed to paternal age as a risk factor for sporadic cases of ataxic CP.
What type of diagnostic testing is available?
With the advance of neuroimaging and genetic testing, diagnostic testing is becoming more accessible for individuals with CP.
Neuroimaging, such as a brain MRI, is recommended for individuals with findings suggestive of CP. It can help clarify whether a patient sustained an injury to the brain and also may contribute to determining the underlying etiology of CP if any brain abnormalities are present.
In addition to neuroimaging, genetic testing is becoming more common for individuals with CP. According to the International Standards for Cytogenomic Arrays Consortium, current evidence points to using a chromosomal microarray as a first-tier genetic test for all patients with unexplained developmental delays. If microarray results do not identify an underlying diagnosis, whole exome sequencing may be offered. This type of testing has been shown to identify an underlying genetic diagnosis in 41% of individuals in a child neurology practice.
There are a variety of recognized benefits to determining the cause of CP in a child. Understanding the cause of CP may change medical management, help connect families with appropriate support groups, as well as provide a family with information on the risk of having a child with CP in the future.
What to do if your child was injured
A cerebral palsy diagnosis can bring up all sorts of issues, least of which may be legal. Most CP cases aren’t preventable. However, when your child’s CP is the result of brain damage caused by negligence or error on the part of your doctor or medical team, it can be devastating. Your doctor may have missed obvious signs of a problem, or failed to perform a standard diagnostic test. Or maybe your child’s CP was caused by asphyxia, when your doctor should have performed a c-section.
If your child has cerebral palsy and you believe it may have been caused by a medical professional, you should speak with an experience birth injury attorney right away. Although it varies by state, typically you need to file a claim within two to four years of the injury.
Even if you aren’t sure your child’s cerebral palsy was the result of medical negligence or malpractice, it’s a good idea to talk with someone who is skilled in birth injury law. Contact us today to learn how Safe Birth Project can help.