Cerebral Palsy (CP) is a permanent movement and posture disorder due to damage to the brain that continues its development. The lesion in the brain creates problems in muscle tone and coordination, and secondary disorders in the musculoskeletal system develop over time. CP is seen in brain lesions that occur before birth, during birth, or in the early postnatal period. Although the early development period of the brain is the first 18 months, all non-progressive brain lesions that occur up to the age of 6 can be defined as CP. Apart from neuromotor control disorder, CP may also have visual, speech, swallowing and cognitive dysfunctions. Epidemiology Although it varies from country to country in the world, the average incidence is 2-3/1000. In narrow-scale studies conducted in Turkey, this figure is reported as 8/1000. The incidence of CP has not decreased much in the last thirty years, despite the development level of countries and advances in medical technology. This situation is attributed to the fact that premature and low birth weight babies, whose survival rate was low in the past, are being kept alive today.
Problems may vary from mild to severe.
There is no method that completely cures the disease. However, the aim is for affected patients to meet their own needs, sit, walk, go to school on their own, and have a job, depending on their degree of impact.
Problems That May Be Seen in Cerebral Palsy:
Difficulty in movement
Spasticity (excessive tension in the muscles)
Weakness in the muscles
Balance defect
Involuntary movements
Intelligence problems
Attention and perception disorders
Seizures
Visual impairment and strabismus
Hearing problems
Speech difficulty
Feeding disorder and growth retardation
Physical disability (balance and movement difficulties) Social and Mental disorders (making friends, low morale, behavioral disorders)
EARLY SYMPTOMS
BETWEEN 0-1 MONTHS
- Sucking disorder, excessive vomiting p>
- Money Transfers.
2. month
-Abnormal contractions in the muscles.
3rd month
-When placed on the back standing on head and heels like a bow.
4. ay
-Inability to hold the head
-Removing the thumb from the palm and holding the hand into a very hard fist
-permanent strabismus.
8th month
-Lack of turning and sitting
-Inability to hold the head
-Legs crossing each other while sitting
-Do not push both legs when kicking.
10 months.
- Lack of ability to stand up by holding on
- Not responding when called by name
- Crossing legs when standing up
- Oral excessive drooling.
1 Year Old
- This is the period when diagnosis is easiest.
Muscle Weakness
Along with difficulty in movement, there is almost always muscle weakness. Especially children with weak trunk muscles cannot hold their heads and fall forward while sitting. In addition to excessive tension in the arm and leg muscles, there is also weakness and weakness.
Spasticity
Excessive tension and contraction in the muscles is called spasticity. A spastic child is not a child with mental retardation, as it is known among the public, but a child who cannot control his movements due to tension in his muscles. Spasticity makes the child's care difficult or movement difficult.
Treatment Plan:
Physical therapy should be started as soon as the diagnosis is made. Aim; To increase muscle, joint balance and coordination development and to prevent contractures that may occur.
Treatment should be checked and treated regularly for accompanying pathologies (convulsions, vision problems, hearing problems, malnutrition, dental problems).
>Reducing muscle contractions by performing rhizotomy in some selected patients by neurosurgeon.
Physical therapy should continue with the harmony of the family, physiotherapist and child from the moment the diagnosis is made.
Orthopedic interventions;
Until the age of 5
-
Botox application when necessary
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If there is a bone and joint disorder, according to the examination and x-ray results, Surgery can be done.
After the age of 5
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Soft tissue release surgeries (Muscle and tendon lengthening)
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Tendon transfers (adjusting the muscle balance by transferring the tendons that move the joint to another place) is detected)
-
Dislocation surgeries (surgeries for radius head dislocation in the hip and elbow)
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Arthrodeses (deterioration and smoothness in the joints) Surgeries performed only to fix the affected joint due to the inability to use it)
Purpose of Treatment:
Depending on the affected state of the child with cerebral palsy, correcting the posture, facilitating care, increasing better mobility, ensuring independent movement and improving social relations in society. This should only be possible with teamwork and the participation of many branches (physical therapy, orthopedics, psychology, child neurology, etc.), the child's family and the child himself. .
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