Pregnant women are just as careful and caring for their babies as the ones who have given birth. However, there are some circumstances which lead to irreversible consequences outside of their control. One of these is cerebral palsy, also known as brain paralysis. The most common result of cerebral palsy is spasticity, which involves restriction of muscle movements. Encountered in premature babies in particular, cerebral palsy can occur during pregnancy, birth or the neonatal period. Professor Memet Özek, a pediatric neurosurgery specialist at Acıbadem Kozyatağı Hospital, provides information on cerebral palsy, which is caused by permanent damage in the brain, and cerebral palsy-associated spasticity.
Infections in the brain tissue of the baby due to infections in the mother, as well as embolisms and hemorrhages that occur while the baby is in the womb are among the causes of cerebral palsy that develops during pregnancy. In Turkey, the most common cause of cerebral palsy in a baby is lack of sufficient oxygen supply during birth. The brain tissues of babies who are born blue, as well as babies whose umbilical cords get stuck around their necks and babies who are unable to cry right after birth, are the ones that suffer injury due to insufficient oxygen supply. The most common problems leading to cerebral palsy during the neonatal period, on the other hand, are infections such as meningitis.
It is possible for parents to detect cerebral palsy in the early stage (0 to 9 months) by observing the differences in the natural movements of the child. Babies with this condition either have hypotonia, which limits arm and leg movements due to low muscles tone and makes them look “floppy”, or spasticity, which limits movements due to muscle stiffness. The brain tissue of such children fails to move the limbs at the desired speed. Delays in development can also be signals indicating the disorder. For instance, failure to control the head at the end of the 3rd month, sit down with support at the 5th or 6th month and sit down without support at the 7th or 8th month are good causes for suspicion.
If the baby has been born before the end of 30 gestational weeks…Just like any other disorder, early diagnosis and treatment is very important in cerebral palsy as well. In babies who are growing and developing, the functions of the dead cells in the brain, which cause cerebral palsy, can be transferred to the surrounding cells; this method is referred to as “neuroplasticity”. This can only be done if rehabilitation practices are started very early. In babies with serious risk, the rehabilitation can even be started in the incubator. The rate of incidence for cerebral palsy is particularly high in babies born before the end of 30 gestational weeks and babies who have brain hemorrhages during premature birth. Therefore such babies need to be treated as potential patients. Definitive diagnosis requires brain MRI.
The treatment of babies diagnosed with cerebral palsy-associated spasticity begins with physiotherapy. If the condition is mild, it is possible to overcome it with physical therapy. What is important here is for physical therapy to be performed regularly, every day. In such cases, the problem is resolved without need for any additional treatment. However, in cases where it is believed that the condition cannot be resolved with physiotherapy only, surgical options are available. It is essential for the surgical interventions for spasticity to be performed without delay. Spasticity operations should not be postponed until after the ages 3 to 6. On the other hand, interventions that are too early and orthopedic interventions that are performed before the age of 7 or 8 should also be avoided. In other words, if the treatment fails to be performed on time, spasticity will pose even more problems as the child grows. Spastic muscles fail to grow as the child ages while the bones continue to develop naturally. Therefore, the restriction of movement becomes worse as the child gets taller.