American Medical Association Family Medical Guide - American Medical Association [186]
Symptoms
The symptoms of cerebral palsy can range from mild to severe, can differ from child to child, and can change over time. In most cases, lack of normal muscle tone and muscle control makes it difficult for an affected child to maintain balance and to coordinate and control his or her movements. A baby with cerebral palsy may have difficulty sucking and swallowing. Normal developmental milestones (see page 377), such as rolling over, sitting, crawling, smiling, speaking, and walking, usually are delayed. Muscle stiffness, spasms, or poor muscle tone in the arms and legs cause many children with cerebral palsy to adopt unusual body postures or to perform involuntary limb, body, mouth, tongue, or facial movements. Because the brain damage that causes cerebral palsy can disrupt the electrical activity of the brain, some children have seizures (see page 686).
Some children with cerebral palsy have vision, hearing, or speech problems. Many affected children have normal intelligence but may have a learning disability. About half of all children with cerebral palsy have some degree of mental retardation.
Diagnosis
To diagnose cerebral palsy, a doctor takes a complete medical history and performs a physical examination that includes testing a child’s motor skills and reflexes. The doctor will ask you to describe how well your child can move about and will ask you questions to determine if your child has reached specific developmental milestones, such as sitting, crawling, standing, or walking. The doctor may recommend blood tests, genetic tests, a CT scan (see page 112), or an MRI (see page 113) to help make a diagnosis.
Treatment
Treatment for cerebral palsy focuses on helping the child overcome the disabilities caused by the disorder (or minimizing their effects) so the child can reach his or her full potential. After evaluating the type and extent of a child’s disabilities, the doctor will recommend appropriate measures, such as special education, physical therapy, occupational therapy, speech therapy, or counseling.
Speech therapy can improve the child’s ability to speak and swallow. In some cases, a feeding tube may be needed to help ensure proper nutrition and to help prevent food from entering and blocking the airway. Surgery is sometimes performed to correct bone and joint deformities, enabling some children to walk with braces, crutches, or a walker. Some doctors prescribe muscle-relaxing medication to control involuntary movements and to make movement easier. These medications can be given by mouth, injected directly into the muscles, or delivered directly into the cerebrospinal fluid (the fluid that surrounds the brain and spinal cord). Doctors also may prescribe anticonvulsants to help prevent seizures. Surgery performed on certain spinal nerves may help decrease stiffness. Hearing problems can be improved with hearing aids (see page 1018). The doctor may recommend prescription eyeglasses or surgery to correct misaligned eyes (see page 1055).
A child who has cerebral palsy should be examined regularly by a doctor to monitor his or her general physical and mental progress. Your doctor can recommend steps you can take to help your child reach his or her full potential and to enhance the quality of his or her life. Caring for a child with cerebral palsy can be demanding and stressful. Ask your doctor or a hospital social worker about support groups and other organizations that can help you and your child.
Febrile Seizures
A febrile seizure is a disturbance in the electrical activity of the brain caused by the rapid onset of a high fever in infants and children. Febrile seizures are very common, affecting 4 to 10 percent of all children between ages 6 months and 5 years. Febrile seizures can be simple or complex. A simple febrile seizure, the most common type, lasts 1 to 5 minutes and affects the entire body. Complex febrile seizures last