CEREBRAL PALSY: ASSOCIATED PROBLEMS

Mental Retardation

It has been estimated that more than one half of children with cerebral palsy have problems with intellectual functioning (thinking, problem solving). Many are classified as mentally retarded, while others have average abilities with some learning disorders. Some have perfectly normal intelligence.

Seizures

One out of every three people with cerebral palsy has or will develop seizures. (Some start having them years after the brain is damaged.) Fortunately, these seizures can usually be controlled with anticonvulsant medications.

Vision Difficulties

Because the coordination of the eye muscles is often affected by the brain damage, more than three out of four children with cerebral palsy have strabismus, a problem with one eye turning in or out, with or without nearsightedness. If this problem is not corrected early, the vision in the affected eye will get worse and eventually will be lost permanently. This makes it extremely important to have your child's eyes checked regularly by your pediatrician.

Limb Shortening and Scoliosis

Of those children with cerebral palsy affecting only one side of the body, over half will develop a shortening of the involved leg and arm. The difference between the legs is rarely more than two inches, but an orthopedic surgeon should be consulted if shortening is noticed. Depending on the degree of difference between the legs, a heel or sole lift may be prescribed to fit into the shoe on the shorter side. This is done to prevent a tilt of the pelvis, which can lead to curvature of the spine (scoliosis) when standing or walking. Sometimes surgery is required to correct a serious degree of scoliosis.

Dental Problems

Many children with cerebral palsy have more than the average number of cavities. One reason may be that it is difficult for them to brush their teeth. However, they also have enamel defects more frequently than normal children making their teeth more susceptible to decay.

Hearing Loss

Some children with cerebral palsy have a complete or partial hearing loss. This most often happens when the cerebral palsy is a result of severe jaundice at birth. If you find that your baby does not blink to loud noises by 1 month or is not turning his head toward a sound by 3 months to 4 months, or is not saying words by 12 months, discuss it with your pediatrician.

Joint Problems

In children with spastic forms of cerebral palsy, it is often difficult to prevent "contracture," an extreme stiffening of the joints caused by the unequal pull of one muscle over the other. A physical therapist, developmental pediatrician or physiatrist (doctor of physical medicine) can teach you how to stretch the muscles to try to prevent the onset of contracture. Sometimes braces, casting, or medication may be used to improve joint mobility and stability.

Problems with Spatial Awareness

Over half the children with cerebral palsy affecting one side of the body cannot sense the position of their arm or hand on the affected side. (For example, when his hands are relaxed, the child cannot tell whether his fingers are pointing up or down without looking at them.) When this problem is present, the child rarely will attempt to use the involved hand, even if the motor disability is minimal. He acts as if it is not there. Physical or occupational therapy can help him learn to use the affected parts of his body, despite this disability.