A medical provider caring for an expectant mother and the fetus are responsible to assure that they provide adequate care during the pregnancy, during labor and delivery, and immediately after the delivery of the baby.
Failing to provide adequate care can result in the doctors and nurses being held accountable for medical negligence and the outcome of a pregnancy.
Some common forms of birth injuries arising from medical negligence or malpractice include:
- Cerebral Palsy
- Brachial Plexus and Erb’s Palsy
If you have recently given birth to a child with Cerebral Palsy, Brachial Plexus Palsy or Erb’s Palsy you are probably wondering just what went wrong and when. Let us help you find out what really happened. If you suspect that medical negligence has been a factor in your child’s birth injury, you should contact us immediately. You may be entitled to compensation by filing a birth injury lawsuit and we can help.
What is Cerebral Palsy?
Cerebral palsy is a medical condition caused by permanent brain damage that occurs before, during, or shortly after birth. The effect of cerebral palsy, or CP, is characterized by a lack of muscle control and abnormal body movement. While it is not a progressive disease of the brain, the effects of cerebral palsy may change gradually over the years.
What is Medical Malpractice?
Medical malpractice occurs where a physician acts in a negligent manner when treating a patient’s condition. Malpractice can occur from an action taken by the medical practitioner, or by the failure to take an appropriate action. Examples of medical malpractice include:
- Failure to diagnose, or misdiagnosis of a disease or medical condition
- Failure to provide appropriate treatment for a medical condition
- Unreasonable delay in treating a diagnosed medical condition
Many physicians have taken the position that cerebral palsy is not and cannot be caused by doctors, and that it is virtually always caused by factors beyond the doctor’s control before the baby is born. This view, while not supported by credible research or literature, is nevertheless surprisingly common among certain physicians and nursing practitioners. To get a fair review of the probable causes of your child’s cerebral palsy brain injury, it is very important for the lawyer representing you to make sure that the professionals who review your case are free of such biases.
Types of Cerebral Palsy
There are several types of cerebral palsy because the term is broad and used to describe brain impairment caused at birth or in the first years of life that is typically marked by motor impairment and other hindrances. Cerebral palsy types are classified based on the types of motor impairments caused by this condition, and the parts of the body this impairment affects.
Cerebral palsy often occurs while the embryo is developing during pregnancy where some form of abnormal development or damage is caused to the brain. It can also result from a trauma that was caused during the birth process itself where, for one of many reasons, the infant was deprived of either blood or oxygen.
In either event, if the area of the brain affected controls muscle tone or motor activity, the baby will have a form of cerebral palsy. Parents who notice an apparent deviation from the developmental norm of their child should seek professional medical advice from an experienced clinic or medical practitioner.
To describe the particular area of the brain which was damaged and the types of movement which are challenged, medical specialists classify cerebral palsy into 5 broad categories:
- spastic cerebral palsy – Spastic cerebral palsy is the most common type of cerebral palsy, accounting for nearly 80% of all cases of the disease. Children with this type of cerebral palsy have 1 or more tight muscle groups which limit movement. Children with spastic cerebral palsy have stiff and jerky movements. They often have a hard time moving from 1 position to another. They may also have a hard time holding and letting go of objects.
- athetoid cerebral palsy – Form of athetonia marked by slow, writhing involuntary muscle movement. A mixed muscle tone where some are too high and others too low also characterize athetoid cerebral palsy. Damage to the basal ganglia, located in the midbrain, is the cause of this type of cerebral palsy. Approximately 25% of cerebral palsy patients are affected by athetoid cerebral palsy.
- hypotonic cerebral palsy – Form of the disorder marked by floppy (overly relaxed) muscles; hypotonic CP is rarer than the spastic forms of the disorder.
- ataxic cerebral palsy – The least common form of CP, affecting between 5-10% of those afflicted by the disease, caused by damage to the cerebellum which controls balance and coordination. The cerebellum also coordinates the movement of several groups of muscles. Ataxic cerebral palsy generally affects coordination of movement in an individual’s arms, legs, and trunk.
- mixed cerebral palsy – According to the U.S. Center for Disease Control (CDC), about 10% of all cerebral palsy patients have what is referred to as a mixed form of the disorder. Mixed cerebral palsy refers to cases in which patients display symptoms of 2 or 3 different types of cerebral palsy.
There may be a combination of these types for any one individual. Other types do occur, although infrequently. Cerebral palsy may be congenital, caused by injury during labor and delivery or acquired after birth. Children born with CP face many challenges throughout their lifetime, as they will often have to rely on the help of others to live a full and productive life. Depending on the nature and extent of the condition, children with cerebral palsy have anywhere between 90 and 70% chance of surviving past their 20th birthday.
Even though there is no cure for cerebral palsy, children afflicted with this terrible condition can lead productive lives and grow into mature, healthy adults. The reality is that these children have special needs, and depending on the level of their disability may or may not need constant supervision and assistance.
Diplegic Cerebral Palsy
Diplegia is a form of cerebral palsy primarily affecting the legs. Most children with CP will also have some problem with their arms, but with diplegia, they are less involved and less severe. Most children with diplegia have spasticity, and have difficulty with balance and coordination.
Spastic diplegic cerebral palsy tends to affect the legs of a patient more than the arms. Spastic diplegia CP patients have more extensive involvement of the lower extremity than the upper extremity. This allows most people with spastic diplegia cerebral palsy to eventually walk. The gait of a person with this type of CP is typically characterized by a crouched gait. Toe walking and flexed knees are also common attributes, and can be corrected with proper treatment and gait analysis.
The symptoms of spastic diplegia include spastic legs, meaning stiff or contracted. The legs are weak and walking is difficult. People with spastic diplegia often walk with a “scissor gait” caused by tight muscles in the hips and legs. The muscles become so tight, the legs want to turn inward and sometimes cross over each other at the knees. A spastic diplegia victim’s arm, face, and neck muscles are usually affected to a lesser degree than the legs. Outside of the physical characteristics of spastic diplegia, the disorder is often accompanied by mental retardation.
The goal of any treatment intervention for cerebral palsy is to increase joint range of motion by decreasing the individual’s rigidity or spasticity. Several modes of treatment have been developed to reduce symptoms of cerebral palsy. These include therapy or rehabilitation, tendon transfer surgery, selective posterior rhizotomy, as well as medicinal interventions. All of these treatments have been shown to be effective; however, each treatment plan is different, depending on the severity and etiology of the physical disability for each individual.
Dysphagia Cerebral Palsy
Dysphagia cerebral palsy is an incurable condition that makes it painful, difficult, and in some cases nearly impossible for a person to swallow. Usually a symptom of cerebral palsy that shows up shortly after birth, dysphagia causes a number of problems associated with eating, talking and breathing.
Dysphagia in cerebral palsy children is a result of a lack of coordination or weakness of the muscles associated with swallowing. An estimated 60% of cerebral palsy children experience dysphagia.
Dysphagia in cerebral palsy children may be exhibited by:
- drooping of the palate
- depressed gag reflex
- pooling of saliva in the pharynx
- weak cough
- poor control of the tongue
Choking and coughing while eating can be caused by this lack of coordination in swallowing, frequently followed by aspiration, or sucking food into an airway. Aspiration of oral contents introduces bacteria into normally sterile airways, resulting in pulmonary infection and lung damage.
Every year an estimated 60,000 people will die from dysphagia, mainly affecting cerebral palsy or stroke sufferers. New treatment methods are being researched to help dysphagia in cerebral palsy children all the time.
Most recently, a new electric procedure has been shown to help dysphagia. Over time, a device similar to the one used for electrical stimulation has been developed, which required extra care because the throat has so many arteries leading to the brain.
Congenital Cerebral Palsy
As the most common form of cerebral palsy, congenital cerebral palsy is an incurable form of brain damage that results in mildly to severely impaired cognition, speech, coordination and general movement. In the most severe cases, congenital cerebral palsy patients also suffer from epilepsy, mental retardation and paraplegia or quadriplegia.
Congenital cerebral palsy occurs when a baby’s brain does not develop normally in the womb, or when brain damage has occurred during development. There are many causes of congenital cerebral palsy, some of which are not completely understood. Genetic abnormalities sometimes cause brain malformation, but the majority of congenital CP cases result from brain damage due to fetal stroke, maternal infection, or medical malpractice on the part of doctors or medical staff. Good prenatal care can lower the risk of these conditions, but it cannot entirely prevent them.
Early signs of congenital cerebral palsy usually appear before a child reaches 3 years of age, according to the National Institutes of Health (NIH). Parents are often the first to suspect that their baby’s motor skills aren’t developing normally. Typically, a sign of cerebral palsy in infants is a developmental delay. They are slow to reach developmental milestones such as learning to roll over, sit, crawl, smile, or walk. Another sign of cerebral palsy in some infants is abnormal muscle tone, either hypotonia (relaxed) or hypertonia (rigid). Signs of cerebral palsy may also include unusual posture or favoring one side of the body when the child moves.
All infants, whether developmentally disabled or not, require the same basic care: nutrition, exercise and socialization. Early diagnosis of an infant’s cerebral palsy is beneficial. Once diagnosed, a cerebral palsy infant can begin the necessary treatments to improve motor skills and other capabilities. As soon as your infant is diagnosed with cerebral palsy, speak with your doctor about what special care your child will need. Doctors often refer parents to a pediatrician who specializes in the care of infants with cerebral palsy. It will take a team of professionals to determine the appropriate combination of therapy, health care and education for an infant with cerebral palsy. This extensive medical care can be horrifically expensive. You should contact a cerebral palsy attorney to help make sure your infant can afford the extensive care necessary.
Hemiplegic Cerebral Palsy
Hemiplegia is a form of cerebral palsy that affects one arm and leg on the same side of the body. For most children with hemiplegia, the arm is more involved than the leg and the end of the limbs have more problems. The wrist and hand have more physical problems than the shoulder, with the elbow literally somewhere in the middle. Similarly, the ankle and foot will exhibit more difficulties than the knee.
Hemiplegia is caused by damage to a part of the brain, which can occur before, during, or soon after birth, when it is known as congenital hemiplegia. If it occurs later in childhood (up to age 3), it is called acquired hemiplegia. Generally, injury to the left side of the brain will cause a right hemiplegia and injury to the right side a left hemiplegia. Childhood hemiplegia is a relatively common condition, affecting up to one child in 1,000.
Hemiplegic CP can cause trouble with walking; a patient may have difficulty with balance. Tasks using the hands such as writing or sewing may be difficult. The muscles on one side of the body may be stiff and weak (this is the most common symptom). Children with spastic hemiplegia may be developmentally delayed; they may not sit up, crawl, walk or talk as soon as other children do (this is another very common symptom).
Some individuals with hemiplegia may experience seizures. This form of CP can also affect the intelligence. Approximately 25% children with spastic hemiplegia have an IQ below 70 (mental retardation).
The treatment of hemiplegia is geared towards trying to develop maximum function of the paralyzed body. To prevent complications, the individual is placed on blood thinners to ensure that blood clots do not form. The primary therapy for individuals who have paralysis include entering a program of physical and occupational therapy. Those individuals who can’t speak may need to undergo speech therapy and learn how to speak, write and understand speech. Physical therapy is vital and may include daily living activities to keep the muscles stimulated and prevent joint contractures. Some individuals may benefit from anti spasmodic drugs to relieve muscle spasms. Sometimes the surgeon may have to relieve joint contractures to relieve the deformity from prolonged spasticity.
Athetoid Cerebral Palsy
Athetoid cerebral palsy is an irreversible condition in which brain damage to the midbrain (basal ganglia) causes patients to experience involuntary movements and abnormal muscle tone. Around 25% of all cerebral palsy cases are diagnosed as athetoid cerebral palsy, also known as dyskenetic cerebral palsy.
Of the different types of cerebral palsy, severe athetoid cerebral palsy is one of the least prominent. It is a strong form of athetonia, which is marked by slow, writhing involuntary muscle movement. A mixed muscle tone where some are too high and others too low also characterizes severe athetoid cerebral palsy. Approximately 10 to 20% of CP patients are affected by severe athetoid cerebral palsy.
Symptoms of athetoid cerebral palsy are generally caused by an inability to control muscle states of being tense versus relaxed. In most cases, symptoms include some combination of:
- eating difficulties
- difficultly holding posture (particularly with walking, sitting or doing anything that necessitates an upright posture)
- problems holding objects (such as pencils, eating utensils, etc.)
- slow, constant, writhing movements (while such involuntary movements typically affect the hands, arms, feet or legs, occasionally, they can also occur in the face or tongue)
- speech problems (due to an inability to control the tongue and vocal cords)
Physical therapy is the cornerstone of therapy for athetoid cerebral palsy and all other forms of CP. Therapy for school-aged children with CP is incorporated into the school day along with the appropriate educational experiences. This combination of school and therapy may be begun in early childhood.
Speech therapy can help improve communication skills. Some patients with athetoid CP have difficulty chewing and swallowing, and may benefit from therapy for these problems. Surgery many be used to correct or prevent limb deformities. Medications may help control or prevent spasms.
Alternative medicine practices such as massage and yoga have been found to ease symptoms for some CP patients, but caution should be used when selecting appropriate options; alternative therapies are a supplement to standard medical treatments for athetoid dyskinetic cerebral palsy and should be used only with the advice of qualified physicians.
Spastic Cerebral Palsy
Spastic cerebral palsy occurs when the cerebral cortex is damaged. It is the most common form of cerebral palsy, affecting 70 to 80% of patients. Spastic CP has varying forms, depending on the area of the body it affects, whether it is one side of the body or just the legs.
In normal cases, muscles function in pairs – one to send the signal to the brain, and the other to carry the brain’s command back to the concerned body area. Both work in tandem, one following the other, to ensure the desired free movement. In spastic CP, both sets of muscles become active together. Their messages flood the nervous system – the spinal cord, nerves, & neurons – and create a virtual traffic jam. This leads to tenseness in the muscle, which blocks simple movement. In spastic CP, the cerebral cortex and gray matter (where neurons are located) are damaged, causing the muscles to malfunction.
Although the exact symptoms of spastic cerebral palsy will vary according to the type and severity of a patient’s condition, in most cases, spastic cerebral palsy symptoms include:
- crossed eyes
- difficulties speaking
- learning disabilities
- ‘scissored’ gait
- vision problems
- dysfunction of tongue and/or mouth muscles (which is usually accompanied by drooling)
- toe-walking (the act of walking with all weight rolled onto toes and little, if any, placed on the heels)
The methods of treatment depend on the development of the patient and severity of the condition. For parents without medical knowledge, deciding on treatment can be very difficult, confusing and frustrating. Parents in this situation should consult with a team composed of a neurosurgeon and orthopedic surgeon, a neurologist, pediatrician, and a physical therapist.
Ataxic Cerebral Palsy
Ataxic (a-tax-ick) cerebral palsy is the rarest form of CP, affecting only 5 to 10% of people suffering from the disorder. While the main characteristics of other forms of cerebral palsy center on muscular contraction issues, the common traits of ataxic cerebral palsy are shakiness, poor balance, and an unsteady gait.
Ataxic cerebral palsy occurs when the cerebellum has been damaged, which causes a lack of coordination and jerky movements. It is not degenerative in nature and is not associated with other forms of ataxia. A child with ataxic cerebral palsy may have low muscle tone and look very unsteady and shaky. It can affect the child’s sense of balance, and one may observe that the child walks with his or her feet spread apart. You may also see some shakiness that resembles tremors. This can result in difficulties writing and performing tasks that require fine motor skills.
People with ataxic cerebral palsy experience a difficulty in keeping their limbs steady, called dysmetria. Reaching for objects can initiate an “intention tremor.” The tremor gets worse as the person’s hand gets closer to the object they are trying to reach. Difficulties with motor skills become much more pronounced the longer the person with ataxic cerebral palsy attempts motor specific tasks.
Ataxic cerebral palsy can be caused my mistakes made in the birthing process. Sometimes these mistake occur when the labor itself is mismanaged and danger signs are not caught by the doctors or nurses. Other times the injury can occur earlier in the pregnancy. Both situations may be the result of medical malpractice.
Mixed Cerebral Palsy
About 10% of children with CP have what is known as “mixed-type” cerebral palsy. These children have both the tight muscle tone of spastic cerebral palsy and the involuntary movements of athetoid cerebral palsy. This is because they have injuries to both the pyramidal and extrapyramidal areas of the brain.
There are several different forms of cerebral palsy including spastic, athetoid, and ataxic. While each one is devastating in its own way, mixed CP combines different types of cerebral palsy along with each individual type’s effect.
The signs and symptoms for mixed cerebral palsy include:
- Injury to the brain
- Athetoid movements
- Limited movements
- Stiff jerky movements
- Difficulty grasping objects
- Difficulty releasing objects
- Involuntary movements
- Speaking difficulty
- Feeding difficulty
- Reaching difficulty
- Grasping difficulty
- Involuntary grimacing
- Involuntary tongue thrusting
- Swallowing problems
- Slurred speech
- Exacerbation of involuntary movements when stressed
- Involuntary movements cease during sleep
- Low muscle tone
- Difficulty sitting
- Difficulty walking
- Difficulty maintaining posture
Mixed cerebral palsy is treated according to the symptoms present. Spasticity may be reduced with medications. Contractures (stiffened muscles which deform the bones or impair mobility) may be treated with surgery. Vision and hearing problems may be corrected or eased with assistive devices (eyeglasses, hearing aids, etc).
Hypotonic Cerebral Palsy
Hypotonic cerebral palsy describes a CP child with decreased muscle tone. The child will seem very relaxed, even floppy. Infants with hypotonia have a “rag doll” appearance because their arms and legs hang by their sides, and they have little or no head control.
By definition, hypotonic cerebral palsy refers to the brain’s two halves (cerebral), to any disorder involving impairment in control of bodily movement (palsy), and low muscle tone (hypotonic). Hypotonic cerebral palsy sufferers might seem floppy or unsteady when they walk. Additionally, hypotonic CP sufferers often have difficulty in maintaining posture while sitting or standing.
Unfortunately, hypotonic cerebral palsy is incurable. The effects of this condition are more pronounced in some patients than in others. However, hypotonic cerebral palsy does not, generally, get worse over time. There are several main causes of hypotonic cerebral palsy: acquired hypotonic cerebral palsy from head injury or asphyxiation, congenital hypotonic cerebral palsy from infections during pregnancy, jaundice, or lack of oxygen to the brain.
Most cases of hypotonic cerebral palsy are the result of brain injuries or infections acquired during prenatal development. A mother who has a serious infection, such as rubella or German measles, may transfer it to her fetus. Congenital spinal cord defects, premature birth, or oxygen deprivation during labor can also affect the brain’s ability to regulate muscle development and movement. Rarely, a serious brain injury acquired in the first year of life can cause hypotonic symptoms.
Depending on the degree of muscle involvement, an infant may need to stay in a critical care unit for several weeks or months. Babies who are able to breathe and swallow with minimal assistance may be allowed to go home. As infants continue to develop, muscle tone issues become more prevalent. They are typically small and frail, and have significant difficulties learning to speak and swallow solid food. Intelligence is usually not affected by hypotonic cerebral palsy, but communication issues can impair a child’s ability to learn.
Mild Cerebral Palsy
Mild Cerebral Palsy, if left untreated, is potentially more problematic than advanced cases of cerebral palsy. Mild cerebral palsy is often undetected in children as they are intellectually unaffected and are only physically limited.
Mild cerebral palsy is caused by a lower level of brain damage resulting in slight physical impairment. The symptoms are subtle and difficult to discern. Often symptoms are not as disruptive, and not apparent to the naked eye. Even parents and doctors are unlikely to recognize the symptoms of mild cerebral palsy, making early intervention difficult. This is unfortunate since early treatment tends to produce very positive results. Toe walking, for example, can be treated using specialized footwear to train motor skills.
Cerebral palsy affects each person differently, so it is hard to determine what any one person might (or might not) be able to do. Many people with mild cerebral palsy will be able to participate in almost any activity their peers do. Mild cerebral palsy sufferers will have more success in some kinds of activities more than others. For example, mild cerebral palsy children are better steered toward participating in sports like martial arts or swimming. Sports like football, baseball or basketball require a large amount of running, which can be difficult for people with mild cerebral palsy. Just as non-disabled people have different talents and difficulties, so do those with mild cerebral palsy. Take the time to ask questions and get to know people affected. They are people who have faced great challenges and survived.
Severe Cerebral Palsy
While patients with mild cerebral palsy may not need any special medical attention, patients with severe cerebral palsy may be unable to walk, suffer a number of related health conditions, and require extensive lifelong help. Due to the seriousness of a patient’s condition, those with severe cerebral palsy may have a significantly reduced life expectancy.
Sadly, babies born with severe cerebral palsy often have an irregular posture; their bodies may be either very floppy or very stiff. Birth defects, such as spinal curvature, a small jawbone, or a small head sometimes occur along with CP. Symptoms may appear or change as a child gets older. Some babies born with CP do not show obvious signs right away. Classically, cerebral palsy becomes evident when the baby reaches the developmental stage at six and a half to 9 months and is starting to mobilize, where preferential use of limbs, asymmetry, or gross motor developmental delay is seen.
The symptoms of severe cerebral palsy will depend on several factors, such as the exact area of the brain that is damaged and the severity of the damage. Symptoms may include a combination of the following:
- abnormally toned muscles (which an be under- or overly toned)
- an inability to perform tasks that require dexterity, such as writing
- bowel control problems
- difficulty speaking
- difficulty walking
- mental retardation
- paraplegia or quadriplegia
- problems with balance and coordination
- tremors, writhing and/or other involuntary movements
Cerebral palsy can be caused by any number of traumatic events, such as fetal infections, prolapsed umbilical cord, or congenital abnormalities. However, when medical professionals make mistakes that cause or worsen an infant’s brain damage and result in cerebral palsy, victims and their families will have a strong personal injury claim in which they will be able to seek financial compensation.
Cerebral Palsy in Children
Unfortunately, cerebral palsy is one of the most common congenital disorders in children. CP children are born two to four times for every thousand births, and usually have muscle problems and difficulty with motor skills. Children with cerebral palsy may also have issues with breathing, eating, bladder and bowel control, hearing, vision, and learning disabilities.
Cerebral palsy is a disability that affects children in the first few years of life. Children who have CP have trouble controlling their muscles and coordinating body movements. They may have stiff or weak muscles, which can cause them to make unusual muscle movements. Babies who have CP may take longer than usual to start rolling over, sitting up, crawling, smiling, or walking.
A child who has mild CP may have awkward movements but they may require little or no assistance. A child who has severe CP may not be able to walk, may have trouble speaking, and may require lifelong care and assistance.
Most children are suspected to have CP when they have a delay in their motor development. This is usually after six months of age, and many children with CP aren’t diagnosed until they are 18 months old. Some early signs and symptoms of CP can include excessive crying or irritability, feeding problems, excessive stiffness when dressing, changing diapers, or bathing.
Besides the movement and posture problems, children with CP can also have mental retardation, language disorders, learning disabilities, behavioral problems, seizures, poor growth, hearing and vision problems, and many have excessive drooling. The degree to which they may have these disabilities varies with each child.
Fortunately, in the past few decades, information on the many facets of cerebral palsy has significantly increased. Today, the medical community has great interest in studying cerebral palsy to determine its causes and the most effective ways to treat it. As knowledge and treatment techniques have expanded and improved, so too have the prospects of all children living with cerebral palsy.
Cerebral Palsy in Adults
Even though it is considered a non-progressive condition, secondary conditions usually found with cerebral palsy in adults – such as muscle tightness and other internal distress – can get worse over time. Due to certain physical limitations and emotional changes that come with age, specialized research on cerebral palsy in adults is critical.
Adults with cerebral palsy face unique challenges. They have to simultaneously deal with symptoms of cerebral palsy, and with the problems of aging. Additionally, there is very little information available about what to expect as you grow older with cerebral palsy. The focus of cerebral palsy research seems to have always been on how kids live with the disorder. Health professionals and researchers neglected to study aging issues associated with cerebral palsy because it is a non-progressive disorder. However, even though cerebral palsy doesn’t progress, aging does.
Health Concerns in Adults With Cerebral Palsy
The extra stress and physical strain an adult with cerebral palsy experiences is likely to result in symptoms of premature aging by the time they reach their 40s. This is in part due to organ systems having not developed properly because of developmental delays. Adults with cerebral palsy are at risk for conditions such as hypertension.
Additionally, the rate of depression is 3 to 4 times higher in adults with cerebral palsy and other disabilities than it is in non-disabled adults. This has less to do with the severity of the person’s condition and more to do with coping skills. How much support a person has, as well as their outlook on the future, all relate to the incidence of depression.
Sources of frustration may include having difficulties functioning in the workplace. As adults with cerebral palsy age, more accommodations may be necessary to continue working. Such adjustments may include: an adjusted work schedule, adaptive equipment, or frequently resting. Others may discover that early retirement is necessary.
Many of the concerns adults with cerebral palsy have with aging are the same we all must face, albeit with a certainly more challenging spin. With proper help, care, patience, and determination, any adult with cerebral palsy can live a functional, healthy, and long life.
What Causes Cerebral Palsy?
Some of the most common reasons that a baby is born with cerebral palsy include:
- Failure to understand and respond to the altering conditions of the fetus during labor
- Failure to take action on changes in the mother’s condition during pregnancy
- Failure to require specific tests during pregnancy and/or not interpreting the tests correctly
- Failure to carry out a cesarean section in the incidence of fetal distress
- Failure to induce when the membranes have been ruptured for too long
- Excessive use of vacuum extraction
- Lack of oxygen to the brain or trauma to the head during labor and delivery can also cause cerebral palsy. If an infant does not get enough oxygen the brain they can be seriously injured.
Chief among the causes is an insufficient amount of oxygen or poor flow of blood reaching the fetal or newborn brain. This can be caused by premature separation of the placenta, an awkward birth position, labor that goes on too long or is too abrupt, or interference with the umbilical cord.
Delivery Issues That Cause Cerebral Palsy
It is widely believed that many cerebral palsy cases are a direct result of delivery mistakes. Sadly, procedural errors can be made by doctors that have severe consequences including birth asphyxia, cerebral palsy, and even death.
Although the cause of most cerebral palsy is present before birth, the period of labor and delivery is still risky. Overdue pregnancies, overly large babies, prolonged labor, and breech deliveries increase the risk of injury occurring during birth. A pregnancy which runs beyond the normal gestational period of 40 weeks is a risk for a difficult delivery because the baby can be larger than normal.
Cerebral palsy delivery risk factors include (but are not limited to):
• Premature delivery (less than 37 weeks gestation)
• Prolonged rupture of the amniotic membranes for more than 24 hours leading to fetal infection
• Severely depressed (slow) fetal heart rate during labor, indicating fetal distress
• Abnormal presentation such as breech, face, or transverse lie, which makes for a difficult delivery
Does My Child Have Cerebral Palsy?
Below is a list of symptoms related to cerebral palsy:
- The infant demonstrates poor sucking after birth
- Seizures develop within 24 to 48 hours
- The child is limp at birth
- The skin is blue at birth
- The infant needs resuscitation because he/she is not breathing
- There is no history in the family of brain damage
- The infant has problems maintaining temperature after birth
- The bag of waters was ruptured for over 24 hours
- There is meconium (fecal) staining on the baby at the time of delivery.
A diagnosis of cerebral palsy can be a parent’s worst nightmare, raising important questions about how and why, and who will responsible for the expenses of taking care of their child. Many parents are looking for answers, for information, and for hope. Often parents want to know “How could this happen?” and “Could this have been prevented?”
More often than not, the parents are the first to notice any problems or signs of symptoms, and parents that have any suspicions with regards to the presence of cerebral palsy are advised to seek medical advice as early as possible. There are various tests that a doctor can perform in order to confirm whether the child does have cerebral palsy, so seeking advice will enable you to confirm the presence of the disorder or will put your mind at rest if the doctor advises that there is no presence of cerebral palsy.
Doctors diagnose cerebral palsy by testing an infant’s motor skills and looking carefully at the infant’s medical history. In addition to checking for symptoms, a physician also tests the infant’s reflexes and looks for early development of hand preference.
When diagnosing cerebral palsy, the doctor will carefully examine the child’s medical history for signs that cerebral palsy is the root of developmental problems. These signs include:
- Breech birth
- Complicated labor and/or delivery
- Low Apgar score: An Apgar score is determined by monitoring the infant’s condition. Babies are rated according to heart rate, breathing, muscle tone, reflexes, and skin color in the first 10-20 minutes after birth
- Premature birth or low birth weight
- Multiple births
- Nervous system defects
- Other physical defects
- Maternal bleeding in the last 3 months of pregnancy
Identifying these accompanying conditions is important and is becoming more accurate as ongoing research yields advances that make diagnosis easier. Many of these conditions can then be addressed through specific treatments, improving the long-term outlook for those with cerebral palsy.
Detecting cerebral palsy at a young age can greatly help in regards to treatment and helping a child develop motor skills and abilities to lead a more normal life. There is no cure for cerebral palsy, but early detection and treatment can help.
The effects caused by cerebral palsy can range from mild to severe. There may be physical signs such as challenges in walking, involuntary movements, and communication problems. Typically, parents start to become aware during the developmental stages in infancy when milestones are not being met.
Examples of some common milestones are holding up his/her head, smiling, crawling, walking, speaking. Every child develops at their own unique pace; however, a severe delay in development should be assessed by a physician. Luckily, during the first 2 years of life, most doctors will check for motor milestones frequently.
During a cerebral palsy screening, certain tests are employed to evaluate the developmental progress of the child. Three of these tests are the Revised-Denver Pre-screening Developmental Questionnaire (R-DPDQ), the Early Motor Pattern Profile (EMPP), and testing for motor milestones. The R-DPDQ is a form that assesses a child’s developmental advances and is filled out by the child’s parents. The EMPP is used for children less than 1-year-old and checks for muscle tone, reflex, and body movement problems. Finally, testing for motor milestones is usually performed several times during the first 2 years of life. It involves checking if the baby has motor skills appropriate to its age.
Other issues that may need to be addressed are difficulties with coordination, speech, and swallowing. All these come naturally to a healthy child, so if one child is having difficulty with them, they must be taken in for a medical checkup as soon as possible. There are different types of cerebral palsy, and the severity varies depending on the cause of the brain damage and when it occurred. However, many of the children that are suffering from the condition tend to display normal or above average intelligence, but are limited by the communication difficulties they experience. Early detection and specialized treatment enable them to live a normal life as much as possible.
Cerebral Palsy Gait
Cerebral palsy is a disease that impedes neurological development and results in abnormal and awkward movements, especially when it comes to walking. Not all people with cerebral palsy are ambulant, but those who can walk exhibit noticeably atypical gaits.
Cerebral palsy gait aberrations are the result of neurological damage to the part of the brain that regulates the muscles and other parts of the body responsible for ambulation. CP gait abnormalities are typically presented around the time a child begins to walk. Many children with cerebral palsy will begin to walk and master other developmental tasks later than average. While most children begin to walk at a little over 1 year of age, cerebral palsy children may not begin to walk until the age of 4, and some may not even walk independently at all. The individual nature of a person’s condition will affect the onset and extent of cerebral palsy gait problems.
In general, cerebral palsy gaits are characterized by non-fluent and non-coordinated movements that feature muscle spasticity and excessive flexing of the knee and ankle joints. Depending on the body part or parts most involved in the irregular gait, the cerebral palsied patient will show different types of atypical gaits, such as toe-walking and ‘crouch’ gait. Gait assessment is a useful tool for identifying specific gait dysfunctions and guiding treatment, which usually includes the use of orthotic devices.
Cerebral palsy gait problems can often be fixed or improved through surgery and mechanical support equipment. Gait analysis can be performed by a specialist in order to discover a patient’s precise problems and how to better facilitate ambulation. CP gait analysis is a painless process which can help discover what types of surgery, physical therapy, and support equipment would best help a patient. In some cases, a patient with cerebral palsy develops their condition as a result of another person’s negligence. In these cases, it may be possible to seek compensation for the cost of cerebral palsy gait analysis procedures.
Cerebral Palsy Brain Damage
Cerebral palsy brain damage is the cause of motor disability in patients who develop this condition. A person can develop cerebral palsy brain damage in the womb, during the birth process, or within the first few years of life. Cerebral palsy brain conditions prevent adequate brain control over motor, sensory, and central nervous system functions.
Brain damage, the root cause of cerebral palsy, can occur as a result of many things, including head trauma, infection (like meningitis), bleeding into the brain, lack of oxygen, failure of the brain to develop properly (developmental brain malformation), and neurological damage to a child’s developing brain.
In many cases, a person suffers cerebral palsy brain damage because of labor and delivery complications. A newborn can suffer a stroke or hemorrhage in the brain during gestation or delivery. Anoxia, or lack of oxygen to the brain, before or during birth can also lead to cerebral palsy brain damage. Cerebral palsy brain damage is often caused during complications in delivery. These can include: low amniotic fluid, twisted umbilical cord, hemorrhage, macrosomia (large infant size), long labor, and other complications. In many cases difficult or forceful forceps or vacuum delivery methods can cause cerebral palsy brain damage.
Cerebral palsy is undoubtedly caused by brain injury, and in many cases is preventable. Prevention of a possible brain injury starts before conception and runs into the first few years of a child’s life. In some cases, the doctors or medical team performing the delivery cause the brain injury. If you had difficulty during labor or think that medical malpractice may have caused your child’s brain injury, you should speak with a lawyer who can evaluate your case.
Sadly, one of the leading risk factors for the development of cerebral palsy is medical malpractice. This is also one of the most emotional and difficult things to deal with, as parents don’t want to find out their child’s condition could have been prevented by the doctor, nurse, or another medical professional. When mistakes are made during the birthing process, the responsible healthcare providers should be held accountable.
Risk factors are variables that have been observed to have an effect on the diagnosis of medical conditions. Risk factors do not, by themselves, indicate that a condition will occur, nor does the lack of a risk factor mean that a condition will not occur. The presence of risk factors may simply point to an increased likelihood, not a certainty, for the development of cerebral palsy.
Most children with cerebral palsy don’t have any apparent problems during development in the womb and birth. Aside from medical malpractice, some factors that may increase the risk of cerebral palsy include:
- Premature birth – A normal pregnancy lasts 40 weeks. Babies who are born less than 37 weeks into the pregnancy are at higher risk of cerebral palsy. The earlier the baby is born, the greater the risk of cerebral palsy.
- Low birth weight – Babies who weigh less than 5.5 pounds (2.5 kilograms) are at higher risk of developing cerebral palsy. This risk increases as birth weight falls.
- Breech births – Babies who are in a feet-first position (breech presentation) at the beginning of labor are more likely to have cerebral palsy.
- Multiple babies – The risk of cerebral palsy increases with the number of babies sharing the uterus. If one or more of the other babies die, the chances that the survivors may develop cerebral palsy increase.
- Toxic substances – Babies whose mothers were exposed to toxins, such as mercury, during pregnancy are at higher risk of having cerebral palsy.
- Mother’s health – Women who have thyroid problems, mental retardation or seizures are at higher risk of having a baby with cerebral palsy.
Doctors alone are not experts on the life expectancy for individuals with cerebral palsy. Only a physician is qualified to appraise the individual, and only a statistician or actuary is qualified to relate the appraisal into a life expectancy for individuals with cerebral palsy. Life expectancy for adults and children with cerebral palsy has many factors such as the type, severity and associated disabilities, as well as the quality of care involved.
When a person has a disability such as cerebral palsy, it leads many to wonder if it will affect that person’s longevity. Cerebral palsy life expectancy rates are difficult to determine. People with the condition may be affected by numerous complications that can affect their health and alter the course of their life.
The first thing you need to understand when examining cerebral palsy and life expectancy rates is that there are no hard and fast statistics. The life expectancy for a person with cerebral palsy can range from 30 years of age to age 60 or 70. People with rigidity and severe spasticity are likely to have shorter life expectancy, while people with mild to moderate cerebral palsy complications are likely to live longer.
Additionally, it has been found that there is a decline in motor functions of cerebral palsy patients. They may need repeated surgeries to tackle spasticity related problems. The ability to walk or to be active affects life expectancy in cerebral palsy. The more mobile the patient is, the greater his or her life expectancy. Adult as well as young cerebral palsy patients with low mobility have decreased life expectancy.
It is clear that stress should be given on improving motor skills in childhood, with the aim of improving the life expectancy of cerebral palsy patients. Physical therapy for cerebral palsy, in the form of exercises, to promote muscle strengthening must be looked into, in order to avoid surgeries and promote social and independence skills and educational achievements which can boost morale. Training in maintaining good seating posture combined with treatment for reduction of pain due to stiffened joints, may help in avoiding postural scoliosis. Good health care and fiber rich and low fat diets may help these patients achieve maximum life expectancy.
Quality of Life
Cerebral palsy can significantly affect a patient’s quality of life, particularly because it generally has emotional, mental, and physical symptoms. The quality of life for a patient will depend on a number of factors.
According to a 2007 study, most children aged 8-12 years with cerebral palsy will have similar quality of life (QoL) to other children. The researchers found that for children with cerebral palsy, type and severity of impairments did not affect QoL for in 6 KIDSCREEN categories: psychological well-being, self-perception, social support, school environment, perception of financial resources, and social acceptance.
However, they found that specific impairments were associated with poorer QoL in 4 categories. Children with poorer walking ability had poorer physical well-being; children with intellectual impairment had lower moods and emotions and less autonomy, and children with speech difficulty had poorer relationships with their parents. Further, they found that pain reduced children’s QoL across all categories.
The quality of life for a cerebral palsy patient will depend on factors including:
- The area in which the brain damage occurred
- The severity of the brain damage
- How early the condition is diagnosed and treatments begin
- Whether patients pursue all prescribed treatments
- Whether patients are diagnosed with other health problems, such as diabetes, blood clots, or hypertension
Can Cerebral Palsy be Cured?
There is no treatment that will cure cerebral palsy. The main goal of professionals who work with patients affected by cerebral palsy is to foster as much independence for the individual as his or her impairment will allow. Individuals with seizure disorders may be effectively controlled with anti-convulsive medications. Physical therapy, speech therapy, and occupational therapy are frequently utilized to maximize participation and independence. For individuals who do not have intellectual involvement, accommodations can be made to living spaces, places of employment, and schools so that they may be included in the everyday world of business, education, and recreation. For many individuals with cerebral palsy, inclusion is more a matter or management of their disorder, rather than treatment or a cure.
Does Cerebral Palsy Get Worse?
No. Cerebral palsy is a non-progressive disorder. This means that whatever damage was done to the brain will not get any worse. The problem that many parents face is that, generally, it is impossible to diagnose cerebral palsy with any certainty in infancy. Many cases are not diagnosed until somewhere around age 2. It only appears that the disorder is progressive because the symptoms may not appear until the child’s lack of motor skills, or other developmental delays begin to emerge. For example, a child at age 2 may have difficulty walking and at age 6 difficulty in writing and reading. The difficulty in reading and writing is not a progression of the cerebral palsy, but has appeared as a developmental milestone that should have been attained. In other words, the difficulty at age 6 will occur if the brain injury affected that particular developmental milestone, regardless of any interventions on the part of the parents.
Following your child’s interdisciplinary assessment, the professionals providing care for your child will develop recommendations for treatment of his or her cerebral palsy. Thankfully, many treatments are available to help a child function at the highest level possible. Treatment aims to improve quality of life, enhance participation socially and academically in school, increase strength, facilitate personal hygiene, reduce disabilities, and prevent complications, such as slowed growth and joint problems.
The plan of care depends on the needs and condition of each child and may include:
- Physical therapy
- Orthotic devices
- Occupation therapy
- Speech therapy
- Hearing aids
- Eye glasses or eye surgery
In order to learn more about the cerebral palsy treatment that is right for your child you need to discuss the options with your local doctor, who can then determine what the needs of your child are, and which forms of treatment will best suit your child. A combination of medical treatment and therapy is often used in order to most benefit the child, and again your child’s doctor will discuss the combinations and options with you.
Speech therapy can help improve a cerebral palsy patient’s ability to communicate with the world around them. As part of a comprehensive treatment plan, speech therapy can help someone with CP function normally.
Cerebral palsy can affect motor skills and muscle coordination throughout the entire body, meaning all muscles in the body are susceptible. Besides the extremities, muscles that control eating, speaking, and breathing can be affected as well. Additionally, trouble communicating is commonly an issue with CP patients, and speech therapy can aid in establishing a communication method best suited for the individual.
Speech problems associated with cerebral palsy are linked to poor respiratory control as a result of muscular weakness, laryngeal and soft palate dysfunction, and articulation disorders that result from imprecise movement of the oral-facial structures. The incidence of dysarthria (difficulty in articulating words due to emotional stress or to paralysis, incoordination, or spasticity of the muscles used in speaking) varies in relation to the type and degree of motor impairment. Other communication disorders (e.g., hearing loss, language delay or disorder) may also be associated with cerebral palsy.
A speech and language therapist can help develop better control of the jaw and mouth muscles, which can improve speech and language skills and eating abilities of children with cerebral palsy. They also help develop creative communication methods for those who cannot speak. This means using sign language or a communication aid. Children who are able to talk may work with a speech therapist on making their speech clearer, or on building their language skills by learning new words, learning to speak in sentences, or improving their listening skills.
Cerebral Palsy Prevention
When genetic abnormalities do not play a role in causing cerebral palsy, the condition is preventable as long as mothers and doctors take measures to minimize a number of significant risk factors.
In certain cases, treating and preventing cerebral palsy is possible. A healthy pregnancy is always a good idea, though even parents with the best prenatal care may have a child with cerebral palsy. Doctors and nurses sometimes make mistakes before, during, or after the birthing process that lead to cerebral palsy. While the causes of cerebral palsy are often unknown, medical professionals can take numerous prevention measures. Medical professionals have a duty to address and mitigate the risks of cerebral palsy before, during, and immediately following childbirth. Failure to take necessary preventative measures may constitute medical malpractice in the event that a child develops this chronic condition.
Cerebral Palsy Facts
Here are some key facts about cerebral palsy:
- Cerebral palsy is usually not diagnosed until a child is 2 to 3 years of age.
- Lack of oxygen to the fetus is only responsible for a minority of cerebral palsy cases.
- Some of the known causes of cerebral palsy are: Medical malpractice, infections during pregnancy, a lack of oxygen reaching the fetus, premature birth, birth asphyxia, blood disease, severe jaundice, other birth defects, or acquired cerebral palsy.
- There are three main types of cerebral palsy based on symptoms: spastic, athetoid, ataxic, and mixed.
- Common symptoms of cerebral palsy include spasticity, paralysis, seizures, dyarthria, and unsteady balance or foot movement.
- Cerebral palsy is not contagious and is not progressive.
- With quality medical attention before, during and after pregnancy, cerebral palsy can be prevented.
- Cerebral palsy occurs while the brain is under development.
- Cerebral palsy was first identified by a British surgeon named William Little in 1860.
- Cerebral palsy is an abnormality of motor function which affects the ability to control movements and move.
- Cerebral palsy may be associated with mental retardation or seizures.
- Many children who suffer from cerebral palsy have a normal intellect and only suffer from physical complications.
- It is estimated that the lifetime costs of medical and other care for a child born with cerebral palsy average $500,000.
Cerebral Palsy Statistics
The statistics regarding cerebral palsy are associated with mothers and children alike. What follows are some statistics regarding mothers and fathers who are at a higher risk for giving birth to a cerebral palsy child.
- If the mother is over the age of 40;
- If the mother is below the age of 20;
- If the father is below the age of 20;
- If the parents are African-Americans;
- Blood incompatibility between mother and infant (Rh or ABO);
- If the mother is infected with German measles or other virus early in pregnancy.
The following are statistics regarding children who are at a high risk for cerebral palsy:
- The eldest child;
- A child born fifth or later in the family;
- One of a set of twins, especially if one of them dies;
- If the infant has a birth weight of 3.5 lb or lower;
- A premature infant born less than 37 weeks;
- If the central nervous system of the infant is attacked by micro-organisms.
Do I have a Cerebral Palsy Lawsuit?
The Birth Injury Litigation Group at our law firm is an experienced team of trial lawyers that focus exclusively on the representation of plaintiffs in Cerebral Palsy, Brachial Plexus Palsy and Erb’s Palsy lawsuits. We are handling individual litigation nationwide and currently accepting new birth injury cases in all 50 states.
If you suspect that medical negligence has been a factor in your child’s birth injury, you should contact us immediately. You may be entitled to compensation by filing a birth injury lawsuit and we can help.