What is Cerebral Palsy? Symptoms -Diagnosing and Treatment

What is Cerebral Palsy?

The overall pooled prevalence of cerebral palsy per 1000 children surveyed was 2.95. The observed prevalence of cerebral palsy in India is nearly similar to global estimates. Cerebral Palsy (CP) is a condition that affects muscle tone, posture, and movement due to abnormalities in the developing fetal or infant brain. It results in permanent motor dysfunction and limitations in functional abilities. CP has additional symptoms, such as altered sensation or perception, intellectual disability, communication and behavioral difficulties, seizures, and musculoskeletal complications.

Early Signs of Cerebral Palsy

  • Early (before age 12 months) hand dominance 
  • Poor head control
  • Spasticity starts at 2 to 3 months of age
  • Adduction of the thighs results in typical scissoring of the legs
  • Floppy limbs may be more noticeable when the child is asleep or relaxed.
  • A weak cry, which may sound high-pitched or hoarse
  • Abnormal behavior (e.g., excessive docility or irritability)
  • Failure to achieve motor milestones

Diagnosing Cerebral Palsy

The diagnosis of CP is made clinically. No specific test confirms or excludes the diagnosis of CP. However, a diagnostic evaluation should be performed in all children with CP to identify the underlying cause of CP when possible and to exclude other conditions.

Early diagnosis of CP begins with a detailed medical history and physical examination and involves standardized neurologic and motor development assessments. The initial assessment may lead to further diagnostic evaluation, which typically includes neuroimaging.

A prenatal and birth history review helps identify the risk factors for CP. Then follows a review of the newborn screening result for inborn errors of metabolism, newborn hearing test results, and ophthalmologic evaluation. 

A review of the family history is important. Relatives with any of the following should raise                     suspicion for a genetic cause of CP:

  • Intellectual disability/developmental disabilities
  • Seizures
  • CP
  • Neuromotor/movement disorders
  • Neurobehavioral disorders
  • Congenital anomalies
  • Recurrent miscarriages 

Investigations in Cerebral Palsy

Medical imaging, such as an MRI brain scan, can show brain abnormalities.

If the MRI brain is normal – further metabolic and genetic testing would follow to check for mutations in specific genes that cause CP.

Ancillary tests for vision (VEP), Hearing (AER/BERA), and seizures (EEG) would be undertaken to look for comorbidities.

Causes of Cerebral Palsy

The underlying causes of cerebral palsy (CP) are often unknown, though several perinatal risk factors have been identified.

  • Infections during pregnancy
  • Genetic mutations
  • Premature birth
  • Lack of oxygen during birth

Cerebral palsy symptoms include

  • Muscle stiffness or tightness
  • Impaired muscle coordination (unable to perform tasks smoothly)
  • Limping gait (walking with an abnormal stride pattern)
  • Problems with balance and posture, such as falling over easily when sitting down

Treatment Options for Cerebral Palsy

  • Physical therapy can help with muscle tone and strength.
  • Occupational therapy helps people with cerebral palsy learn how to do everyday tasks

like dressing themselves, using crayons for drawing, or using a spoon to feed themselves.

  • Individuals with cerebral palsy who have difficulty communicating their needs and desires through speech can benefit from speech therapy, which can teach them how to do so effectively.

In addition to these therapies, assistive devices/orthoses may be prescribed by your doctor if your child has difficulty walking or performing other tasks independently.

Tips for Parents of Children with Cerebral Palsy

  • Seek the right medical care.
  • Provide emotional support.
  • Advocate for your child and his or her medical and social needs.

How to Find Financial Support for Cerebral Palsy

If you are looking for financial support, several options are available. 

The first place to start is by applying for a unique disability ID card from the government. india.gov

In India, people with physical disabilities can apply for disability benefits through their local district collector’s office.

Niramaya (Health Insurance Scheme)

Niramaya is a health insurance scheme that is specifically designed for individuals with Autism, Cerebral Palsy, Mental Retardation, and Multiple Disabilities. This scheme provides comprehensive coverage for all types of disabilities without any selection or exclusion criteria based on pre-existing conditions. The insurance coverage can go up to Rs. 1 lakh with a single premium across all age groups. The services covered under this scheme include regular medical check-ups, hospitalization, therapy, corrective surgery, transportation, repetitive medical intervention as an in-patient, pre & post-hospitalization expenses, cashless hospitalization in empanelled hospitals, reimbursement of claims in case of OPD services, and treatment through non-empanelled hospitals. 

To know more: thenationaltrust.gov.in

Income Tax concessions

Under Section 80U, in case of a Person with a Disability (at least 40%) deduction of Rs 75,000 /- is allowed. In the case of a Person with a Severe Disability (80% of one or more disabilities) deduction of Rs. 1,25,000/- is allowed.

Under Section 80DD – Tax Deduction of Rs 75,000 (Person with Disability of at least 40%) and Rs 1,50,000 (Person with Disability of 80 % or more) in respect of maintenance, including medical treatment of a dependent who is a person with a disability.

Travel Concessions

Railways allow disabled persons to travel at concession fares up to 75% in the first and second classes. Escorts accompanying blind, orthopedically, and mentally handicapped persons are also eligible for a 75% concession in the basic fare. Submission of a disability certificate may be required. 

Hotel Discounts

All India Tourism Development Corporation (ITDC) hotels in India offer a 50% discount on room rent and do not charge extra for the accompanying person/attendant, i.e. 50% on a single room tariff for a double room. In addition, there is a 30% discount on food on the a-la-carte menu. It would be necessary to carry a disability certificate to the hotel.

Charitable organizations can also help out by providing grants or low-interest loans that will help cover medical bills or equipment costs related specifically to treating cerebral palsy symptoms such as spasticity or dystonia (muscle stiffness).

Cerebral Palsy Clinic in Nashik

Finding a cerebral palsy clinic in Nashik is more challenging than it sounds. The city has many pediatricians and adult neurologists, but you may need proper evaluation and guidance on your child’s condition by a trained Pediatric Neurologist.

Dr. Nikhil Pawar is the only practicing Pediatric Neurologist in North Maharashtra who heads the Pediatric Neurorehabilitation Center at Vidya Vikas Pediatric Neurosciences Center, Nashik. The center provides Physiotherapy, Occupational Therapy, Speech Therapy, Neurodiagnostics, and counseling under one roof.