My nephew is 9 years old and cannot walk or talk since he was born. With this in mind he has great hand-eye coordination, he is very affectionate, and is very particular (he has became used to a routine). I refuse to categorize him as “mentally disabled” because the boy is smart in his own way, he just cannot verbally express it. The doctor who performed the c-section had sealed the medical records so my family and I believe that my nephew’s problem is birth related (maybe a lack of/too much oxygen). I am just sooooo very tired of seeing my nephew in the condition he is in and if there is any possibility that his quality of life can be heightened I will do whatever it takes to achieve that.

My question is what kind of birth related problems can be attributed to the condition that my nephew represents? Thank you ahead of time for reading my post. Any advice given is extremely appreciated. Thank you.

Answered by: Maria/ MD Health Forum.com Team

Thank you for your question. I understand how difficult it is to see your nephew in that state. Lack of oxygen during delivery is considered as one of the possible causes of cerebral palsy, a group of permanent but non-progressive disorders that affect body movement and muscle coordination. Injury to the motor areas of the brain can disrupt posture and ability to control movement. A child with cerebral palsy might not be able to perform some tasks the way most children do. The symptoms depend on what area of the brain is affected.

Causes of cerebral palsy
The period of labor and delivery may put the baby at risk for injuries. Overdue pregnancies, overly large babies, prolonged labor and breech deliveries generally increase the risk of injury during birth. Delays in carrying out appropriate emergency delivery techniques could deprive the baby of oxygen which may be enough to cause brain damage. However, studies have shown that birth complications contribute to only 5 to 10 percent of cases of cerebral palsy.

In about 70% of cases, brain damage results from events occurring before birth that can disrupt the development of the brain. Conditions that may affect the fetal development include infections during pregnancy and autoimmune or coagulation defects in the mother.

Premature babies are at increased risk for medical problems affecting various organs of the body. The blood vessels in a premature baby’s brain are very fragile, immature and easily rupture, hence, at risk of bleeding. Severe bleeding can damage some areas in the brain and may lead to cerebral palsy. In addition, a premature baby’s lungs are not fully developed and this may cause respiratory distress. Decreased oxygen delivered to the brain may result in cerebral palsy.

Babies can also develop brain injuries in the first months or years of life and that might result in cerebral palsy. Many cases of cerebral palsy have unknown causes.

Types of cerebral palsy
There different types of cerebral palsy. Symptoms and severity varies from person to. Some people with cerebral palsy have barely noticeable symptoms but in severe cases, extremely poor motor skills and mental retardation may be apparent.

Spastic diplegia is the most common form of cerebral palsy. An individual with spastic diplegia has one or more tight muscle groups which limit movement. It usually affects muscles of the legs, hips and pelvis.

Hypotonic cerebral palsy is characterized by diminished muscle tone (hypotonia). Other symptoms may include: poor reflexes, weak joints and posture problem. Speech may also be difficult. Children with severe hypotonias may find it extremely difficult to attain motor skill milestones and cognitive development.

Aside from hypotonic cerebral palsy, low muscle tone may be related to other developmental disorders such as cerebral ataxia, sensory integration dysfunction, developmental dyspraxia and congenital hypothyroidism. Hypotonia may also be evident in genetic disorders like myotonic dystrophy
and down syndrome.

Diagnosis
Parents concerns regarding their child’s development should be discussed with the primary care physician or pediatrician. The child may also be referred to specialists such as pediatric neurologist or developmental pediatrician. The doctor will ask the parents about the child’s history and development characteristics. The mother’s medical history during her pregnancy will also be examined.

During physical examination, the doctor will observe the child’s posture, movements, muscle tone and motor skills. The child’s reflexes will also be assessed.

To rule out other conditions that may have similar symptoms, the doctor may request for some tests to confirm diagnosis. This may include blood tests and imaging procedures such as MRI, CT scan and cranial ultrasound.

Treatment
There are many treatments available to help a child achieve his or her optimal level of functioning. It is necessary to involve the patients, families, and caregivers in planning, decision making, and treatment. Treatment plan will be based on patient’s needs and problems. Managing cerebral palsy may require specialists such as of a physical therapists, occupational therapist and speech and language pathologist, orthopedist or orthopedic surgeon and psychologist.

I commend you for your concern about your nephew. You should ask his parents to talk to the doctor. The exact cause of your nephew’s condition may have been puzzling your family for years, but I think its about time to bring the child to a doctor for evaluation. The sooner you do that, the sooner you will find out about the measures to improve your nephew’s quality of life.

This blog entry is for your general information. I recommend that you discuss your nephew’s symptom with his own doctor.

References:
http://www.ninds.nih.gov/disorders/hypotonia/hypotonia.htm
http://www.ucp.org/ucp_generaldoc.cfm/1/9/37/37-37/447
http://www.healthsystem.virginia.edu/uvahealth/peds_neuro/cpalsy.cfm

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Tags: cerebral palsy, cerebral palsy treatment, cerebral palsy types, developmental disorders, developmental problems, spastic diplegia

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