cerebral palsy الشلل الدماغى

Cerebral palsy

• a group of chronic disorders impairing control of movement that appear in the first few years of life and generally do not worsen over time.
• The disorders are caused by faulty development of or damage to motor areas in the IMMATURE brain that disrupts the brain's ability to control movement and posture.
Spastic CP
where there is too much muscle tone or tightness. Movements are stiff, especially in the legs, arms, and/or back. Children with this form of CP more their legs awkwardly, turning in or scissoring their legs as they try to walk. This is the most common form of CP.
Athetoid CP
(also called dyskinetic CP) can affect movements of the entire body. Typically, this form of CP involves slow, uncontrolled body movements and low muscle tone that makes it hard for the person to sit straight and walk.
Mixed CP
is a combination of the symptoms listed above. A child with mixed CP has both high and low tone muscle. Some muscles are too tight, and others are too loose, creating a mix of stiffness and involuntary movements.

The symptoms differ from person to person and may change over time. Some people with cerebral palsy are also affected by other medical disorders, including seizures or mental impairment, but cerebral palsy does not always cause profound handicap. Early signs of cerebral palsy usually appear before 3 years of age. Infants with cerebral palsy are frequently slow to reach developmental milestones such as learning to roll over, sit, crawl, smile, or walk. Cerebral palsy may be congenital or acquired after birth. Several of the causes of cerebral palsy that have been identified through research are preventable or treatable: head injury, jaundice, Rh incompatibility, and rubella (German measles). Doctors diagnose cerebral palsy by testing motor skills and reflexes, looking into medical history, and employing a variety of specialized tests. Although its symptoms may change over time, cerebral palsy by definition is not progressive, so if a patient shows increased impairment, the problem may be something other than cerebral palsy.

Children with cerebral palsy have many problems, not all of them related to the brain injury. Most of these complications are neverthelneurological. They include epilepsy, mental retardation, learning disabilities, and attention deficit-hyperactivity disorder.

Children with cerebral palsy may also develop hip subluxation or have problems with the gait. Cerebral means having to do with the brain. Palsy means weakness or problems with using the muscles. Often the injury happens before birth, sometimes during delivery, or soon after being born. CP can be mild, moderate, or severe. Mild CP may mean a child is clumsy. Moderate CP may mean the child walks with a limp. He or she may need a special leg brace or a cane. More severe CP can affect all parts of a child's physical abilities. A child with moderate or severe CP may have to use a wheelchair and other special equipment. Sometimes children with CP can also have learning problems, problems with hearing or seeing (called sensory problems), or mental retardation. Usually, the greater the injury to the brain, the more severe the CP. However, CP doesn't get worse over time, and most children with CP have a normal life span.
Diagnosis of Cerebral Palsy
Cerebral Palsy (CP) simply means that there has been some injury to the brain during development which has resulted in difficulty transmitting the necessary impulses from the brain to the muscles for coordinated movement.
Many children born prematurely will develop some movement difficulties related to early neurological injury. These impairments emerge slowly over time and are typically not evident during the newborn period. Most mild motor abnormalities noticeable during the first few months of life will improve and may completely resolve with time. When motor impairment persists, a diagnosis of cerebral palsy may be considered. About 10% of children born at birth weights of less than 1000 grams will eventually receive a diagnosis of cerebral palsy (McCarton, et. al, 1996; O'Shea, et. al., 1998), a permanent condition. Diagnosing cerebral palsy in children born prematurely is often a difficult process which requires observing the child's development over time.
For a diagnosis of CP, the following are necessary:
1) Movement of muscles has to be adversely affected.
As voluntary control of the muscles develops with age, it takes time to determine whether and to what extent movement of the muscles has been affected by brain damage (which may or may not have been detected neonatally). Even with significant PVL or other injury known to be related to cerebral palsy, cerebral palsy will not be diagnosed unless and until movement is affected.
2) The motor impairment has to be due to a neurological injury.
That is, the source of the problem is at the level of brain functioning, rather than being due to a problem with another part of the motor system such as the spinal cord or muscle. Neurological injury may not be apparent using imaging techniques, however, and may be assumed from associated signs and symptoms.
3) The injury or lesion must be static (not getting worse, but no longer resolving).
A diagnosis of cerebral palsy is not given if the source of the problem is a progressive or deteriorating neurological condition. Although relatively rare, it is important to rule out such conditions as treatment options may be very different. Because of the amazing ability of the very young brain to recover from injury, it is also important to wait until the healing process is complete before diagnosing a permanent condition.
The level of impairment may increase with development for children with cerebral palsy. That is, as a child develops, the impaired use of a muscle or muscle group can become more apparent as he or she is unable to keep up with age expectations. As the demands increase, the impairment becomes more obvious. This is the imapirment which is becoming worse with time; the injury to the brain remains the same.
4) The injury has to occur while the motor system is still developing (usually before, during, or right after birth).
For premature infants, the injuries resulting in CP are thought to most often happen during the perinatal period (right around the time of birth). For some children, however, the injury may have happened prenatally; for others, injury may have happened during the neonatal period. It can be very difficult to determine exactly when the injury occurred.
5) The impairment in movement does not resolve with time.
Many children with motor problems during infancy do "grow out of" their symptoms, even after the first year of life. This is not considered to have been cerebral palsy. (There are a variety of other motor problems associated with prematurity.) For this reason, medical professionals tend to be very cautious about diagnosing mild to moderate cerebral palsy in prematurely born children during infancy.
CEREBRAL PALSY IN ADULTS
Generally defined: cerebral palsy is physical condition that inhibits the brain from properly controlling the functions of the body, particularly motor skills.
Cerebral palsy in adults and children can have a variety of physical manifestations that range from highly debilitating to highly manageable through a comprehensive treatment program.
Statistics show that there are approximately half a million cases of cerebral palsy in adults and children in the United States with 4,500 new cases each year.
Cerebral palsy can be the result of complications in pregnancy, difficult childbirth, medical negligence related to either of these events, or a traumatic brain injury accident in the first few years of life. Cerebral palsy in adults is therefore a condition that these patients have had for all, or most, of their lives.
Many people with cerebral palsy can live a long productive life. Ninety eight percent of the general population survives into their twenties as compared to ninety percent of the population that has cerebral palsy. Life expectancy and quality of life is contingent upon the severity of cerebral palsy in adults. Children who have severe mental retardation or considerable physical impairment have less of a chance of reaching adulthood. Only seven in ten of these patients will survive into their twenties.
Treatment of cerebral palsy in adults
There is no cure for cerebral palsy in adults or children. Early intervention and a comprehensive rehabilitative therapy program is the best way to manage cerebral palsy in adults and children. Treatment of cerebral palsy in adults and children can involve a whole host of different therapies including: speech and language therapy, physical therapy, occupational therapy, the use of adaptive equipment, surgical procedures, and other therapeutic techniques.
Treatment of cerebral palsy in adults may include a number of services that foster and facilitate functional living. Vocational and educational training can increase functioning in cases of cerebral palsy in adults. Personal assistance services, recreational and leisure activity participation, counselling, independent living services, employment opportunities, and other services are available to adults with cerebral palsy.
Cerebral palsy in adults should be considered by parents who have children with cerebral palsy. A plan should be prepared with regards to handling care of cerebral palsy in adults if parents or guardians should pass before their child is able to adequately care for him or herself. Estate planning and other guardianship matters involving cerebral palsy in adults is also important to consider.
Cerebral palsy in adults and children does not bar these individuals from experiencing a full and satisfying life. Problems of cerebral palsy in adults can often be traced back to medical negligence or other violations that occurred throughout development. If cerebral palsy in adults is complicated as a result of another party's wrongful actions or negligence, you should speak to a qualified legal professional who can advise you of your legal rights and options in a case to recover your losses.

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What are other problems associated with CP?

In addition to problems controlling their muscle movement, children with CP may have some other problems too. Most of these are caused by the same brain injury that caused the CP.
Talking and Eating
Just as CP can affect the way a person moves their arms and legs, it can also affect the way they move their mouth, face and head. This can make it hard for the person to talk clearly and to bite, chew and swallow food. If you meet a girl with CP you may notice that her speech is hard to understand or that she seems to work very hard just to get out a few words. This is because she is not able to make her lips, jaw and tongue move as quickly as you can. She may also have trouble controlling her breath flow to make her voice work. All of these parts of your body are very important in talking.
Try this: Make a "g" sound (say "guh"). To do that, you must pull your tongue back and touch the back of your tongue to the back part of the roof of your mouth (your palate). Then, you must breathe out a little but not let the breath through until you are ready to make the sound. When you say "guh," you let your tongue drop while letting the breath out and turning on your voice. Whew! That's a lot of stuff to do just to make one sound. Just think of all the movements you must put together to say a whole word, or a sentence. Now imagine what it would be like to make sounds and words if you had trouble controlling your tongue. lips and breathing!
The speech problem
most children with CP have is called dysarthria (dis-are-three-a). That means it is hard for them to control and coordinate the muscles needed to talk. Their speech may sound very slow and slurred and their faces may look a little funny when they are trying to talk. Some kids' voices may sound different too. If too much air comes through your nose when you talk you sound hyper nasal (hyper means too much), like Erkel from the old TV show "Family Matters". If not enough air comes through your nose you sound hypo nasal (hypo means not enough), like when you have a bad cold and can't breathe through your nose. If you meet someone with CP who has speech problems, try hard to listen carefully when they are talking, and don't be afraid to tell them when you can't understand something they've said. Most people would rather say it again or find a different way to communicate (maybe writing or pointing) than have you pretend you understood them when you did not.
Many of the same muscles involved in talking are also used when you eat. Some kids with CP might not be able to bite and chew foods like a hotdog or a peanut butter sandwich. They may also have trouble sucking through a straw or licking an ice cream cone.

Learning Problems
About one-fourth to one-half of children with CP also have some type of learning problem. It may be a learning disability so that they have trouble with one or two subjects in school but learn other things pretty well, or may be a more severe learning problem like mental retardation in which they learn everything at a slower rate. There are many different levels of mental retardation so that people with mild mental retardation may learn to read and write and do math, but people with more severe mental retardation probably will not. This does not mean that children with severe mental retardation can't learn. It means that they learn at a slower pace than most other kids, and that they will need some special learning help in school.

Seizures
About half of all children with CP have seizures. This means that they have times when there is some abnormal activity in their brains that interrupts what they are doing. Often, the abnormal brain activity happens in the same place as the brain injury which caused the CP. Your brain is constantly sending messages out to your body - to breathe, to move, to keep your heart pumping. A seizure is a series of abnormal messages being sent out very close together. These abnormal messages may cause someone to stare and stop moving during a seizure, or may cause them to loose control of their body and fall down. Some people show shaking movements all over when they are having a seizure. Seizures usually last a few seconds to a few minutes, and in most case are not dangerous. Many children take special medicine to help prevent seizures or reduce the number of seizures they have.
You may already know that seizures also occur in many people who do not have CP.
What type of therapy is available for CP?
Children with CP often go to different kinds of therapy to help them improve their motor skills for things like walking, talking and using their hands. Some kids get therapy at school and some kids go to a special clinic to see their therapists. Therapists are special teachers who are trained to work with people on learning better or easier ways to do things. Just like a coach who helps you learn and practice new skills to make you a better soccer or basketball player, therapists "coach" people to help them learn and practice new skills.

Physical Therapy

Physical therapists help children learn better ways to move and balance. They may help children with CP learn to walk, use their wheelchair, stand by themselves, or go up and down stairs safely. Kids may also work on fun skills in physical therapy like running, kicking and throwing a ball, or learning to ride a bike. Physical therapy is usually called "PT" for short.

Speech and Language Therapy

Speech therapists work with children on communication skills. Communication skills may mean talking, using sign language, or using a communication aid. Children who are able to talk may work with a speech therapist on making their speech clearer (easier to understand) or on building their language skills by learning new words, learning to speak in sentences, or improving their listening skills. Children who are not able to talk because of their difficulty controlling the muscles needed for speech may learn sign language or use some kind of communication aid. A communication aid might be a book or poster with pictures that show things the person might want, or an alphabet board that the person can use to spell out their message. There are also computers that are used as communication aids that actually talk for the person!

Occupational Therapy

Occupational therapists usually work with children on better ways to use their arms, hands, and upper body. They may teach children better or easier ways to write, draw, cut with scissors, brush their teeth, dress and feed themselves, or control their wheelchair. Occupational therapists also help children find the right special equipment to make some everyday jobs a little easier.

Recreational Therapy
Recreational therapists help kids with CP have fun! They work with children on sports skills or other leisure activities. In recreational therapy kids may work on dance, swimming or horseback riding. They may also work on art or horticulture (growing and taking care of plants) or almost any other hobby they are interested in.

It is generally accepted that injury to the brain before, during, or shortly after birth can cause Cerebral Palsy. In many cases, no one knows for sure what caused the brain injury.

Whatever the cause, the severity of the brain damage generally depends on the type and timing of the injury. In very premature babies, bleeding into the brain (intraventricular hemorrhage) can cause extensive damage. Also, the longer an unborn child goes without oxygen, the greater the brain damage.

Infants who have suffered severe asphyxia (lack of sufficient oxygen to the brain) during birth can be born with Cerebral Palsy. When Cerebral Palsy is diagnosed in childhood, it is often discovered that the child suffered lack of oxygen at birth. The birthing process must be monitored and handled with skill. Accidents and incompetence during the birth process can cause cerebral palsy. Modern prenatal care and improved obstetric care have significantly reduced the incidence of birth injury, but human error will probably never be completely eliminated.
Other risk factors can contribute to a baby being born with cerebral palsy:
The highest risk babies are those who are born prematurely and do not cry within the first five minutes of being born. Babies who have seizures, have to put into a ventilator or have internal brain damage are also at risk. In general, low birth weight babies are at an extremely high risk.

Some cases of Cerebral Palsy are caused by conditions of the mother during pregnancy. These include drug use or infections such as rubella (German measles). Other causes can be related to high-blood pressure, diabetes or thyroid problems. Pregnancy complications such as placental problems can also potentially cause Cerebral Palsy.

Birthing is extremely complicated and many childbirths have some form of complication, whether it being the umbilical cord wrapping around the baby's neck or the need for a C-section. Doctors must make sudden split-second decisions to react to problems during childbirth. Unfortunately, too often a doctor or nurse may make the wrong decision under pressure and that error could cause Cerebral Palsy.

Once a child is born, there are a whole series of errors that could lead to cerebral palsy. There are many factors that suggest the injury occurred as a result of improper medical care, or injury to the brain during the birthing process.
The simplest answer to this question is because your child has brain damage. This leads naturally into the second question: Why does your child have brain damage? There are many possible answers to this second question, because there are many reasons children can sustain brain damage. Your doctor must carefully review your child's health history and conduct a variety of medical and neurological tests to help determine the cause. Cerebral palsy is caused by an injury to the brain before, during, or shortly after birth. In many cases, no one knows for sure what caused the brain injury or what may have been done to prevent the injury. A large number of factors which can injure the developing brain may produce cerebral palsy. In general, however, there are two problems that can cause cerebral palsy:
1. failure of the brain to develop properly (developmental brain malformation)
2. neurological damage to the child's developing brain
Developmental malformations
Occasionally, something may disrupt the brain's normal development process. A fetus's brain may fail to develop the usual number of brain cells, communication between brain cells may be impaired, or brain cells may not migrate to the areas they are supposed to. Causes of these malformations are frequently unknown, but can include genetic disorders, chromosome abnormalities with either too much or too little genetic material, or faulty blood supply to the brain. Developmental brain malformations in the areas of the brain which control voluntary movement may cause cerebral palsy

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Neurological Damage
: If your child does not have a developmental brain malformation, then their cerebral palsy may be the result of an injury to their brain before, during, or after birth. These injuries are most often caused by problems associated with premature births, difficult deliveries, neonatal medical complications, or trauma to the brain. Types of problems that can lead to brain injuries include:

1. lack of oxygen before, during, or after birth.
2. bleeding in the brain.
3. toxic injuries, or poisoning, form alcohol or drugs used by the mother.
4. head trauma resulting from a birth injury, fall, car accident, or other cause.
5. severe jaundice, very low glucose levels, or other metabolic disorders.
6. infections of the nervous system such as encephalitis or meningitis.

Whatever the cause of your child's cerebral palsy, the severity of the brain damage generally depends on the type and timing of the injury. For example, in very premature babies, bleeding into the brain (intraventricular hemorrhage) can cause extensive damage. Also, the longer an unborn child goes without oxygen, the greater the extent of brain tissue damage.

10% to 15% of cerebral palsy is caused from a recognized brain injury, such as infection (like meningitis), bleeding into the brain, and damage caused by lack of oxygen. It is very important that you understand that a brain injury caused during delivery in many cases could have been prevented. Medical mistakes are responsible for thousands and thousands of cerebral palsy cases. It would be virtually impossible for a parent, on their own, to determine if a medical mistake caused their child's cerebral palsy or brain damage. It is only through the concerted efforts of a legal/medical team that can answer the question, "was my child's cerebral palsy preventable?

Following your child's interdisciplinary assessment, the professionals providing care for your child will develop recommendations for his or her treatment. Many treatments are available to help a child function at the highest level possible. Although many treatments are available, we will touch upon a few of the most basic approaches used today to help a child achieve their optimal level of functioning.
Since no two children are affected by cerebral palsy in exactly the same way, individual treatment programs vary widely. But because all children with cerebral palsy have movement problems, you can expect that an important component of your child's treatment will be a therapeutic exercise program. Depending on your child's needs, a physical therapist, an occupational therapist, and a speech-language pathologist will work with your child to help him or her improve posture and movement.
Physical Therapy
: A physical therapist specializes in improving the development of the large muscles of the body, such as those in the legs, arms and abdomen (gross motor skills). Physical therapists help children learn better ways to move and balance. They may help children with cerebral palsy learn to walk, use a wheelchair, stand by themselves, or go up and down stairs safely. Physical therapists will also work on fun skills such as running, kicking and throwing, or learning to ride a bike. Physical therapy usually begins in the first few years of life, or soon after the diagnosis of cerebral palsy is made. These therapists use specific sets of exercises to work toward the prevention of musculoskeletal complications. An example of this is preventing the weakening or deterioration of muscles that can develop with lack of use. Also, physical therapy will help avoid contractures, in which muscles become fixed in a rigid, abnormal position. Physical therapy will help prevent muskuloskeletal problems, as well as helping your child perform common everyday activities.
Occupational Therapy
An occupational therapist specializes in improving the development of the small muscles of the body, such as the hands, feet, face, fingers and toes. These therapists also teach daily living skills such as dressing and eating, as well as making sure children are properly positioned in wheelchairs. They may teach your child better or easier ways to write, draw, cut with scissors, brush their teeth, dress, and feed themselves. Occupational therapists will also help your child find the right special equipment to make everyday jobs a little easier
.
Speech / Language Therapist:
A speech and language therapist helps develop better control of the jaw and mouth muscles, which can improve speech and language skills and eating abilities. They also help develop creative communication methods for those who can not speak. A speech and language therapist will work with your child on communication skills. This means talking, using sign language, or using 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. Children who can not talk may learn sign language, or how to use special equipment such as a computer that actually talks for you.

At first, your child will likely see his or her therapist quite often, sometimes at least twice a week. As your child grows, he or she may need a less intensive program. The therapists will probably expect you to work on the child's movement skills at home, and will train you in special exercises and handling techniques. Because the time commitment to a therapy program is tremendous, it is wise for both parents, or other caretakers, to be involved. In general, it is considered very early intervention if a baby begins therapy before six months of age. Most infants are not referred until later in the first year or sometime in the second year of life. Of course, the age at which your child is referred will depend to some extent on how quickly the physicians diagnose cerebral palsy, or other problems requiring therapy. Researchers are still studying the long term benefits therapy can offer. But it is generally agreed that children who receive good treatment not only have fewer movement limitations, but also have better postures, better muscle development, and better abilities in toileting, feeding, and dressing themselves. Furthermore, therapy programs enrich children's lives by enabling them to explore and experience activities that they might not otherwise be able to do independently.
Medical Treatment:
There are two major medical treatments that help children with cerebral palsy achieve their optimal level of functioning.
1) Surgery
2) Surgery is not always necessary, but it is sometimes recommended to improve muscle development, correct contractures, and reduce spasticity in the legs. Before selecting any surgical procedure, make sure the doctor thoroughly discusses the risks involved, long-term effects and postoperative follow-up. Also, always get a second opinion and speak with other parents whose children have had the same surgical procedure.
Children with cerebral palsy often walk on their toes. This may indicate a tight heel cord. When other treatments for this fail, such as splints and braces, surgery may help correct it by lengthening the tendon. This surgery may help improve the child's ability to walk, improve balance, and prevent further deformity. Surgery is also available to relieve spacticity in the legs and hips of children. This surgery involves identifying sensory nerve fibers being the spinal cord, and then selectively cutting those nerve fibers therefor reducing spacticity. Research on this surgery is still being conducted. The adductors are muscle groups that bring the legs together. If a child's physician determines that the adductors are causing deformities or problems with walking, he or she may suggest a surgical procedure to cut the tendon, which can release muscle contractures and improve mobility. Again, surgery may not always be necessary, but in many instances it can help your child achieve his or her optimal level of functioning.
2) Drug Therapy
: Your child's doctor may prescribe drugs to prevent or control seizures associated with cerebral palsy. These drugs are very effective in preventing seizures in many children. Because there are different types of seizures, different drugs may be prescribed because no one drug prevents or controls all types of seizures. Such drugs may include Tegretol, Dilantin and Phenobarbital. Drug therapy can also help reduce spacticity associated with cerebral palsy. These drugs include Diazepam, Baclofen, and Dantrolene. If surgery is contradicted, these drugs can help reduce spacticity for short periods, however, their long term value is still being researched. Although drug therapy may not completely correct complications associated with cerebral palsy, evidence does show that it helps manage problems such as seizures and spactisity. Consult with a physician to find out if drug therapy is appropriate for your child.
One other approach to help children with cerebral palsy achieve their optimal level of functioning is Sensory Integration Therapy. This therapy helps to overcome problems experienced by many young children in absorbing and processing sensory information. Encouraging these abilities ultimately improves balance and steady movement. Therapies include stimulating touch sensations and pressures on different parts of the body. With the use of certain items, such as Styrofoam chips, water, or textured toys, this therapy will also motivate children to learn sequences of movements.
Special equipment is also available for children with cerebral palsy. Because of the muscle problems children with cerebral palsy have, your child's doctor or therapist may recommend them using some special equipment to help them get around or do everyday activities.
A Wheelchair
A Walker is a piece of equipment usually made out of light metal. It most often will have four legs that are adjustable in height. Some children with cerebral palsy can walk, but have poor balance and fall a lot. They use a walker to help them balance and get around without the use of a wheelchair. You may also see a walker with wheels on it, as well as a basket to put some of the child's belongs in.

Because of the fine motor problems often associated with cerebral palsy, children may have a hard time using utensils for eating. Special handles or grips are available for children who have trouble holding onto small objects, such as a fork or spoon. You may also find eating utensils that are specially designed for children with fine motor problems. They may be curved or bent, and are usually designed to fit the child's needs. Special grips and handles are also used on pencils and pens to make them easier for the child to hold and use.

Communication Aids are available for children who are hard to understand, or who have difficulty talking with others. A communication aid might be a book or poster with pictures that show things the child might want, or an alphabet board that the person can use to spell out their message. There are also computers that are used as communication aids that actually talk for the child.

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Treatment of Cerebral Palsy can take many forms and depends on the severity of the case
There is no standard therapy that works for all Cerebral Palsy patients. Drugs can be used to control seizures and muscle spasms, special braces can compensate for muscle imbalance. Surgery, mechanical aids to help overcome impairments, counseling for emotional and psychological needs, and physical, occupational, speech, and behavioral therapy all may be employed.
Specialists needed may include:
Pediatric psychiatrist
Pediatric neurologist
Pediatrician
Orthopedist
Physical therapist
Occupational therapist
Speech pathologist
PsychoClinical Social Worker Case Manager

Other Treatment may include:
Physical Therapy:
A physical therapist specializes in improving the development of the large muscles of the body, such as those in the legs, arms and abdomen (gross motor skills). Physical therapists help children learn better ways to move and balance. They may help children with cerebral palsy learn to walk, use a wheelchair, stand by themselves, or go up and down stairs safely. Physical therapists will also work on skills such as running, kicking and throwing, or learning to ride a bike. Physical therapy usually begins in the first few years of life, or soon after the diagnosis of cerebral palsy is made. These therapists use specific sets of exercises to work toward the prevention of musculoskeletal complications. Physical therapy can help prevent muskuloskeletal problems, as well as helping your child perform common everyday activities.

Occupational Therapy:
An occupational therapist specializes in improving the development of the small muscles of the body, such as the hands, feet, face, fingers and toes. These therapists also teach daily living skills such as dressing and eating, as well as making sure children are properly positioned in wheelchairs. They may teach your child better or easier ways to write, draw, cut with scissors, brush their teeth, dress, and feed themselves. Occupational therapists will also help your child find the right special equipment to make everyday jobs a little easier.

Speech / Language Therapist:
A speech and language therapist helps develop better control of the jaw and mouth muscles, which can improve speech and language skills and eating abilities. They also help develop creative communication methods for those who can not speak. A speech and language therapist will work with your child on communication skills. This means talking, using sign language, or using 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. Children who can not talk may learn sign language, or how to use special equipment such as a computer that actually talks for you.

Surgical Intervention for Cerebral Palsy
Surgery:
Surgery is not always necessary, but it is sometimes recommended to improve muscle development, correct contractures, and reduce spasticity in the legs. Before selecting any surgical procedure, make sure the doctor thoroughly discusses the risks involved, long-term effects and postoperative follow-up.

Children with cerebral palsy often walk on their toes. This may indicate a tight heel cord. When other treatments for this fail, such as splints and braces, surgery may help correct it by lengthening the tendon. This surgery may help improve the child's ability to walk, improve balance, and prevent further deformity. Surgery is also available to relieve spacticity in the legs and hips of children. This surgery involves identifying sensory nerve fibers being the spinal cord, and then selectively cutting those nerve fibers therefore reducing spacticity. Surgery may not always be necessary, but in many instances it can help your child achieve his or her optimal level of functioning.

Drug Therapy:
Your child's doctor may prescribe drugs to prevent or control seizures associated with cerebral palsy. These drugs are very effective in preventing seizures in many children. Because there are different types of seizures, different drugs may be prescribed because no one drug prevents or controls all types of seizures. Such drugs may include Tegretol, Dilantin and Phenobarbital. Drug therapy can also help reduce spacticity associated with cerebral palsy. These drugs include Diazepam, Baclofen, and Dantrolene. Although drug therapy may not completely correct complications associated with cerebral palsy, evidence does show that it helps manage problems such as seizures and spactisity.
1 .Sensory Integration Therapy:
One other approach to help children with cerebral palsy achieve their optimal level of functioning is Sensory Integration Therapy. This therapy helps to overcome problems experienced by many young children in absorbing and processing sensory information. Encouraging these abilities ultimately improves balance and steady movement. Therapies include stimulating touch sensations and pressures on different parts of the body. With the use of certain items, such as Styrofoam chips, water, or textured toys, this therapy will also motivate children to learn sequences of movements.

2 . Adaptive Equipment:
Special equipment is also available for children with cerebral palsy. Because of the muscle problems children with cerebral palsy have, your child's doctor or therapist may recommend that they use some special equipment to help them get around or do everyday activities.
3 . A Wheelchair
is sometimes used when a child cannot walk. This will allow the child to move from one place to another. Many children with cerebral palsy can use their arms to roll the wheels of their wheelchair themselves, and can move around without much difficulty at all. There are also wheelchairs available that are motorized. This type of wheelchair has a motor that moves the wheels for the child. There may be a joystick on one arm rest that the child can operate on his or her own.
4 . A Walker is a piece of equipment usually made out of light metal. It most often will have four legs that are adjustable in height. Some children with cerebral palsy can walk, but have poor balance and may fall. They use a walker to help them balance and get around without the use of a wheelchair. You may also see a walker with wheels on it, as well as a basket to put some of the child's belongs in.
Because of the fine motor problems often associated with cerebral palsy, children may have a hard time using utensils for eating. Special handles or grips are available for children who have trouble holding onto small objects, such as a fork or spoon. You may also find eating utensils that are specially designed for children with fine motor problems. They may be curved or bent, and are usually designed to fit the child's needs. Special grips and handles are also used on pencils and pens to make them easier for the child to hold and use. Orthotics, casts and splints are often used with therapy programs.

Rehabilitation and Cerebral Palsy
There are a variety of rehabilitation options for people and children with cerebral palsy. Some are dependent on which type of cerebral palsy the patient has. All of the rehabilitations, however, usually center on developing a few key areas of improvement including physical movement and coordination, speech, vision, and intellectual development. Ongoing treatments and options are available that could make life for the cerebral palsy sufferer better. Most rehabilitation centers and treatments use some combination of physical therapy, biofeedback, occupational and speech therapy, drugs, and even surgery.
Cerebral palsy rehabilitation will invariably involve some sort of long-term physical therapy. These slight exercises will usually involve extending the child’s range of movement and often concentrate primarily on developing basic motor skills. There are several techniques touted in the field of cerebral palsy rehabilitation such as the Bobath technique. The Bobath technique centers on positive reinforcement of voluntary movements on the child’s part and on gradual physical conditioning. The physical therapy may also include external aids such as wheelchairs, walkers, braces, and how to use them for maximum mobility.
Biofeedback is another common physical therapy that uses machines to concentrate on developing specific parts of the body. The machines are connected to various muscles in the body with electrodes. The electrodes produce some sort of discernable results such as beeping noises or flashing lights that provide the wearer with a stronger relationship with their bodies. Through manipulation of their movements, children with cerebral palsy can control overactive muscles and develop coordination.
Occupational therapy is a fine-tuning of the child’s necessary motor skills. The motor skills developed in occupational therapy focus on providing the cerebral palsy child with the ability to function as an individual, rather than relying on others to do things for them. This may include such necessary functions as: learning to dress one’s self, how to comb their hair, brush their teeth, drink properly, write, and many other necessities for individual living.
Speech and language rehabilitation often involve lengthy, lifetime therapy involving a speech therapist and several electronic and mechanical devices. The ability to function and develop one’s speech and language is a necessary tool for regaining control over one’s life, and there have been many successful cases of cerebral palsy patients overcoming deficiencies in these areas.
Other rehabilitation treatments for cerebral palsy include drug therapy, such as Botox injections to relax over-tense muscles, some types of surgery, and the use of orthopedic devices ranging from wheelchairs and leg braces to special footwear.
The rehabilitation treatments vary as to the severity and type of cerebral palsy but all require repeated visits and usually the purchase of or use of several types of equipment.
Strength training, also known as resistive training, for people with cerebral palsy is a type of therapy that is often used in conjunction with other forms of exercise to increase muscle strength and flexibility. Strength training also prevents the atrophy of muscles that are rarely used—a common problem among children and adults with cerebral palsy.
How Strength Training Helps
People who don't have cerebral palsy or other conditions that affect movement and posture are able to freely move and stretch their muscles and tendons as they walk, run or perform daily functions. This ensures that muscles, tendons, and bones all grow at the same rate. However, children with cerebral palsy often have difficulty engaging in such activities, causing their muscles to grow slower than their bones. This results in contracture, one of the most serious complications of cerebral palsy. Strength training works to reduce the chances of developing contracture by keeping the muscles strong and limber.
Research has also found a correlation between leg muscle strength, posture, and walking ability, indicating that people with weaker leg muscles exhibit a tendency to crouch more in their gait. People with cerebral palsy may develop a “scissor gait” in which they walk on their toes with their knees bent inward. Strength training is aimed at significantly improving gross motor skills such as standing, walking, and sitting.
More Benefits of Strength Training
Studies have shown that strength training for people with cerebral palsy may lead to increased walking speed, walking efficiency, motor activity, and a reduction in spasticity.
Additionally, through repeated, controlled motion, muscles become trained to perform in specific ways that mimic normal body movement. So with strength training, a child with cerebral palsy may learn to walk, stand, and move in the proper way allowing him/her to reach their maximum potential.
Your Legal Rights
If you suspect your child's condition was the result of medical negligence, you may be eligible to recover your losses including pain and suffering, past and future medical bills, the cost of strength training and other forms of cerebral palsy treatments, and more.
Please contact us today to speak with a qualified and compassionate medical malpractice attorney who can examine your case FREE of charge, inform you of your legal options, and ensure your rights are fully protected.
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أبو صلاح

هوكل ده هناخده فى اطفال

شكرا

على الخضه يا ابو صلاح
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مستقبل كليه العلاج الطبيعى

يا عم ولا خضة ولا حاجة

ده دى حاجة مهمة فى اطفال وياعم خليك فى اعصاب وروشن لغاية ما تيجى اطفال
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أبو صلاح

اروشن دهعلى اساس ان اعصاب هنقزقز فيها لب
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مستقبل كليه العلاج الطبيعى

ههههههههههه حلوة منك

بس ارحم من اطفال شوية
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أبو صلاح

ممكن سؤال ؟
يعنى هى دى كل حاجه مطالبين فيها عن cpاخر كلام؟؟؟؟؟؟؟؟؟؟؟؟؟؟؟؟؟

ولا لازم برده نتابع سكاشن المستشفى؟

والله يا دكتورة هو اللى انا جايبه عن ال CP
جبته قبل بداية الدراسة وعامة الموضوع ده مهم جدا
واحنا اكيد مطالبين باللى بيتقال فى السكاشن لانه متركز فى اللى احنا عايزينه فى مراحلة الدراسة الاكاديمية
واكيد ان الموضوع ده من اهم الموضوعات عندنا ولازم نقرا عنه كتير
وانا عن جبته عن طريق زيادة معرفة واطلاع على اهم موضوع فى اطفال ولكنه ليس مغنيا عن ما يتم تدريسه فى الكلية و شكرا

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أبو صلاح

[img][/img][img]ولله هايل يا ابو صلاح[/img]

هايل لكل الموقع وياريت نستمر على كده يا جماعه[img] ZAKER

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