| Tragically, severe injuries can occur during pregnancy, | | | | Movement Problems |
| labor, or shortly after birth. | | | | The next step in diagnosing cerebral palsy is ruling out |
| Many parents face the challenge of providing for a | | | | the other disorders that may cause movement |
| child with special needs and seeking to secure the | | | | problems. Most importantly, doctors must determine |
| child's future care and treatment. If medical error | | | | that the child's condition is not getting worse. |
| caused the child's injury, a medical malpractice claim | | | | Although its symptoms may change over time, |
| may be possible, to help ensure financial security for | | | | cerebral palsy by definition is not progressive. If a |
| potentially staggering medical and financial costs. While | | | | child is continuously losing motor skills, the problem is |
| most injuries or illnesses are usually not caused by | | | | more likely to spring from other problems, like genetic |
| medical treatment errors, others are linked closely | | | | diseases, muscle diseases, metabolism disorders, or |
| with medical negligence or medical mistakes. Thus, it | | | | tumors in the nervous system. The child's medical |
| is necessary to take a close look, to determine | | | | history, special diagnostic tests, and, in some cases, |
| whether a birth injury was caused by a physician or | | | | repeated check-ups can help a physician determine |
| hospital mistake, or if the birth injury was something | | | | whether or not disorders are at fault. |
| that simply could not be avoided. | | | | CT Scan |
| Cerebral palsy is one major group of illnesses, which | | | | The doctor may also order special tests to learn |
| may result from avoidable medical mistakes. | | | | more about the possible cause of cerebral palsy in an |
| Medical History of Cerebral Palsy | | | | individual child. One test is computed tomography, or |
| In the 1860s, an English surgeon named William Little | | | | CT, which is a sophisticated imaging technique that |
| wrote the first medical descriptions of a puzzling | | | | uses x-rays and a computer to create an anatomical |
| disorder that struck children in the first years of life, | | | | picture of the brain tissues and structures. A CT scan |
| causing stiff, spastic muscles in their legs and, to a | | | | may reveal brain areas that are underdeveloped, |
| lesser degree, in their arms. These children had | | | | abnormal cysts (sacs often filled with liquid) in the |
| difficulty grasping objects, crawling, and walking. As | | | | brain, or other physical problems. With the information |
| they grew up, they did not get better, but they did | | | | from CT scans, doctors may be better equipped to |
| not get worse. Their condition, which was called | | | | judge the long-term outlook for an affected child. |
| Little's disease for many years, is now known as | | | | MRI Scan |
| spastic diplegia. It is just one of several disorders that | | | | Magnetic resonance imaging, or MRI, is a brain imaging |
| affect control of movement and are grouped under | | | | technique used to identify brain disorders. This |
| the term cerebral palsy. | | | | technique uses a magnetic field and radio waves, |
| In fact, cerebral palsy is an umbrella-like description | | | | rather than x-rays. An MRI gives better pictures of |
| for several chronic disorders impairing control of | | | | structures or abnormal areas located near bone than |
| movement, which appear in the first few years of | | | | a CT scan. |
| life and generally do not worsen over time. The term | | | | Ultrasonography |
| cerebral refers to the brain's two halves, or | | | | Another test that exposes problems in brain tissue is |
| hemispheres, and palsy means any disorder that | | | | ultrasonography, or ultrasound. This technique |
| impairs control of body movement. Thus, problems in | | | | bounces sound waves off the brain and uses the |
| muscles or nerves do not cause these disorders. | | | | pattern of echoes to form a picture, or sonogram, of |
| Instead, faulty development or damage to motor | | | | its structures. Ultrasonography can be used with |
| areas in the brain, disrupt the brain's ability to control | | | | infants before the bones of the skull harden and |
| movement and posture adequately. | | | | close. Although it is less precise than CT and MRI |
| Symptoms of cerebral palsy range in severity. An | | | | scans, this test can detect cysts and structures in |
| individual with cerebral palsy may have difficulty with | | | | the brain, is less expensive, and does not require long |
| fine motor tasks, such as writing or cutting with | | | | periods of immobility. |
| scissors; experience trouble maintaining balance and | | | | EEG |
| walking; or have involuntary movements, such as | | | | If the doctor suspects a seizure disorder, he or she |
| uncontrollable writhing motion of the hands. The | | | | may order an electroencephalogram, or EEG. During |
| symptoms differ from one person to the next, and | | | | this test, special patches called electrodes are placed |
| may even change over time in the individual. Other | | | | on the scalp and will record the natural electrical |
| medical disorders, like seizures or mental impairment, | | | | currents inside the brain. The recording can help the |
| may affect some people with cerebral palsy. | | | | doctor see patterns in the brain's electrical activity |
| Contrary to common belief, cerebral palsy does not | | | | which suggest a seizure disorder. |
| always cause profound disability. While a child with | | | | The Intelligence Test Issue |
| severe cerebral palsy might be unable to walk and | | | | Intelligence tests are often used to determine if a |
| need extensive, lifelong care, a child with mild cerebral | | | | child with cerebral palsy is mentally impaired. |
| palsy might require limited special assistance. Cerebral | | | | However, some children's intelligence may be |
| palsy is not contagious and not usually inherited from | | | | underestimated because problems with movement, |
| one generation to the next. At this time, there is no | | | | sensation, or speech due to cerebral palsy make it |
| cure, although scientific research continues to yield | | | | difficult for them to perform well on these tests. |
| improved treatments and methods of prevention. | | | | Medical Problems Related to Cerebral Palsy |
| The United Cerebral Palsy Association estimates that | | | | Physicians will look for other conditions linked to |
| more than 500,000 Americans have cerebral palsy. | | | | cerebral palsy, including seizure disorders, mental |
| Despite advances in preventing and treating certain | | | | impairment, and vision or hearing problems. For |
| causes of cerebral palsy, the number of children and | | | | potential vision problems, the doctor may recommend |
| adults it affects has remained essentially stable, or | | | | an examination by an ophthalmologist. If the treating |
| may have risen slightly over the past 30 years. This | | | | physician suspects hearing impairment, he or she may |
| is partly because more critically premature and frail | | | | refer the patient to an otologist. Identifying these |
| infants are able to survive with improved neonatal | | | | accompanying conditions is important and is becoming |
| intensive care. Unfortunately, many of these infants | | | | more accurate as ongoing research yields advances |
| have developmental problems of the nervous system | | | | that make diagnosis easier. Specific treatments may |
| or suffer neurological damage. Medical research is | | | | address many of these conditions, to improve the |
| under way to improve care for these infants. | | | | long-term outlook for those with cerebral palsy. |
| Early Signs | | | | What Causes Cerebral Palsy? |
| The signs of cerebral palsy usually appear before 3 | | | | Often, parents of children with cerebral palsy are led |
| years of age, so that parents often are the first to | | | | to believe that their child suffers from a birth defect |
| suspect that their infant is not developing normal | | | | that was unavoidable. Rarely are they told that |
| motor skills. Frequently, infants with cerebral palsy are | | | | medical errors caused their child's disability. Many |
| slow to reach developmental milestones, such as | | | | parents feel that there is no way to know what |
| learning to roll over, sit, crawl, smile, or walk. | | | | caused cerebral palsy and are unaware of the ways |
| Sometimes this is called developmental delay. | | | | to search for answers. The reality is that cerebral |
| Some affected children have abnormal muscle tone. | | | | palsy is sometimes the result of a medical mistake |
| Decreased muscle tone is called hypotonia and | | | | that deprived a child of oxygen during pregnancy, |
| caused a baby to seem flaccid and relaxed, even | | | | often while the mother was in labor. |
| floppy. Increased muscle tone is called hypertonia and | | | | Doctors have an obligation to provide adequate care |
| causes the child to seem stiff or rigid. In some cases, | | | | during all stages of a woman's pregnancy, including |
| a newborn baby has an early period of hypotonia | | | | labor and the period immediately after birth. |
| that progresses to hypertonia after 2 to 3 months. | | | | Unfortunately, doctors are capable of error or |
| Affected children also may have unusual posture or | | | | negligence. |
| favor one side of the body. | | | | Physician mistakes that may cause cerebral palsy |
| Parents who are concerned about their baby's | | | | include: |
| development for any reason should contact their | | | | - Failing to perform a cesarean section when the |
| physician, who can help distinguish normal variations in | | | | fetus is in distress or getting too little oxygen. |
| development from a developmental disorder. | | | | - Inadequately monitoring the mother during |
| Clinical Diagnosis | | | | pregnancy and throughout the labor process. |
| Doctors diagnose cerebral palsy by testing an infant's | | | | - Misinterpreting test results during pregnancy, or |
| motor skills and looking carefully at the infant's | | | | outright failure to conduct necessary tests. |
| medical history. In addition to checking for the | | | | - Failing to monitor closely when the mother has a |
| symptoms described above -- slow development, | | | | condition like diabetes, heart disease, hypertension, |
| abnormal muscle tone, and unusual posture -- a | | | | asthma, renal disease, lupus, or thyroid disease. |
| physician also tests the infant's reflexes and looks for | | | | Peace of Mind |
| early development of hand preference. | | | | If your child has cerebral palsy, it may have been |
| Reflexes | | | | caused by medical malpractice. You owe it to your |
| Reflexes are movements that the body makes | | | | child and your family to see if the cause of your |
| automatically in response to a specific cue. For | | | | child's condition can be determined. A good |
| example, if a newborn baby is held on its back and | | | | malpractice attorney will obtain all relevant medical |
| tilted so the legs are above its head, the baby will | | | | records, review all documentation, and consult with |
| automatically extend its arms in a gesture, called the | | | | leading medical experts to determine definitively |
| Moro reflex, that looks like an embrace. Babies | | | | whether a medical professionals negligence caused |
| normally lose this reflex after the age of 6 months. | | | | your child's condition. |
| However, those with cerebral palsy may retain it for | | | | The Lifelong Cost of Caring for Your Child |
| much longer. This is just one of several reflexes that | | | | The cost of caring for children who suffer from |
| a physician may check. | | | | cerebral palsy can be financially catastrophic. You |
| Hand Preference | | | | must expect significant expenses throughout your |
| Doctors also look for hand preference -- a tendency | | | | child's lifetime, because the condition will not improve |
| to use either the right or left hand more often. When | | | | over time. However, if your child's condition is |
| the doctor holds an object in front and to the side of | | | | determined to be the fault of a hospital or physician, |
| the infant, a child with hand preference will use the | | | | then there should be medical malpractice insurance in |
| favored hand to reach for the object, even when | | | | place to provide financial compensation for these |
| the object is closer to the opposite hand. During the | | | | costs. |
| first 12 months of life, babies do not usually show | | | | If your child or grandchild has been diagnosed with |
| hand preference. But infants with spastic hemiplegia, | | | | cerebral palsy that you believe may have been |
| may develop a preference much earlier, because the | | | | caused by a doctor or hospital's mistake, talk with a |
| hand on the unaffected side of the body is stronger | | | | lawyer experienced in cerebral palsy law. |
| and more useful. | | | | |