Dealing with cerebral palsy in children: a doctor explains

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The most common treatment for cerebral palsy is physical therapy, which helps the child reach their milestones and prevent complications like contractures and deformities later in life.

from dr Jayanth S Sampath

Cerebral palsy (CP) is a group of conditions that affect a person’s ability to move and maintain posture and balance. It is the most common form of mobility impairment in children. CP can occur due to genetic causes or due to damage to the brain in the first two years of life. Premature births with low birth weight, brain infections (meningoencephalitis), lack of oxygen in the brain during childbirth, and untreated jaundice in the neonatal period and near-drowning are other common causes of CP. In addition to walking difficulties, children with CP often have speech delays, seizures (epilepsy), difficulty swallowing, vision problems, and learning difficulties.

Treatment for cerebral palsy is best performed by a multidisciplinary team of professionals. This improves the quality of decision-making and reduces the overall cost and effort of caring for the child and family. Specialists from different fields need to work closely together to provide optimal care for a child with CP.

Accurate diagnosis of CP is important and should be performed by a pediatric neurologist. The most common treatment for CP is physical therapy, which helps the child reach their milestones and prevent complications such as contractures and deformities later in life. Splints (orthoses or special shoes) are used to support the legs when the child is learning to walk. Control of seizures and muscle tension (spasticity) is primarily achieved through medication. In some situations, medication is injected into tight muscle groups to relieve spasticity and plaster casts are applied to gently stretch the muscle.

Many children with CP benefit from an intervention called gait improvement surgery, typically after age 7, once natural brain maturation is complete. Children with CP may also develop deformities of the feet and legs, dislocation of the hip joint, scoliosis (curvature of the spine), and difficulty in hand function. Regular follow-up care by a pediatric orthopedist is therefore important in order to identify these problems at an early stage and to treat them appropriately. We aim to complete all corrective surgeries before the age of 12 so that the child’s education is not compromised during the secondary school years.

Pragati, our state-of-the-art facility at Rainbow Children’s Hospital, Marathahalli, Bengaluru, offers all the necessary services for children with cerebral palsy, autism and disabilities under one roof. This includes multidimensional physical therapy including gross motor, fine motor and virtual reality rehabilitation, occupational therapy, sensory integration (SI), speech therapy and pediatric psychological services in an integrated manner.

Our therapy center is supported by an experienced team of specialists in the fields of pediatric orthopaedics, pediatric neurology, clinical genetics and child development. We have an orthopedic workshop that makes custom splints and orthotics.

Walking problems in CP are complex and determining the right surgical plan can be difficult. For such cases, we use the 3D Gait Analysis Lab, which provides accurate information about the child’s gait at every level from torso to foot. The motion capture equipment in the gait lab is similar to the technology Hollywood uses for CGI and special effects. This data improves surgical decision-making and eventual surgical outcomes are much better when 3D gait analysis is used as part of the assessment process.

The government has a health insurance plan called the Niramaya scheme under the National Trust for children with cerebral palsy, autism and multiple disabilities which provides family health-related expenses reimbursement of up to Rs 1 lakh per year. We also encourage parents to obtain a disability card from the state government as this will help the family receive various discounts and access to government programs for people with disabilities.

Children with cerebral palsy can expect to lead fairly normal lives as fully functioning members of society. Providing the right treatment at the right time during childhood is essential for a successful outcome.

dr Jayanth S Sampath

MBBS, FRCSEd, MSc, FRCS ED (Tr&Ortho)

Consultant – Pediatric Orthopedics, Marathahalli, Bengaluru

This article was published in partnership with Rainbow Children’s Hospital.

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