Cerebral
palsy: New hope through researchCerebral palsy is a non-progressive disorder of the central nervous system (brain and spinal column) that is a result of an injury to the developing brain. The injury causes a palsy (muscle weakness or paralysis) that effects a child's abilities to regulate muscle tone (the readiness of a muscle to act), initiate movement, and maintain their posture. The degree of severity and the effect on the motor skills of the child depends on the specific area of brain injury (lesion) and the extent of the damage. Cerebral palsy (CP) one of the most commonly identified forms of orthopedic impairment, although it is not the most prevalent type of disability in this classification. Review the following document to get an overview of CP.
Cerebral
palsy: New hope through research
As you read in the online document, the injury or damage associated with cerebral palsy can occur prior to birth, during birth, or after birth and can have many causes, although in most cases the cause is unknown. Cerebral palsy is a nonprogressive disorder meaning that the initial damage to the brain does not become worse. You should note, however, that some of the associated or secondary conditions such as contractions in the joints, curvature of the spine, and possibly seizure disorders may worsen over time.
CP is classified along three dimensions: severity, the anatomic locations that are effected, and the effect of the brain injury on the child's ability to regulate voluntary movement. Severity is rated as mild, moderate, or severe and is generally less precisely defined than the other two dimensions. The hyperlink below is an example of one of the more objective scales for assigning the severity of the movement disorder.
The
USCPAA's Eight Level Classificiation System for Sporting Events
The anatomic locations that are effected by the movement disorder are listed in the table below.
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Topographical Classification
System
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Monoplegia - one limb Hemiplegia - one side of the body Triplegia - three limbs are effected Quadriplegia - all four limbs are effected Diplegia - all four limbs are effected but the legs are more involved
than the arms Double Hemiplegia - all four limbs are involved arms are more effected than the legs |
Finally, the effect of the brain injury on movement is categorized by the particular movement disorder. The most common form of movement disorder of cerebral palsy is spasticity, or tightness in the muscle. Other major forms of CP include athetosis, and ataxia. Each condition may effect the entire body or only selected parts (e.g., hemiplegia, quadriplegia, monoplegia).
What is spasticity?
The degree of cerebral palsy will vary across persons, types, and the limbs involved. No two persons with cerebral palsy are the same. In many cases the person with cerebral palsy will experience other, associated, disabilities. Review the document below for a summary of some of the more common associated conditions.
Other
problems associated with CP
A second type of neurologic condition, one that is becoming alarmingly more prevalent in the U.S. and other industrialized nations, is traumatic brain injury, or TBI. In contrast with CP, traumatic brain injuries are often acquired injuries, occurring after birth and throughout the lifespan. As you will see in the documents below, the incidence of brain injuries is increasing significantly in our population.
In order to fully understand the impact of a brain injury you need a basic understanding of the major divisions of the brain and their respective functions. Visit the site below to review a summary of brain functions by specific lobes. When you reach the bottom of the page, click on each area of the brain model to go to an additional description of the typical functions for that lobe.
The specific types and effects of the injury to the brain vary according to the method of injury. As the graphic from the USA Today issue showed, TBI has many causes, most of which we directly control. The accident or injury that produces a TBI produces both primary and secondary injuries. Now that you have a basic foundation in brain function, you are ready to review the specific impacts of a brain injury.
Finally, it is important that you understand the potential outcomes of a TBI. While these often vary by the extent of the injury and by the persons pre-injury personality (this is felt to be the major variable in recovery rates), certain general outcomes occur in many instances.
Epilepsy is the most common orthopedic impairment, even though many do not consider this condition to be an orthopedic impairment at all. Epilepsy, or a seizure disorder, does cause significant orthopedic consequences. The root problem with epilepsy is an abnormal discharge of electrical activity by one or more cells in the brain. This discharge disrupts the normal functioning of the brain causing altered consciousness, unusual motor activity, hallucinations, and sometimes problem or inappropriate behaviors. Read the following pamphlet for more detailed information about epilepsy
Epilepsy:
New Hope through Research
As you read in this pamphlet, there are a variety of seizure types. Teachers must be able to recognize each, understand the potential effects of the type of seizure and know basic first aid procedures to help the child through an epileptic episode. Review each of the documents below to learn about how to recognize and treat seizures.
Seizures can be managed through a number of interventions. Most often the child will be given anticonvulsant medications. These medications seek to either (a) prevent the initial abnormal discharge of electricity in the brain or (b) prevent the seizure from spreading to adjacent cells.
The primary difficulty with epilepsy is less a physical concern and more of an educational problem. Review the following document to learn about the educational implications of seizures and epilepsy.