Early Signs of Cerebral Palsy in a Child

By Dr. Okechukwu Amako, MBBS (Ibadan)
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There was this woman who already had 5 children, all of them girls, and she lived with her husband in a rural area. But she was not happy because she didn't have a male child; her husband had the same concern. So, the couple kept trying to get pregnant, even though the woman was over 40 years old.

Finally, she got pregnant. However, this woman has had a few miscarriages before this pregnancy. She took herbal concoctions occasionally and only stopped when her tummy became very big; she never bothered to go for antenatal care because the nearest health centre was very far from her community. In addition, she never received any antenatal care while pregnant with each of her 5 daughters and she gave birth to each of them at home with the help of a traditional birth attendant.

When she was due to give birth, the same traditional birth attendant came around to deliver her of the baby. But unlike the previous deliveries, something unusual happened. When the baby came out, though fortunately a male, he didn't cry immediately. It was after almost 5 minutes of the traditional birth attendant doing trial and error of turning the baby around, rubbing and gently hitting him at the back that the baby started crying. Everybody was very happy not only because of the sign of life (the baby's cry) but finally, a male child had arrived.

A year later, this male child was still not able to sit upright without someone supporting him let alone standing or walking. The child had other problems which the mother noticed earlier but ignored because she taught they were going to resolve as the baby grew. But these problems never disappeared, and they included:

1. The child's head was still lagging (head rolls back) at 9 months like that of a new-born baby and has remained that way.

2. The baby was having difficulty with breastfeeding hence he could not feed properly

3. The mother also complained that the baby's body felt floppy (weak and sluggish) like he had no strength

4. One day towards the baby's first year, the mother noticed he was shivering like someone who had a convulsion. And this has been repeating itself occasionally since then.

The woman and her husband finally decided to visit a hospital in the city very far from their rural community because their one-year plus male child couldn't sit up (people were saying they gave birth to a lame child) and the child also had a convulsion. After the doctor at this hospital examined the child, he referred them to a medical specialist called a paediatric neurologist in a teaching hospital. It was at the teaching hospital that the doctor they were referred to made a diagnosis that this child had cerebral palsy.

Cerebral palsy is a condition in which there is an abnormality with movement (involving different parts of the body) and how the body is positioned when standing, sitting or lying down. This is due to a permanent injury to a brain that is still developing which can happen to a child while he or she is still in the womb (during pregnancy), during the time he or she is being delivered and immediately after birth. This injury to the brain is non-progressive (once it happens to a certain part of the brain, the injury doesn't spread to other parts).

Children with cerebral palsy have a delay in their development such as sitting upright without support, standing and walking, meaning they may never be able to carry out these activities for life without someone supporting them. Depending on the type of this disorder a child has, he or she may have other problems like mental retardation (learning disability), hearing and eye problems, speech (talking) abnormalities, muscle and bone problems.

Possible risk factors that can contribute to a woman giving birth to a child with cerebral palsy include:

-Exposure of the pregnant woman to radiation

-Infections, taking drugs without a doctor's prescription, alcohol intake, and herbal concoctions use in pregnancy. This most likely happens when the pregnant woman fails to register for and receive antenatal care as was the case in the woman's story. This shows the importance of antenatal care for pregnant women.

-Any injury to the baby's head during delivery, or the baby not crying immediately after birth

-Giving birth to a premature baby or a baby with a low birth weight (meaning the baby did not grow well while in the womb)

-Infections such as meningitis which can occur in the baby during birth or in the first 30 days of life

-severe trauma to the baby's head in the first one month after birth and a condition in which the chemical compound (bilirubin) released from the breakdown of red blood cells leaks into the new-born baby's brain.

Cerebral palsy is a lifelong condition and requires the collaboration of different medical specialists (paediatric neurologist and neurosurgeon, ophthalmologist, physiotherapist, orthopaedic surgeon, and so on) for proper management of the child for life.

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For more advice and help, feel free to consult a doctor.
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Published Tuesday, June 6th 2017

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