Who We Are?
Samvedna Trust is a fully charitable trust & working for children & adult with cerebral palsy & other physical disability. in last 9 year trust has managed > 1800 children with cerebral palsy & organized >1000 camps for cerebral palsy affected children in various part of India
Cerebral Palsy- An Overview
Cerebral palsy is the term used to define brain damage at the time birth on in utero. it is commonest cause of childhood nuro-muscular disorder . it is not a disease. It is group of Neuro-motor disorder which comprises of motor dysfunction, disturbance of sensation, perception, cognition, communication , behavior, epilepsy, hearing, speech & immunity etc It is a life long condition that affect individual & his immediate surrounding . it occur because of Non-progressive disturbances in the developing fetal or infant brain upto 3 year of postnatal period . Cerebral palsy is the disorder that causes impair control of movement due to damage in the developing brain. Severity of Lesion may range from sectoral defect to global affection of brain. The brain injury is static; it is not progressive. However, the dysfunctions or disabilities associated with cerebral palsy can be static, progressive or regressive depending upon type of intervention modality and surrounding environments. Risk factor and probable possibility of cerebral palsy can be determined at the time of birth but definite diagnosis can only be made earliest at 3-6 mth of age. Spectrum of presentation range from clumsiness in gait to severe disability. Premature (<8 month )& low birth weight (<1.5 kg )infants are mostly vulnerable to this disorder. most of the time etiology of Cerebral palsy is unknown . know causes are birth asphyxia, sever jaundice, encephalitis, brain structural anomaly, genetic and metabolic causes etc.
Cerebral Palsy is broadly classified into four types- Spastic cerebral palsy,Athetoid cerebral Palsy, Ataxic cerebral palsy & mixed variety.
Diagnosis of Cerebral Palsy
The diagnosis of cerebral palsy can be made on the basis of clinical assessment which include detail history and physical examination . usually they does not require any investigation except in doubtful cases and to confirm the etiology of brain damage. they may need MRI, CT scan , Genetic and metabolic assessment. early diagnosis & early intervention in the form of physiotherapy always give excellent outcome.
In most of the cases (approx. 70%), Cerebral Palsy originates due to brain injury during a baby’s evolution in the womb. Some of the additional cases are also diagnosed in which brain injury occurs during the birthing process. Premature delivery particularly those who have weight less than 3.3 pounds (1.510 gms ) are more vulnerable. Some of the major causes of Cerebral Palsy are:-
1. Infection during pregnancy: It directly harms the developing nervous system of the fetus. Also, some virus and parasites like toxoplasmosis, rubella, cytomegalovirus (TORCH) etc. are responsible for infection.
2. Intense jaundice in the infant : in the case of new-borns, jaundice is treated with light therapy however, in some rare cases, intense and uncured jaundice can damage the brain cells.
3. Incompatibility of antibodies or RH between mother and infant: in this case the mother’s body may behave as allergic to the baby and this will cause to the attack of antibodies to fetus’s red blood cells, and this creates anemia. Finally it causes severe brain damage in the fetus or causes cerebral Palsy.
4. Significant trauma to the head during delivery : severe lack of oxygen to the brain during delivery also causes brain damage in infants.
Cerebral Palsy Treatment
we dont have any cure for cerebral palsy as Brain damage can not be repaired !however, a proper cerebral palsy treatment can enhance the capabilities of a child.
Our aim of management is to rehabilitate the child to their maximum ability & diminish their disability & impairment by all means.Goal is to allow the individual live with least impact of disability. Even small degrees of improvement makes a great difference. Getting a child to walk, be it in crutches, in braces or with a walker, is much better than having him in a wheelchair.With Early intervention more than 8o% children can be given fully acceptable life in society . Quality of life & survival in CP child with Ambulatory capability with or without walking aid is roughly equal to normal population
More than 70% children with mild to moderate affection have nearly normal IQ. they Can be active, productive members of their communities.they Can have jobs, live independently, marry, have children & retire. These childrens & adult can also excel in all the activity given to them. Developmental Physiotherapy along with judicious use of light wt polypropylene brace & walking aid is the mainstay of treatment. NDT, SI, TRP, MRP, CIMT, Context therapy, Strength training, Mirror therapy, FES, Hydrotherapy, Horse riding etc are few example of therapeutic technique. use of oral drugs are limited to control of seizure, other medical problem but most of them are not much helpful in controlling spasticity and getting physical improvement. most of the spastic children are going to develop contracture & fixed deformity after achieving certain milestone so at some time in early life they need good intervention modality to prevent further deterioration. without intervention they are going to deteriorate at very fast speed. at that age they need intervention of good quality, which should have selective control of spasticity and management of fixed contracture without any negative effect on already weakened muscle and posture balance. Cerebral Palsy surgery treatment is used to formulate to treat anatomical abnormalities like bony torsion and release of tight muscles. botulinum toxin in early age children with spasticity is very helpful in getting control on spasticity without causing further weakness. it is being given in all affected spastic muscle. but when the child develop contracture and fixed deformity this is not so much helpful then they need orthopedic surgical intervention but routine orthopedic surgical intervention is not so much useful and even some time they cause harm in the child . these children and adult require advance farm of surgical intervention in the form of surgery ie. SEMLOSSS. Results of SEMLOSSS is matchless compare to other surgical technique and in last 8 year more than 500 children and adult who have undergone treatment by concept of SEMLOSSS got excellent recovery . we have to continue physiotherapy for long duration till the maturity. Yoga, regular exercise, sufficient intake of calcium & vit D and weight maintenance , walking with or without support have long term impact on quality of life in person affected with cerebral palsy