Managing common symptoms of cerebral palsy in children

摘要

Cerebral palsy describes a heterogeneous group of permanent disorders of movement and posture which are attributed to non-progressive disturbances in the developing fetal or infant brain and cause limitations in activity. The motor disorders of cerebral palsy are often accompanied by disturbances of sensation, perception, cognition, communication, and behavior; epilepsy; and secondary musculoskeletal problems. Worldwide, cerebral palsy is the commonest cause of motor disability in childhood, with an incidence of 2-3 per 1000 live births, increasing to 40-100 per 1000 live births in premature babies and those of very low or low birth weight. As cerebral palsy is a permanent disabling condition it is a major consumer of healthcare resources in developed countries. The motor disorder results from centrally mediated abnormal muscle tone: spasticity ("high tone") is the commonest abnormality. Multiple impairments can limit involvement in life situations in childhood and place great strains on the family. Thirty per cent of affected children are unable to walk, 3O°/o have a severe intellectual impairment, 28% have impaired or no speech, and 12% are blind. Family doctors can and should play a pivotal role in coordinating care, identifying associated problems early, and providing lifelong support. This article presents an overview of cerebral palsy but focuses on the common problems of spasticity, pain, and feeding difficulties that affect a substantial number of children.