Prof. Dr. Memet Özek, Division of Pediatric Neurosurgery Acibadem Healthcare Group

Babies With Cerebral Palsy Can Be Helped With Early Rehabilitation

More than 17 million people worldwide suffer from cerebral palsy (brain paralysis), a disorder of the musculoskeletal system

Cerebral palsy develops due to a brain injury that may occur during pregnancy, birth or the neonatal period. In many cases, however, the exact cause is unknown. The brain injury adversely affects muscle and body movements of children. This can also be accompanied by other health issues, such as problems in speaking, sight, hearing, as well as learning difficulties.

Professor Memet Özek, a pediatric neurosurgery specialist at Acıbadem Altunizade Hospital, Turkey talks to us about this and the importance of early rehabilitation of cerebral palsy.

Baby Born Blue

Complications that develop in babies, such as brain haemorrhages, lack of blood and oxygen supply, and infection of the brain due to an infection in the mother are listed as pregnancy problems that cause cerebral palsy. The causes that lead to the disorder after birth consists of infections such as meningitis and severe head traumas.

In Turkey, the most common cause of cerebral palsy in a baby is the lack of sufficient oxygen supply during birth. The brain tissues of babies who are born blue, as well as babies whose umbilical cords get stuck around their necks and babies who are unable to cry right after birth, are the ones left with insufficient oxygen supply. It causes permanent damage to the brain and leads to cerebral palsy.

The severity of spasticity

Cerebral palsy, which affects muscle control and body movements in children, has varying characteristics and types which depend on the area of the brain where the injury occurs. In cerebral palsy-associated spasticity, children suffering from the disorder experience severe stiffness in their arms and legs. Since the restriction of movements depends on which area of the brain is injured, some children only have stiffness in their arms while others have it in both arms and legs.

Milestones in development

It is possible to detect abnormalities in normal movements of babies born with cerebral palsy; therefore, families need to observe their children very carefully. The arm and leg movements of babies with the disorder are very limited or out of control, and the limbs hang loose.

Furthermore, it is observed that these children also have limited capacity for movement due to spasticity, which is stiffness of muscles. Delays in gaining head and body control and sit- ting up, referred to as milestones in a baby’s development, are the first signals families should watch out for. Babies should be able to control their heads at three months.

Furthermore, they should be able to sit up without support when they are 7 or 8 months old. Parents who that their children are failing to develop according to this natural course should consult a specialist immediately.

Early-stage rehabilitation

Even if the brain injury cannot be treated completely, a well-planned treatment can help patients lead an independent life. However, early diagnosis is critically important for such treatment. Any delays can lead to serious risks. The treatment approach varies with the condition of the patient. Starting rehabilitation procedures in the early stage is particularly important.

At this point, it is essential to make use of the shape-changing capability of the brain, referred to as neuroplasticity, without wasting any time. It is possible to transfer the functions of the cells in the damaged area to the surrounding cells in the brain of a developing baby. This, however, can only be done through early-stage rehabilitation.

Therefore, the rehabilitation procedures for premature babies who are born with brain haemorrhages before the end of the 30- week period and who face a serious risk for cerebral palsy, can be started even while the baby is still in the incubator. However, MRI scanning is a must for definitive diagnosis in babies with a high risk of cerebral palsy.

Daily physiotherapy 

Since a child’s development is very rapid in the first three years of his life, rehabilitation in this period can yield very effective results. Daily physiotherapy in the first three years for children with mild spasticity, in particular, can in many cases almost completely resolve the disorder. This enables these children to live independent lives. The brain injury causing cerebral palsy is not progressive.

However, the movement abnormalities in children who do not receive treatment as they grow are progressive. In cases of cerebral palsy where spasticity cannot be alleviated with rehabilitation methods, it is essential to resort to surgical intervention without delay. Otherwise, it is possible for the condition and the related problems to become worse as the child grows.

Milena Argirović, MD, Country Head For Serbia, Montenegro, Albania, North Macedonia And Kosovo At Takeda

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