For children with cerebral palsy, Botox injections have helped reduce disability.

A healthy mind in a healthy body is what we all wish for but not every one is blessed. Ask those parents whose children are afflicted with Cerebral Palsy. The little ones face social discrimination for a physical handicap, which often gets them tagged as ‘retarded' or ‘mentally challenged'.

What is Cerebral Palsy?

There is a compelling need to understand Cerebral Palsy. The disease is a disabler known least to people. It is rapidly becoming the commonest cause of disability in India. However, not all is lost if the problem is detected in the early stages. With proper care, medical treatment and society's empathy and warmth, patients can lead a near-independent life.

‘Cerebral' refers to brain and ‘Palsy' means lack of muscle control. The disease is a group of disabling conditions, which arises due to damage to the central nervous system (CNS) during pregnancy or childbirth or in early childhood. It is a disorder of movement and posture usually appearing early in life. Sometimes the damage also occurs in nearby areas of the brain as well, resulting in hearing and speech defects along with problems of perception.

A difficult prolonged labour, suffocation of the child during birth, premature birth, infections in early days, congenital heart disease, a rare genetic defect (Lesch-Nyhan syndrome), infantile jaundice, accidental head injuries and child abuse like repeated shaking or beatings on the head are some common causes.

Contrary to popular belief, most children with CP have average or above average intelligence but remain backward because of their handicap. Their physical disability impedes their chances of normal education. What one forgets is that, given a chance and proper treatment, CP patients can also contribute to the society in their own way!

Symptoms

Poor co-ordination, delay in holding up the neck and sitting, muscle spasms and seizures are typical symptoms. Modern-day therapy can help alleviate these. Traditionally, the treatment for CP has involved physiotherapy, occupational therapy, castings, gaiters, ankle foot orthosis and surgery.

However, in recent years, Botox has emerged as a very promising treatment for CP. The treatment involves giving Botulinum Toxin injections in the spastic muscles. The dose has to be ascertained by an experienced medical practitioner after carefully examining the extent of the condition. This is crucial as only a specialist can identify the muscles to be injected. The toxin works by relaxing the spastic muscles and helps reduce disability. Over a period of time, and in combination with appropriate physio and occupational therapy, the child can start walking or walk better than before and gain self-independence.

The effect of the treatment lasts for about six to nine months and can be prolonged by braces and good physiotherapy. Doctors have observed remarkable improvement in children who start with this treatment at an early stage. It is safe and side effects such as muscle weakness occur only when the wrong muscles are injected. The localised pain at the injection sites too doesn't last long.

Lastly, along with treatment, what is required is a shift in mindset. In the case of CP, early detection can go a long way in helping sufferers and their care givers. As a society, we need to curb discrimination against disability and not the disabled themselves!

The writer is a New Delhi-based paediatric neurologist.