Health Cerebral Palsy is on its way to becoming the commonest cause of disability in India. Knowing about the condition is the best way to treat it
A young mother had taken her wheelchair-bound daughter to visit the Prince of Wales museum in Mumbai. The mother asked the watchman to open the gate as the wheelchair could not be manoeuvred through the turnstile.
But he looked down at the girl, whose head was held at an angle and who was drooling, with a look of disgust.
He glared at the mother and said: “ Yeh paagal ladki museum mein kya karegi!!” (What will this ‘mad' child do in a museum?) The mother saw silent tears rolling down her daughter's cheeks — you see, she'd understood every word uttered by the watchman. The girl had Cerebral Palsy.
Years later, the young girl went on to do her Master's from Oxford University, and the mother went on to found the erstwhile Spastic Society of India.
There is an urgent need to understand Cerebral Palsy because it is on its way to becoming the commonest cause of disability in India. In India, 2.5 million people have been identified with Cerebral Palsy, and three children in 1,000 live births are born with the condition.
What is Cerebral Palsy?
Cerebral Palsy (CP) is a group of disabling conditions that arise due to damage to the central nervous system (CNS).
It is a disorder of movement and posture, usually appearing early in life. ‘Cerebral' refers to brain and ‘Palsy' means lack of muscle control.
Sometimes, the damage involves the nearby parts of the brain as well, leading to hearing and speech defects and problems of perception. Most children with CP have average or above average intelligence, but remain backward because of the unique challenges they face.
They may find it hard to control their facial expressions.
Does CP manifest in many forms?
There are five types of Cerebral Palsy with spasticity being the most common (70 to 80 per cent). Some may have more than one type of CP.
A child with CP is constantly out of step with normal development. What the normal child learns by assimilation, the CP child must be taught as a skill. Symptoms
Depending on the severity and location of the brain damage, some CP children may show no obvious signs for a long time, whereas others may exhibit serious symptoms from birth. The most pronounced features are: poor co-ordination, delay in holding the neck (three to six weeks), sitting (five to six months) and crawling, muscle spasms and seizures.
The infant may also be unusually tense and irritable.
What causes Cerebral Palsy?
If a mother-to-be takes ill during pregnancy (eg. German Measles) or self-medicates herself, it can seriously harm the foetus. Other causes include RH incompatibility, deprivation of oxygen during pregnancy or during difficult and prolonged labour, premature birth, low birth weight, breathing problems, Lesch-Nyhan syndrome, a rare genetic defect, infantile jaundice, accidental head injuries, meningitis in early life, and child abuse — repeated shaking or beating on the head.
Can CP be prevented?
Yes, by maintaining good health before pregnancy, by testing and immunisation for German measles during child-bearing years, at least three months before pregnancy.
Prenatal care is a must. So is foetal monitoring during labour, and incubators for premature and high-risk babies.
Immunisation against childhood diseases such as polio, diphtheria, tetanus, whooping cough and tuberculosis is vital.
How can CP be treated?
The source of the problem is not in the affected limbs, but in the cells of the brain. No treatment has yet been found to repair the damaged brain cells.
The damage does not spread, but without skilled treatment the effect of that damage may become serious.
Thus early detection is important. There is no ‘cure' for CP, but with appropriate and timely help and assistive devices, one can lead a near-normal life.
Most importantly, there are many myths about cerebral palsy that need to be addressed.
CP is not a disease. It is not usually hereditary, contagious and progressive or the primary cause of death. The more we know about CP the more we can do to reduce its occurrence and help those who have CP.