• Women advised not to smoke during pregnancy
By Ogechukwu Agwu
Cerebral palsy (CP) is a group of permanent movement disorders that appear in early childhood. It is a non- progressive neuro-developmental condition initiated early in life that persists into adulthood and could lead to loss or impairment of motor function. Those affected with this condition suffers stiff and weak muscles, abnormal muscle tone reflexes, alongside poor coordination with the use of their body.
They usually appear to be clumsy or awkward and are unable to walk properly. It is the most common movement disorder in children affecting 2.1 per 1000 live births. Cerebral has to do with the brain whereas palsy has to do with the weakness or difficulties involved with using the muscles. Cerebral palsy affects an individual so much so that an individual may not be able to control its brain activities or develop properly.
The level at which this condition affects an individual varies, according to Femi Gbadebo, Director Benola Initiative, said, “some persons working with CP can work and function in the activities that a normal person can do, others have specific limitations in their ability to function and may need some special support or accommodation, some may be severely impaired due to the nature of their disability and may have a totally dependent life.”
The cause of CP is unknown however there are speculations that it is could be as a result of birth injuries and abnormal development or damage to the parts of the brain that controls movement, balance and posture. Sometimes the problem may occur during pregnancy and this may be during childbirth or shortly after childbirth or an infection from the mother to the child, it could also be as a result of bleeding in the brain or changes in the gene that affects the brain development.
This condition occurs in one in four hundred children, approximately two to four out of every one thousand births in the United States and Europe, ten to fifteen out of every one thousand births in developing countries like Nigeria.
According to Prof Afolabi Lesi, a consultant paediatrician, 700,000 children are living with cerebral palsy. .The symptoms of CP normally become noticeable during the first three years of a child’s life. Many people with CP have a number of associated problems including repeated seizures or fits, drooling problems and swallowing difficulties. Some people with this condition may have communication and learning difficulties although intelligence is often unaffected.
According to experts CP is not a progressive condition which means that the original problem in the brain doesn’t get worse with age and life expectancy is usually unaffected. Despite this the emotional and physical strain of living with a long- term condition may put a great deal of stress on the body which may cause problems in life.
People are often disheartened to learn that there is no singular test that will accurately diagnose a child with cerebral palsy. Diagnosis is important in other to understand the person’s status to begin early intervention and treatment to remove fear of not knowing, to find and secure benefits to offset the cost of raising a child with cerebral palsy. The diagnosis is very important for the well-being of children and is usually in three stages; developmental monitoring (surveillance), developmental screening, developmental and medical evaluation. Surveillance involves tracking a child’s growth and development overtime, it is after there is any concern then a need for screening will take place.
Dr Charles Umeh said development screening is a short test that is given to see if the child has specific development delays such as motor or movement delays. These tests are in the form of interviews or questionnaires completed by parents or guidance.
The American Academy of Paediatrics recommends that all children be screened for development delays during regular well child visits at 9 months, 18 months, 24 months or 30 months. In the case of development evaluation, the goal is diagnose the specific type of disorder that is affecting the child in order to evaluate movement or motor delay, the doctor usually examines the child’s motor skills, muscle tone, reflexes and posture. In addition to this, additional tests such as brain imagining tests, x-ray, computed tomography (C T scan), or magnetic resonance imaging (MRI), electroencephalogram (EET), genetic testing, metabolic testing or a combination of these.
According to Umeh, “there are some major problems that people with CP face, one of such problems include: speech and language problems. For people with CP, speech problems are associated with poor respiratory control, laryngeal and velopharyngeal dysfunction and oral articulation. Language delay on the other hand is associated with problems of intellectual disability, hearing loss and learned helplessness. Generally, people with CP usually become passive communicators.
“Pain is another problem that is common with those living with CP and it is usually associated with tight or shortened muscles, abnormal posture, and stiff joints. There is also a case of sleep disorders for people with CP.
“Although there is no cure to CP, there are different therapies and medications that are available under the supervision of a specialist to help people with CP to cope and live right, any therapy that is administered to someone living with CP is usually tailored to meet his/her need this is because a treatment may work for one person and may not work for the other person, in any case the parents, guardian or helper would have to work in close relation with the specialist in charge of the ward to ensure that the therapy administered is the right one bearing in mind that the goal of each therapy is to ensure that he/she reaches his/her potentials physically, socially, mentally and emotionally.”
When prescribing medications the aim is to reduce the effects of CP and prevent complications, these drugs are used to prevent seizures, reduce spasticity and abnormal movements.
Coping with celebral palsy should not be a means to an end according to Gbadebo, “the way to cope with this disability is to understand the issue and this comes with a lot of massive advocacy and education. Knowledge is power and without knowledge, people tend to be afraid, this is why in this part of the country, CP is still attributed to evil spirit and as such there is a stigma, people are afraid of the child that is disabled, and this bounces back on the family, the woman blames herself, the child feels rejected by the community, and the circle of guilt therefore continues.”
He advised that the government should enact laws that will favour people living with disabilities, in his words, “I encourage the federal government to enact the right laws to create a disabled friendly environment, to provide wherewithal for the disabled, for them to be able to maximize their potentials. the reason I say this is because we have people who because there are families who have people with disabilities and they are not able to cater for them, you find that most times, these ones with disabilities have what it takes to become somebody in life but due to financial constraints, their talents are not groomed. For those that their families can support them have ended up with different degrees at different levels, there are people who have degrees in all kinds of fields like medicines, physiotherapy.”
Umeh said “Although the cause of CP is unknown, there are life style practices that could help on the long run; one of such practices is to avoid cigarettes during pregnancy because smoking increases the chance of having a premature delivery that may end up looking deformed. Getting appropriate healthcare during pregnancy can go a long way too, also vaccinations of babies can prevent infections or diseases that could lead to CP.”