Guide To The Causes And Risk Factors Linked To Cerebral Palsy

September 6, 2023

Cerebral palsy is a neurological condition that causes changes in a child's posture, movement, and learning. Symptoms of the condition normally begin by five years old, and they are sometimes apparent at the time of a baby's birth. Approximately ten thousand children with cerebral palsy are born each year in the United States, and an estimated 764,000 Americans display at least one symptom of the condition. Cerebral palsy symptoms vary in severity, and they can range from mild walking problems to eating and speech difficulties. Cerebral palsy is more common in infants born prematurely. To diagnose this condition, doctors use brain scans and examinations of a child's movements, posture, gait, and reflexes. Physical therapists, occupational therapists, and speech therapists help patients with cerebral palsy to improve their motor skills, and some patients may need to have surgery to reduce muscle rigidity.

The medical conditions outlined below are some of the most frequently observed causes and risk factors associated with cerebral palsy.

Genetic Mutation

Over the past several decades, the majority of scientists believed genetics accounted for less than one percent of all cases of cerebral palsy. However, the results of a twenty-year study conducted in Australia and Texas indicate as many as fourteen percent of cerebral palsy cases are the result of a genetic mutation. Published in 2016, the study involved a technique known as whole-exome sequencing. Additional research carried out at the Hospital for Sick Children in Toronto mapped the genomes of 115 children with cerebral palsy, as well as the genomes of the children's parents. The findings showed ten percent of the cerebral palsy cases were due to structural changes in the patient's DNA. All of the patients who exhibited structural changes in their DNA were found to have genetic mutations. The scientists involved in the study identified six genes conclusively linked to the development of cerebral palsy. Although more research is needed, these findings could lead to the creation of genetic tests for cerebral palsy in the future.

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Fetal Stroke

A fetal stroke could occur at any point between from fourteen weeks gestation to the onset of labor. During a fetal stroke, the blood supply to the developing brain of the fetus is disrupted, and this can result in damage. After birth, infants who have had a fetal stroke are often diagnosed with epilepsy, cerebral palsy, or learning difficulties. Doctors are still trying to understand the causes of fetal strokes, and they now believe most cases are caused by ischemic, hemorrhagic, and thrombotic injuries that occur before birth. In fact, a study of forty-seven instances of fetal stroke identified hemorrhagic lesions in more than ninety percent of cases. MRI scans are typically used to detect fetal strokes. Risk factors for a fetal stroke include alloimmune thrombocytopenia and physical trauma to the mother, such as a fall.

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Bleeding Into The Brain

Bleeding into the brain, also known as intracranial hemorrhage, may occur before, during, or shortly after the birth of a newborn. These hemorrhages can damage parts of the brain responsible for motor functions and development. Bleeding can occur from either arteries or veins, and doctors grade the severity of intracranial hemorrhages on a scale of one to four. Risk factors that increase the likelihood of a newborn bleeding into the brain include a fetal stroke, blood clots in the placenta, maternal hypertension or infection, and trauma during delivery. Newborns having an intracranial hemorrhage could display signs such as a drop in blood count, an elevation in bilirubin, retinal bleeding, and weak muscle tone or reflexes. Ultrasounds, MRI scans, and CT scans are normally used to diagnose intracranial hemorrhages. While hemorrhages at grades one and two may heal on their own, those at grades three and four generally require surgery. Some newborns who have had bleeding into the brain may not experience any lasting effects. Others might need therapy for cognitive conditions or developmental delays.

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Cytomegalovirus is a viral infection that can impact individuals of all ages. Although most patients do not have any symptoms, pregnant women who contract this infection could transmit it to their unborn baby. Exposure to the virus increases the baby's risk of developing cerebral palsy, and it can also result in premature birth and low birth weight. Newborns who have contracted cytomegalovirus could have an enlarged liver, jaundice, an enlarged spleen, and small head size (microcephaly). These signs typically occur at birth, though some infants may develop symptoms years after exposure. Late symptoms usually include hearing loss and developmental delays, and some infants could have vision problems. If a pregnant woman tests positive for cytomegalovirus, doctors typically perform an amniocentesis test to determine whether the infection has been passed to the unborn baby. Newborns who display symptoms of cytomegalovirus need to be tested for this condition within the first three weeks of life. Newborns with this virus are given antiviral medications, and other treatments may be given depending on the severity of the infection.

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Bacterial Meningitis

Newborns who contract bacterial meningitis have an increased risk of cerebral palsy. Meningitis is an inflammation of the membranes that surround the brain and spinal cord. The most common causes of bacterial meningitis in newborns include Group B streptococcus and listeria. This form of meningitis occurs more often in male newborns than in female newborns. In neonates who have a low birth weight, the condition develops in two out of every one thousand babies. Approximately fifteen percent of newborns with sepsis will develop bacterial meningitis. Additional signs in newborns include seizures, irritability, vomiting, and lethargy. Newborns with bacterial meningitis may also have a bulging fontanelle, and nuchal rigidity and cranial nerve abnormalities could occur. To diagnose this bacterial infection, physicians perform a lumbar puncture (spinal tap). Antibiotics are the primary treatment method. If treatment is successful, a baby may still have lasting effects such as hearing loss and learning difficulties.

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