Encyclopedia of Health and Medicine

240 The Nervous System
pregnancy. The doctor may conduct diagnostic
imaging procedures such as COMPUTED TOMOGRAPHY
(CT) SCAN and MAGNETIC RESONANCE IMAGING (MRI) to
visualize the structures of the brain. An ELECTROEN-
CEPHALOGRAM (EEG) helps identify electrical irregularities
in the brain that may identify structural
abnormalities. Though none of these tests conclusively
diagnoses cerebral palsy, the tests help rule
out other possible causes of symptoms.
As the child grows older the symptoms of cerebral
palsy often become unmistakable. Among
them are
• spasticity and contractures of the limbs
• inability to crawl or walk
• vision impairment
• hearing loss
• swallowing and speech difficulties
• SIALORRHEA (drooling)
• URINARY INCONTINENCE
The severity of symptoms does not worsen,
though symptoms may change over time. With
some forms of cerebral palsy, notably spastic
hemiplegic, symptoms may change from day to
day. Spasticity may develop into contractures.
However, the person’s overall neuromuscular status
remains unchanged. The doctor may conduct
repeated NEUROLOGIC EXAMINATION and diagnostic
procedures to monitor any changes in symptoms,
though generally can make a firm diagnosis when
the child is age three to five years.
Treatment Options and Outlook
Cerebral palsy is irreversible. Treatment targets
relieving symptoms and may include medications
to relieve spasticity (such as baclofen), tremors,
sialorrhea, and muscle tenseness. Many people
take combinations of medications tailored to their
specific needs and symptoms. People who have
severe spastic cerebral palsy may benefit from
injections of medication into the fluid around the
SPINAL CORD, which allows higher concentrations of
the medication to reach the NERVE cells than the
person could otherwise tolerate.
PHYSICAL THERAPY can specifically target particular
muscle groups and developmental delays, and
KNOWN RISK FACTORS FOR CEREBRAL PALSY
Risk Factor
maternal RUBELLA (viral INFECTION)
Preventive Measures
rubella VACCINE before PREGNANCY
maternal TOXOPLASMOSIS (protozoan infection)
avoid contact with cat feces (such as when cleaning a litter box or
working in an outdoor garden)
thoroughly cook pork and lamb
preterm delivery
low birth weight
appropriate and consistent PRENATAL CARE
appropriate nutrition
diligent management of DIABETES
avoid smoking
avoid drinking ALCOHOL
Rh incompatibility
Rh screening before pregnancy
Rh serum to mother after birth of Rh-incompatible child to protect
future children
NEONATAL JAUNDICE
PHOTOTHERAPY
head injury
methods to reduce risks for falling
appropriate infant restraints in motor vehicles