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Cerebral Palsy Life Expectancy

Cerebral Palsy

Cerebral Palsy (CP) is used to define a broad assortment of neurological conditions that result in permanent movement disorders. It primarily affects parts of the brain responsible for motor control, coordination, and balance. CP is usually caused by brain damage that happens before or during a child's birth, or during the first few years of life and is one of the most common congenital childhood disorders.

As the most prevalent form of childhood disability, with 10,000 babies born each year in the US with cerebral palsy. Symptoms range from stiff muscles, poor coordination, and tremors. Moreover, 58% of children with CP experience difficulty in communication, 42% have vision problems, 56% encounter lower urinary tract dysfunction, and almost 23–56% are diagnosed with learning disabilities.

Life Expectancy of people with Cerebral Palsy

The average life expectancy in the United States is 78.8 years and most people with mild cases of CP can expect to live to a similar age. However, people with more severe cases of CP have a shortened life expectancy than the general population.

A study published by the National Institutes of Health explains that people exhibiting severe cerebral palsy symptoms that check “all four functional disability categories” have a 50% chance of making it to the age of 13 and a 25% chance of living to celebrate their 30th birthday.

With children, almost 1 in 15 with cerebral palsy experience difficulty with swallowing food and require a feeding tube for consumption. Complications like this can decrease life expectancy because as they adversely affect the quality of life and lead to nutritional difficulties.

Keep in mind, these shortened life expectancy estimates only refer to the most severe cases and many people who suffer from CP do go on to live long, happy lives, even if they need care from family members or professional caregivers.

Early signs of Cerebral Palsy

While symptoms are not immediately present in babies with CP, the neurological disorder becomes apparent during the developmental stage of six to nine months, when the baby is starting to mobilize, and motor developmental delay is more noticeable. Some common signs are:

  • Babies with CP do not sit, roll over, walk or crawl when other children of their age start exhibiting the aforementioned developments.
  • Birth defects, like spinal curvature or a small head/jawbone, are common along with orthopedic manifestations like irregular posture, motor dysfunction, slight clumsiness, increased muscle tone, dystonia or spasticity.

Challenges of living with Cerebral Palsy

Cerebral Palsy isn’t a degenerative disease that gets worse as a child ages, however that doesn’t mean it isn’t a challenging condition to manage. With many physical impairments, this can take a toll on a person’s body. The most common challenges someone with Cerebral Palsy faces are:

  • They have learning disabilities, visual impairments, hearing problems, speech problems, drooling issues, and behavior problems
  • They need braces, crutches, or a wheelchair to get around
  • They need help to move around in class or reaching objects
  • They need assistive devices for writing and speaking
  • They have difficulty sitting still and have uncontrolled movements
  • They have difficulty with bladder and bowel control and may need to use a bathroom frequently
  • They have seizures

Causes of Cerebral Palsy

Muscle control takes place in the upper part of the brain called Cerebrum which is also responsible for communication skills, ability to learn, and memory.

CP occurs when there is damage or abnormal development of the cerebrum during pregnancy (more than 3-quarters of cases), delivery, or within five years of post-partum can be linked to causing CP.

While in several cases, there is no identifiable explanation for CP, usual causes include:

Premature birth:
Premature births are a common cause of CP. In the US 40% to 50% of all children with CP had a premature birth. 75-90% of these cases experienced problems around the time of birth and sometimes, just after birth. As opposed to single-birth infants, multiple-birth infants are more likely to have CP, as they are also susceptible to low birth-weight.

Infection during pregnancy:
The risk of a child developing CP is tripled if the mother contracts an infection during pregnancy, especially the kind not easily detected, like one in the fetal membranes. Rh blood type incompatibility can also be responsible for CP in infants, as the mother's immune system will end up attacking the red blood cells of the fetus.

Similarity after birth, infections (such as meningitis) contracted by newborns can cause brain damage. Meningitis causes severe inflammation that can damage the motor control centers of the brain.

Birth injury / trauma:
Asphyxiation is a lack of oxygen reaching the brain. It can cause severe brain damage to a baby during birth when an early detachment of the placenta, a ruptured uterus during birth or the umbilical cord getting pinched in a way that restricts blood flow can cause oxygen deprivation and result in brain damage.

Another common cause of CP is blunt trauma to the infant or toddler brain. Head injuries may occur during labor or delivery or within the first several years of life.

Genetics:
Approximately 2% of all Cerebral Palsy cases are inherited and are autosomal recessive in nature. Glutamate decarboxylase-1 is considered one of the possible enzymes responsible for genetically inherited CP.

Prevention of Cerebral Palsy

Since the major causes of CP are diverse in nature, a range of preventative measures have been investigated over the years.

Electronic Fetal Monitoring (EFM)
EFM was extensively used for propping up obstetric litigation, however, as of 2014, many Obstetrician and Gynecologists associations worldwide have acknowledged EFM does not help in the prevention of CP and has no long-term benefits.

Magnesium Sulphate
In expectant mothers at a risk of a premature delivery, magnesium sulphate decreases the chances of CP in newborns. While magnesium sulphate has no adverse effects on infants, mothers receiving the drug are likely to experience respiratory depression and nausea.

Caffeine
Also used for treating apnea of prematurity and lessens CP risk in premature infants, however, there are multiple concerns regarding the long-term negative effects.

Antibiotics
A reasonable amount of evidence has shown that giving antibiotics to women experiencing preterm labor, whose water has not broken increases the risk of CP in the child. On a similar note, letting a preterm birth proceed instead of attempting to delay the birth can have a moderate risk of CP in the child.

Treatment of Cerebral Palsy

While various factors are expected to increase or decrease the projected life expectancy for a child diagnosed with CP, parental involvement and appropriate medical intervention can greatly help alleviate complications or at least make them less pronounced. Quality of care is critical to improved symptoms, comfort, and longevity.

Most of the childhood therapy efforts are directed towards:

  • Improvement of gait and walking ability. Almost 60% of CP patients can comfortably walk with or without aids as adults.
  • Speech and language therapy, as well. Children with CP experience learning difficulties that can hinder their progress at school, however, with individual attention, these obstacles can be overcome. Furthermore, if the CP patients can effectively communicate with their caregivers, medical professionals, parents, and peers, then their more problems can be more easily understood and solved.
  • Assistive devices to CP patients in becoming more autonomous, by allowing them to work on their muscle control and strength. Supported by physical therapy shows them how to function properly within their environment and enhance their motor abilities.
  • Surgical intervention in cases of severe Cerebral Palsy.

The goal of all Cerebral Palsy (CP) treatment/management is to encourage independence in CP patients. An individual who can take care of daily tasks, like taking a bath, getting dressed, or preparing a meal, becomes more confident and self-sufficient.

While people with severe CP may not perform these tasks, some CP patients achieve them admirably. Over time, the road to CP management has also moved away from conservative attempts to fix the physical problem, like spasticity in a limb, to making these treatments a part of a bigger goal of maximizing community engagement and independence for a CP patient.

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