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Cerebral palsy is a condition characterized
by an impairment of the body's ability to
control movement and posture. It results
from faulty development of or damage to
the "motor" areas of the brain,
which are responsible for controlling movement.
In some cases, cerebral palsy is accompanied
by other manifestations of brain injury,
such as seizures, intellectual impairment,
behavioral problems, hearing deficits, or
vision disorders.
The brain damage that causes cerebral palsy
remains permanent from the time of injury.
There is no cure for cerebral palsy, and
it is not contagious. Accordingly, most
medical authorities describe cerebral palsy
as a "condition" rather than a
"disease." Although the brain
damage that causes cerebral palsy cannot
be cured, the functional problems associated
with cerebral palsy can often be improved
through therapy, medication or, in some
cases, surgery.
If you believe your child acquired cerebral
palsy because of medical malpractice, please
contact the cerebral palsy attorneys of
Kenneth M. Sigelman & Associates .
How common
is cerebral palsy?
Approximately 500,000 people in the United
States have been diagnosed with cerebral
palsy. More than 5,000 children, the vast
majority of whom are babies or infants,
are diagnosed with cerebral palsy each year.
The incidence of cerebral palsy (number
of cases diagnosed as a ratio of the total
population) has remained relatively constant
over the past 30 years. This should not
be interpreted as evidence that, despite
all of the progress during that time with
regard to enhanced access to prenatal care,
more reliable assessments of fetal well-being
through the use of fetal heart rate monitoring,
fetal acid-base measurement, and biophysical
profile scoring, there is nothing that medical
professionals can do to prevent cerebral
palsy. Experience and common sense tell
us that this cannot be true. Rather, the
unchanging incidence of cerebral palsy is
a direct result of continually increasing
survival rates for critically premature
or otherwise frail babies who, without benefit
of recent improvements in prenatal or neonatal
intensive care, would not have survived
beyond the newborn period. These babies
are at substantially higher risk of suffering
brain damage than are babies born at or
near term.
If you believe your child acquired cerebral
palsy because of medical negligence, please
contact the cerebral
palsy lawyers of Kenneth M. Sigelman &
Associates .
Are there
different types of cerebral palsy?
Doctors generally classify cerebral palsy
into four categories, depending upon the
type of motor difficulties experienced by
the patient. They are as follows:
Spastic cerebral palsy is the
most common type, affecting more than half
of all patients. Spastic cerebral palsy
is characterized by muscles that are stiff
and permanently contracted. With this type
of cerebral palsy, the muscle tone in the
affected limbs is increased. In addition,
spastic cerebral palsy is often classified
according to which limbs are affected, and
how severely. A prefix representing limb
involvement is added to the term "plegia"
which means paralysis, or "paresis"
which means weak. The terms used are as
follows:
- Diplegia refers to both arms or both
legs;
- Hemiplegia refers to the right arm and
leg, or the left arm and leg;
- Quadriplegia refers to both arms and
both legs;
- Monoplegia refers to one limb; and
- Triplegia refers to three limbs.
It should be noted that monoplegia and
triplegia are extremely rare.
Ataxic cerebral palsy involves
problems with balance and depth perception.
These patients will walk with an unsteady
gait, have poor coordination, and often
have problems with fine motor control (the
movements needed to perform such tasks as
writing or buttoning a shirt).
Athetoid cerebral palsy is characterized
by involuntary, uncontrolled movement of
the arms, hands, legs, or feet. Severe cases
may also afflict the muscles of the face,
mouth, or tongue, resulting in grimacing,
speech difficulties, or drooling.
Mixed cerebral palsy describes two or
more types occurring in the same person.
At least 10 percent of patients with cerebral
palsy suffer from a mixture of two or more
types.
If you believe your child acquired cerebral
palsy because of medical malpractice, please
contact the cerebral
palsy attorneys of Kenneth M. Sigelman &
Associates .
What are
the symptoms of cerebral palsy?
The symptoms of cerebral palsy differ widely
from one person to another, depending upon
the areas of the brain that were injured
and the extent of damage. Some who are afflicted
with severe cerebral palsy may be completely
disabled and require special medical, surgical,
nursing, and therapeutic care for their
entire lives. At the opposite end of the
spectrum, persons who are minimally injured
may display nothing more than slight awkwardness
with movement and require no special assistance.
Some of the most commonly
encountered symptoms of cerebral palsy include
the following:
- Difficulty or inability to walk
- Inability or difficulty using the arms
and/or hands
- Difficulty speaking
- Swallowing problems
- Inability to control bladder and/or
bowels
- Breathing difficulties
- Seizures
- Learning disabilities
- Behavioral and/or attention deficit
disorders
- Vision problems
- Hearing deficits
- Impaired sense of touch and/or pain
If you believe your child acquired cerebral
palsy because of medical negligence, please
contact the cerebral palsy lawyers of Kenneth
M. Sigelman & Associates .
What are
the causes of cerebral palsy?
There are several possible causes of cerebral
palsy. Lack of oxygen to the brain can ultimately
cause brain cells to die, resulting in permanent
damage. The lack of oxygen can be caused
by various types of problems with the placenta,
umbilical cord compression, or maternal
problems such as a stroke due to toxemia
(also called eclampsia) or a ruptured uterus.
Trauma to the baby's head due to improper
use of forceps or a vacuum extractor at
the time of delivery can cause bleeding
in the brain, resulting in cerebral palsy.
Other possible causes of bleeding in the
brain include a stroke due to broken, abnormal,
or clogged blood vessels in or leading to
the brain, or by respiratory distress due
to prematurity.
Cerebral palsy can also be due to infections
acquired by the baby during passage through
the birth canal, such as herpes, CMV (cytomegalovirus),
or Group B strep.
Over the past 20 years, medical research
has attempted to ascribe an ever-increasing
proportion of cases of cerebral palsy to
events that precede labor and delivery.
While it seems likely that some cases of
cerebral palsy may originate from brain
damage prior to labor and delivery, many
of the recent medical studies in this area
are seriously flawed, and represent little
more than a transparent effort to manipulate
statistics in order to assist doctors and
hospitals in avoiding responsibility for
medical malpractice during childbirth.
If you believe your child acquired cerebral
palsy because of medical malpractice, please
contact the cerebral
palsy attorneys of Kenneth M. Sigelman &
Associates .
Can cerebral
palsy be treated?
Although there is no cure for cerebral
palsy, many of the symptoms can be treated
and/or managed in ways that will improve
many children's functional abilities. Management/treatment
needs will vary widely, depending upon the
nature and extent of brain damage. In general,
optimal care of a child afflicted with cerebral
palsy requires the coordination of an interdisciplinary
team of healthcare professionals. These
generally include some or all of the following:
- A pediatric physiatrist specializes
in treating children with physical disabilities.
Because of his/her special expertise,
a pediatric physiatrist is often the "quarterback"
of the cerebral palsy treatment team.
- A pediatric neurologist specializes
in treating nervous system disorders in
children, including cerebral palsy. The
pediatric neurologist is particularly
involved in seizure management. Occasionally,
a pediatric neurologist may serve as the
"quarterback."
- A pediatrician is required
for general pediatric care. Children with
cerebral palsy tend to get sick more often
than their counterparts without cerebral
palsy, particularly with regard to respiratory
tract infections.
- An orthopedist may be consulted
regarding problems with regard to muscle,
tendon, or bone development, and would
be the physician performing any surgery
that might be required for those problems.
- A physical therapist, pursuant
to a physician's orders, implements an
exercise program designed to improve the
child's range of movement and strength
of the legs, and teaches the parents how
to perform these exercises with their
child at home.
- An occupational therapist performs
similar work to a physical therapist,
with the areas of concentration being
the arms and hands, rather than the legs.
- A speech pathologist evaluates,
diagnoses, and forms a treatment plan
as to any communication problems that
may be identified.
- A psychologist or licensed clinical
social worker may provide counseling
to the child and family to help formulate
the skills needed to cope with the inevitable
stresses and demands presented by a diagnosis
of cerebral palsy.
- A case manager identifies the
resources available in the community to
assist in the management of patients with
cerebral palsy, and coordinates with the
family and providers to make sure that
the child has access to all of the necessary
treatment.
If you believe your child acquired cerebral
palsy because of medical negligence, please
contact the cerebral
palsy lawyers of Kenneth M. Sigelman &
Associates .
Is cerebral
palsy preventable?
The most clearly preventable cases of
cerebral palsy are those that result from
medical mistakes. Maloccurrences during
pre-natal care, labor and delivery, or the
newborn period, which can cause brain damage
resulting in cerebral palsy, and which can
and should be prevented, include the following:
- Miscalculation or mis-recording of
due dates by the prenatal care provider.
- Failure to perform, or improper interpretation
of, ultrasounds during the prenatal period.
- Failure to perform, or improper performance
of, non-stress test.
- Failure to properly evaluate third
trimester bleeding.
- Failure to recognize and/or treat maternal
infections such as herpes, CMV, or Group
B strep.
- Failure to recommend or perform cesarean
section.
- Failure to correctly interpret fetal
monitor strips.
- Failure to diagnose or respond properly
to fetal distress.
- Failure to assign properly qualified
personnel to perform a delivery that is
anticipated to be difficult.
- Failure to properly estimate fetal
weight prior to labor and delivery.
- Failure to properly use and/or monitor
the use of Pitocin (a drug given to help
the uterus contract more strongly).
- Failure to recognize and/or respond
promptly to a detached placenta.
- Failure to recognize and/or respond
promptly to a prolapsed umbilical cord.
- Improper use of forceps.
- Improper use of vacuum.
- Failure to adequately resuscitate a
newborn baby who is in distress at birth.
Not all cases of cerebral palsy have an
identifiable cause. As to those cases, there
is on-going medical research attempting
to identify all of the potential causes
of cerebral palsy, and to develop strategies
to minimize risk factors. Common preventive
measures currently followed include Rh testing
and immunization where appropriate, prompt
recognition and treatment of bacterial infection
of the maternal reproductive and urinary
tracts, avoiding unnecessary exposure to
X-rays and certain medications during pregnancy,
education regarding harmful effects of drugs,
cigarettes, and alcohol use during pregnancy,
improved treatment of diabetes, nutritional
deficiencies and anemia, treatment of newborn
jaundice with photo therapy in the hospital
nursery, enhanced access to early prenatal
care, and established protocols for assembling
pediatric resuscitation teams in the delivery
room whenever a distressed baby is anticipated.
If you believe your child acquired cerebral
palsy because of medical malpractice, please
contact the cerebral
palsy attorneys of Kenneth M. Sigelman &
Associates .
Resources
The web sites listed below contain information
which may be useful to people interested
in learning more about cerebral palsy, including
resources that are available to help cerebral
palsy patients and their families. Kenneth
M. Sigelman & Associates is not affiliated
with any of these other sites, and cannot
be responsible for their content. Please
feel free to contact us if you are aware
of other helpful links to include in this
site.
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