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albertalice920 · 6 months ago

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Dyskinetic Cerebral Palsy: An Overview

Dyskinetic Cerebral Palsy is one of the four subtypes of Cerebral Palsy and occurs due to damage sustained by the cerebellum or basal ganglia. It causes involuntary contractures and gait abnormalities that can be highly painful to navigate, which is why it is vital for children to start receiving treatment as early as possible. It is natural to feel overwhelmed if you hear that your child has Dyskinetic Cerebral Palsy, which is why having a thorough understanding of what to expect is critical. Here, we provide a brief guide to the same.

Understanding Dyskinetic Cerebral Palsy

Dyskinetic Cerebral Palsy is a subtype of Cerebral Palsy, which refers to a group of neurological disorders that affect movement, muscle tone, coordination, and motor skills caused by damage or abnormalities in the developing brain. It typically occurs due to injury or infection before, during, or shortly after birth. Dyskinetic Cerebral Palsy is a subtype characterized by abrupt involuntary movements that can be fast and jerky or slow and writhing. Often, children exhibit a range of symptoms on the basis of which doctors further subdivide the diagnosis. The two main Dyskinetic Cerebral Palsy types include:

Athetoid Dyskinetic Cerebral Palsy: This subtype leads to sudden movements in the limbs, hands, and feet, and sometimes the face and tongue. The movements may be jerky or slow and can be repetitive at times, or may be continuous and writhing and get worse as the child tries to move. Stress may exacerbate the movements.

Dystonic Dyskinetic Cerebral Palsy: This leads to random and twisting involuntary movements when the child tries to move on their own, which can be painful. Here too, the movements may be either fast or slow. Dystonia may occur all over the body or just in certain limbs.

However, these terms are often used interchangeably, and the causes and treatments are the same for both. As a non-progressive disease, Dyskinetic Cerebral Palsy will not worsen with time, although the patient’s needs may evolve as they grow older. Treatment helps to manage the symptoms and improve the patient’s overall functionality.

Symptoms of Dyskinetic Cerebral Palsy

Patients with Dyskinetic Cerebral Palsy have difficulty moving their muscles the way they want them to. The symptoms will vary based on the location and extent of the brain damage. There is considerable overlap between the symptoms of the Athetoid and Dystonic subtypes, which is why we can list them together. The commonly observed Dyskinetic Cerebral Palsy symptoms include:

Developmental delays in crawling, sitting up, standing, walking, or reaching for objects

Abnormal involuntary movements, either fast or slow

Twisting of the torso

Writhing movements in the hands or limbs

Pain during involuntary movements

Uncontrollable eye movements and/or squinting

Involuntary facial movements like grimacing or drooling

Muscle spasms from hypertonia or hypotonia and fluctuations between the two

Difficulty holding onto objects

Difficulties with balance and posture

Problems with speaking and swallowing

Comorbidities like epilepsy

The initial symptoms of Dyskinetic Cerebral Palsy, including jerky movements and poor balance, may be noticeable as early as nine months of age. However, some children may have irregular movement patterns simply because of a developmental delay and not Cerebral Palsy. Parents should thus avoid panicking and rely on the child’s doctor to provide a diagnosis.

Causes and risk factors of Dyskinetic Cerebral Palsy

Cerebral Palsy occurs due to damage to the brain before, during, or shortly after birth. Specifically, Dyskinetic Cerebral Palsy occurs due to damage sustained by either the cerebellum or the basal ganglia.

Basal ganglia damage: The basal ganglia are a group of nuclei located in the cerebral cortex, the part of the brain that controls voluntary movement. The basal ganglia also regulate learning and thinking. When the basal ganglia are damaged, motor function is disrupted, which leads to involuntary movements.

Cerebellum damage: The cerebellum regulates precision of movement, coordination, and balance, along with cognitive functions like attention and communication. When the cerebellum is damaged, it affects fine motor skills and general coordination, and may also lead to co-occurring conditions like epilepsy or autism.

The risk factors for Dyskinetic Cerebral Palsy include:

Infections during pregnancy

Complications during birth or negligence on the part of the physician

Premature birth

Blood clots in the placenta

Fetal strokes

Genetic conditions

Lack of oxygen during pregnancy or at birth

Jaundice, meningitis, or other infections shortly after birth

Head trauma sustained at or after birth

Diagnosing Dyskinetic Cerebral Palsy

There is no specific diagnostic test for Dyskinetic Cerebral Palsy. If you observe symptoms in your child, it is important to get an appointment with a doctor who will observe your child’s movements and reflexes in a clinic setting. As a parent, you will need to provide a full medical history for the child, including any conditions that run in the family, along with detailed information on your child’s symptoms.

If the doctor suspects Dyskinetic Cerebral Palsy, they may then recommend you to a specialist who will closely examine your child’s movement, speech, hearing, reflexes, posture, and coordination. Some of the tests they might order include an MRI, a CT scan, an electroencephalography (EEG), and an electromyography (EMG). These serve to identify brain damage and also rule out any other conditions that may be causing the symptoms. In addition, they may recommend specialists who will assess the child’s speech, hearing, vision, and intellectual capabilities. Getting a final diagnosis might take thus some time, up to several months in some cases. It is important to be patient and not panic unduly.

Treatment for Dyskinetic Cerebral Palsy

A treatment plan tailored to your child’s symptoms and abilities will help to expand their range of functional movement. The earlier the intervention, the better your child’s chances at gaining motor control and functionality. Typically, Dyskinetic Cerebral Palsy treatment will feature the following:

Physical Therapy: This is perhaps the most essential component of Dyskinetic Cerebral Palsy treatment. It includes a variety of exercises to improve muscle strength, coordination, and control over gross and fine motor skills. There will typically be daily sessions with a therapist, which may even be incorporated into the school day to make sure that the child is making consistent progress.

Occupational Therapy: This involves teaching the child how to perform daily activities of living on their own, such as getting dressed, having a bath, or feeding themselves. The therapist will teach them useful exercises that help them improve coordination and control, and may recommend special gadgets to make it easier.

Speech Therapy: Children who have trouble speaking and swallowing can benefit from Speech Therapy, as the therapist will teach them articulation techniques, safe swallowing techniques, and exercises to improve strength in the mouth and jaws. This not only helps them communicate better but also ensures that they are ingesting proper nutrition.

Stem Cell Therapy: This revolutionary form of treatment involves using the patient’s own healthy cells to treat the ones damaged by cerebellar degeneration. The process is safe, easy, and allows patients to go home the very same day.

Assistive devices: Thera[ists may recommend mobility devices like leg braces, walkers, or wheelchairs to help children get around more easily.

Medication/surgery: There are special medicines that doctors may prescribe to ease muscle stiffness and pain. In addition, surgery can correct significant deformities in the limbs and joints, thus helping children move more comfortably.

Yoga: Activities like yoga or stretching, when performed with a trained therapist, can help to alleviate the pain of muscle contractions.

Diet: The doctor may recommend special nutrition for your child to help their muscles grow properly.

Some parents may wish to sign their child up for alternative treatments like herbal medicine or acupuncture. However, always consult your doctor before doing so, as some of these treatments may interfere with the doctor-prescribed therapies.

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placidwaymedicaltourism · 2 years ago

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Adults with Cerebral Palsy Symptoms Understanding Adults' Cerebral Palsy Symptoms Cerebral palsy (CP) is often perceived as a childhood disorder, primarily because its diagnosis usually occurs in infancy or early childhood. However, it is a lifelong condition that continues to impact individuals well into adulthood. It is vital to understand the topic Adults with Cerebral Palsy Symptoms and how to manage them to ensure a high quality of life for those affected by this condition. Understanding Cerebral Palsy Cerebral palsy (CP) is a group of disorders that primarily affect muscle coordination and body movement. It's the most common motor disability in childhood, but its effects extend into adulthood. The condition is caused by damage to or abnormalities in the parts of the brain that control muscle movements. The term "cerebral palsy" is an umbrella term that encompasses a group of non-progressive, yet often changing, motor impairment syndromes caused by lesions or anomalies in the brain that arise in the early stages of its development. Cerebral palsy can manifest in different ways, and the severity of symptoms can vary greatly from person to person. Some people with CP may need special equipment to help them with mobility, while others may have mild impairments and require minimal assistance in their daily lives. There are several types of cerebral palsy, including spastic, dyskinetic (including athetoid, dystonic and choreoathetotic), ataxic, and mixed types. Each of these types is characterized by different kinds of movement patterns. Spastic CP is the most common type, characterized by stiffness and difficulty moving due to muscle tightness. Dyskinetic CP causes uncontrolled, slow, writhing movements, often affecting the hands, feet, arms, or legs, and in some cases, the muscles of the face and tongue, causing difficulty with swallowing and speech. Ataxic CP affects balance and coordination, causing individuals to appear unsteady or shaky. Mixed CP is a combination of two or more of the above types. While the brain damage that leads to cerebral palsy doesn't change over time, the symptoms can evolve as the individual grows and develops. Therefore, understanding and managing CP requires a long-term approach that adapts to an individual's changing needs over their lifetime. Despite the challenges it presents, many individuals with cerebral palsy lead successful, fulfilling lives with the right support and resources. Symptoms of Cerebral Palsy in Adults As individuals with cerebral palsy age into adulthood, their symptoms might evolve or change. The symptoms experienced in adulthood often reflect those seen in childhood, but they may present new challenges or complications. Here are some common symptoms experienced by adults with cerebral palsy: Muscle Spasticity and Rigidity: Adults with cerebral palsy often experience increased muscle tone, leading to muscle stiffness known as spasticity or rigidity. This can make movement difficult and sometimes painful. Pain: Chronic pain is a common symptom among adults with cerebral palsy. This can result from the stress and strain on the body caused by muscle imbalances, abnormal movement patterns, and joint issues. Mobility Issues: Over time, the physical strain of living with cerebral palsy can lead to increased difficulty with mobility. This can range from trouble walking to needing assistive devices like wheelchairs or walkers. Fatigue: Many adults with cerebral palsy report increased fatigue. This can be due to the extra effort required to move and control their bodies, but it may also result from other factors like poor sleep or other health issues. Aging-Related Health Issues: Adults with cerebral palsy may also face common age-related health issues earlier than their peers without cerebral palsy. These can include arthritis, osteoporosis, heart and lung issues, and more. Mental Health Issues: Adults with cerebral palsy also have a higher risk for mental health issues, such as depression and anxiety.

This can be due to the physical challenges and social isolation they may experience. Difficulty with Speech and Swallowing: Some adults with cerebral palsy may continue to have difficulty with speech and swallowing, a symptom that often begins in childhood. This can affect their ability to communicate effectively and eat comfortably. Cognitive Issues: While not all people with cerebral palsy have intellectual disabilities, some may experience cognitive issues. This can include difficulty with memory, concentration, and problem-solving. Remember that every individual with cerebral palsy is unique, and not everyone will experience all of these symptoms. The severity and combination of symptoms can vary widely from person to person. The Effects of Aging on Adults with Cerebral Palsy Cerebral palsy (CP) is a condition that presents unique challenges as individuals age. While CP itself is a non-progressive condition, meaning the original brain damage does not worsen, the symptoms and secondary conditions can evolve and become more complex over time. This process can lead to what is sometimes referred to as 'premature aging.' Here are some of the effects of aging on adults with cerebral palsy: Increased Physical Degeneration: Due to the extra strain placed on the body by cerebral palsy, adults with CP may experience physical degeneration earlier than their peers. This can include a decline in mobility, increased fatigue, and more difficulty with tasks requiring coordination and fine motor control. Premature Joint Wear and Musculoskeletal Issues: The abnormal muscle tone and movement patterns associated with cerebral palsy can lead to premature wear and tear on the joints. This can result in early-onset arthritis, increased risk of fractures, and other musculoskeletal issues. Increased Pain: As adults with cerebral palsy age, they may experience increased pain. This can be due to a combination of factors, including joint issues, muscle stiffness and spasticity, and other health issues related to aging. Mental Health Concerns: Adults with CP may face increased mental health concerns as they age. The physical challenges, coupled with social isolation and potential difficulties with employment and independence, can lead to higher rates of depression and anxiety. Early Onset of Age-Related Health Conditions: Adults with CP may face common age-related health issues earlier than their peers without CP. These can include cardiovascular disease, lung conditions, osteoporosis, and others. Cognitive Decline: While not all individuals with cerebral palsy experience cognitive impairment, those who do may see a decline in their cognitive abilities as they age, similar to the general population. Managing these effects often requires a multidisciplinary approach, involving various healthcare professionals, and a focus on preventative care and maintaining overall health. Support from community resources, family, and peers can also play a crucial role in managing the effects of aging with cerebral palsy. Treatment and Management of Cerebral Palsy in Adults The management of cerebral palsy in adults typically involves a combination of medical treatments, physical and occupational therapies, and lifestyle modifications. While there's no cure for cerebral palsy, these strategies can help manage symptoms, improve quality of life, and promote independence. Here are some common approaches to treating and managing cerebral palsy in adults: Physical Therapy: Regular physical therapy can help manage muscle spasticity, improve mobility, and strengthen muscles. It can also help reduce pain and prevent joint issues. Occupational Therapy: Occupational therapy can help adults with CP develop skills needed for daily living and independence, such as cooking, dressing, and using a computer. Speech and Language Therapy: For those with speech or swallowing difficulties, speech and language therapy can help improve communication skills and make eating and drinking safer and more comfortable.

Medical Treatments: Various medications can be used to manage symptoms of CP in adults, such as muscle relaxants for spasticity, pain relievers for chronic pain, and medications for associated conditions like epilepsy. Surgical Interventions: In some cases, surgery may be recommended to alleviate severe spasticity, correct deformities, or improve mobility. This can include orthopedic surgery, selective dorsal rhizotomy, or the implantation of a baclofen pump. Assistive Devices: Many adults with CP use assistive devices to enhance mobility and independence. These can include wheelchairs, walkers, orthotic devices, adaptive utensils, and communication devices. Healthy Lifestyle: Maintaining a healthy lifestyle is crucial for managing CP in adulthood. This includes a balanced diet, regular physical activity, adequate sleep, and regular check-ups with healthcare providers. Mental Health Support: Given the higher risk of mental health issues, psychological support is a crucial part of managing CP in adults. This can involve counseling or psychotherapy, support groups, and in some cases, medication. Support Services: Various support services can help adults with CP navigate life, such as vocational rehabilitation, social services, and disability services. Managing cerebral palsy in adulthood is a lifelong commitment that requires a comprehensive and multidisciplinary approach. With appropriate support and resources, adults with CP can manage their symptoms and lead fulfilling lives. Coping with Cerebral Palsy as an Adult Coping with cerebral palsy as an adult involves a combination of medical treatment, self-care, and psychological strategies. Here are some tips for adults with cerebral palsy seeking to manage their symptoms and enhance their quality of life: Stay Active: Physical activity is crucial for maintaining strength and flexibility. Work with a physical therapist to develop a safe and effective exercise routine tailored to your abilities and needs. Follow a Balanced Diet: Good nutrition supports overall health, energy levels, and weight management, which can help reduce strain on your joints and muscles. Use Assistive Devices: Assistive devices like wheelchairs, braces, or speech-generating devices can facilitate mobility, communication, and independence. Occupational therapists can help you find the right tools and teach you how to use them effectively. Seek Emotional Support: Coping with a chronic condition like cerebral palsy can be emotionally challenging. Seek support from friends, family, or mental health professionals. Joining a support group can also provide a sense of community and shared understanding. Practice Stress Management: Techniques like mindfulness, meditation, and deep breathing can help manage stress and promote relaxation. Finding hobbies and activities you enjoy can also serve as a positive outlet for stress. Maintain Regular Medical Care: Regular check-ups with your healthcare team are crucial for managing your condition and addressing any new symptoms or concerns that arise. Advocate for Yourself: Speak up for your needs, whether it's requesting accommodations at work, ensuring accessibility in public spaces, or communicating your needs to healthcare providers. Educate Yourself and Others: Understanding your condition can help you make informed decisions about your care. It can also enable you to educate others about cerebral palsy, fostering understanding and empathy in your community. Remember, there's no "right" way to cope with cerebral palsy, and what works best will depend on your individual circumstances, abilities, and needs. It's okay to ask for help, and to seek support from professionals and loved ones as you navigate life with cerebral palsy. Final Advice Cerebral palsy is a lifelong condition, and adults living with CP may face unique challenges as they age. Understanding the symptoms of cerebral palsy in adults, and how to manage these symptoms, is vital to ensuring those with CP can lead fulfilling lives.

Although living with CP can be difficult, remember that with the right support and resources, adults with CP can successfully navigate these challenges and live a fulfilling, rewarding life. In closing, let's adopt a more inclusive perspective, acknowledging and addressing the specific needs and experiences of adults with cerebral palsy. After all, cerebral palsy doesn't stop in childhood – neither should our understanding and support for those living with it. Contact Us: https://globalstemcelltherapy.com/contact/

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uprightkidsortho · 2 years ago

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From Diagnosis to Recovery: The Comprehensive Cerebral Palsy Care at Upright Kids Ortho with Paediatric Orthopaedic Surgeon Bangalore | Dr. Jayanth S Sampath

Cerebral palsy (CP) is a disorder that affects muscle tone, movement, and motor skills (the ability to move in a coordinated and purposeful way).

Cerebral palsy can also lead to other health issues, including vision, hearing, and speech problems, and learning disabilities.

CP is usually caused by damage to parts of the brain before or during a child’s birth, or during the first 2 years of a child’s life.

There is no cure for CP, but treatments such as physical therapy, splints or orthotics, medications such as Botulinum injections and Orthopaedic Surgery will help a child who is living with the condition.

It is worthwhile pointing out that majority of common human ailments such as diabetes, high blood pressure, stroke, heart attack, kidney failure, etc are also incurable conditions. But, treatment of these conditions is essential to prevent complications. Cerebral palsy is no different in that it does not have a cure but treatment is essential.

How does Cerebral Palsy work At Upright Kids Ortho?

What are the symptoms and signs of cerebral palsy?

Paediatric Orthopaedic Surgeon Bangalore | Dr. Jayanth S Sampath says the predominant symptoms and signs of cerebral palsy are related to difficulties with movements of the legs and arms.

The extent and severity of the brain lesion is the leading factor in the magnitude of the motor deficit. For example, developmental motor delay, gait disorders, poor fine and gross motor coordination, swallowing disorders, or speech delay are all the result of the basic movement problem. The way they present varies from child to child. For that reason, it is difficult to describe a clinical picture that will satisfy every child with cerebral palsy. The clinical presentation, even though with many common features, is very much unique for a particular child. In addition, the comorbid conditions add more to the uniqueness of the presentation of the child with cerebral palsy. For example, some children may be blind, while others may have normal vision; some children may have a severe cognitive delay while others may have a normal or near normal cognitive level.

What are the types of cerebral palsy?

Based upon the form of motor impairment, cerebral palsy can be divided into types:

Spastic cerebral palsy

Dyskinetic cerebral palsy (according to the predominant symptoms dyskinetic CP may be either dystonic or choreo-athetoid) which includes ataxic cerebral palsy

Hypotonic cerebral palsy.

These categories are not rigid, and the majority of patients most probably have a mixture of them.

Cerebral palsy can also be classified into different types depending on the mobility level of the child. This system is called GMFCS (Gross Motor Functional Classification System) and is the most widely used classification system to describe children with cerebral palsy. The figure below easily illustrates the different types from Level I to Level V. Kindly note that the mobility level changes slightly as the child goes through the teenage years and pubertal growth spurt.

This is a well-described aspect of the natural history of cerebral palsy. Children who were walking with support until the age of 8 – 10 years lose some or all of their walking ability during early adolescence. This has been attributed to a reduction in the power: weight ratio of children. As muscles become bigger, they also become weaker relative to their weight.

Causes of CP

Paediatric Orthopaedic Surgeon Bangalore | Dr. Jayanth S Sampath says There is no identifiable cause in some children with cerebral palsy.

Typical causes to look for include

Problems occurring before birth (e.g. exposure to radiation, infection, inadequate brain development),

Problems during birth such as asphyxia before birth, hypoxia (poor oxygen supply) of the brain, and birth trauma during labor and delivery

Premature and low birth weight babies

Complications occurring some time after birth or during childhood.

Genetic causes

In the modern context, many premature babies (babies born earlier than 36 weeks and/ or less than 1.5 kg in weight at birth) can be saved thanks to advances in neonatal care but premature babies have an increased risk of CP. Many of the children that we see in our practice have spent some time in the NICU (neonatal intensive care unit). Fortunately, premature babies have spasticity as their predominant movement disorder, most will walk independently and their gait problems can be corrected by orthopaedic surgery.

In the past, conditions such as kernicterus (uncontrolled jaundice in newborn babies causing damage to parts of the brain) were quite common. This group of disorders caused dyskinetic type of CP that was not readily amenable to surgery and prognosis for walking was poor. Due to early detection of jaundice in most neonates and prompt treatment, the incidence of Kernicterus is on the decline.

Why do premature babies develop CP?

Premature infants are vulnerable, in part because their organ systems and control mechanisms are not fully developed, increasing the risk of reduced oxygen supply to the brain that may manifest later as CP.

It is sometimes difficult to differentiate between cerebral palsy caused by damage to the brain that results from inadequate oxygenation and CP that arises from brain damage which occurs when the baby is still in the womb that then precipitates premature delivery. From the point of view of treatment, this distinction is academic and not of much relevance. MR scan of the brain may help in diagnosing this further but in terms of treatment, diagnostic tests such as MR scans do not help with orthopaedic treatment.

After birth (postnatal), other causes include toxins, severe jaundice, lead poisoning, physical brain injury, shaken baby syndrome, incidents involving hypoxia to the brain (such as near drowning), and encephalitis or meningitis.

The three most common causes of asphyxia in the young child are: choking on foreign objects such as toys and pieces of food, poisoning, and near drowning.

In general, postnatal causes of CP (damage to the brain after birth) result in a more severe form of the condition with extreme muscle tone and postures, severe cognitive impairment and the prognosis for walking is less certain compared to CP caused by prematurity.

Diagnosis of Cerebral Palsy:

The initial suspicion of CP is typically raised by family members or noticed by the parents as a failure to achieve motor milestones. The child may not achieve head control by 6 months, sitting may be delayed or mild abnormalities in walking may be noticed.

The child’s paediatrician is usually the first person to raise the possibility of CP. As mentioned earlier, cerebral palsy is NOT a condition resulting from a single cause. It is a clinical diagnosis made by doctors when a child has a number of different problems such as problems with walking, speech, hearing, sight, balance, co-ordination and fine motor control (using the hands for delicate tasks such as writing).

No single factor can confirm or refute the diagnosis of CP. Rather; it is combination of various factors that taken together will help the doctor make the diagnosis of CP.

For instance, a 2 year old child who has not yet started walking; was a premature baby born at 7 months with a birth weight of 1kg may turn out to have cerebral palsy.

Though tests such as an MR scan of the brain are quite commonly done in the process of making the diagnosis of CP, there is no single test which will confirm the diagnosis. As the causes of CP are highly varied, a series of investigations (tests) may need to be carried out.

Who makes the diagnosis?

According to Paediatric Orthopaedic Surgeon Bangalore | Dr. Jayanth S Sampath, Any qualified clinician with experience in the area of child development can make a diagnosis of cerebral palsy. Typical clinicians who may see children with a potential diagnosis of CP include paediatricians, physiotherapists, paediatric orthopaedic surgeons, developmental specialists, and paediatric neurologists, amongst others.

Once the possibility of CP has been raised, it is prudent to seek the opinion of

A paediatric neurologist (to confirm the diagnosis) and

A paediatric orthopaedic surgeon (to discuss treatment options).

It is advisable to seek expert advice early so that parents can be correctly counselled about the particular treatment options suitable for their child.

Clinicians unfamiliar with the modern management of CP are a source of misinformation to parents. Words such as “untreatable” are sometimes used, causing uncertainty and distress to parents. CP is very much treatable with modern scientific methods and good outcomes are routinely obtained in the majority of children.

Treatment for CP

There are several factors which influence choice of treatment for a particular child. The principal among these are:

Age of the child

The age of the child is the single most important factor which influences treatment planning. Cerebral palsy is a “static” encephalopathy, meaning that the primary problem in the brain does NOT change over time. It does not get better or worse. However, bones, muscles and joints of the legs can develop abnormalities due to growth.

Any intervention such as physiotherapy, Botox injection or surgery should be employed after a thorough understanding of the natural history of cerebral palsy. Thanks to the pioneering work of Prof Rosenbaum and co-workers (from CanChild Centre for Childhood Disability Research, McMaster University, Canada), we have a detailed understanding of how children with CP develop in the first few years of life. Similar findings were seen in an independent Swedish study (Developmental Medicine & Child Neurology 2007, 49: 751–756).

The graph below shows that children with GMFCS Level I and II CP (children with independent walking ability) reach their peak motor ability around the age of 6 to 7 years. This NATURAL improvement occurs due to the maturation of brain function. It, therefore, stands to reason that any intervention such as orthopaedic surgery should be performed after the age of 7 years.

The Ontario Motor Growth Study

The Motor Growth Curves report patterns of gross motor development in children with cerebral palsy, classified according to each of the five levels of the Gross Motor Function Classification System (GMFCS) (Palisano et al., 1997). Children in this study were followed longitudinally for several years. The findings were published in a paper entitled ‘Prognosis for Gross Motor Development in Cerebral Palsy. Creation of Motor Growth Curves’, Rosenbaum et al., JAMA 2002; 288; 1357-63.

In the first few years of life, most children with CP will benefit from supportive treatments such as physiotherapy and orthotics. Once the child reaches his or her maximum motor potential (typically between the ages of 8 and 10 years) and achieves a steady state in terms of growth, consideration can be given to whether orthopaedic surgery will be beneficial.

The graph below illustrates common interventions undertaken at different ages in children with CP.

It can be seen that peak age for non-surgical treatments is around 5 years and the peak age for surgery is around 10 years.

GMFCS Level:

The walking ability of the child determines his/ her GMFCS level. Children with GMFCS levels I and II and some children with Level III CP may benefit from Gait Improvement Surgery (also called Single Event Multi-level Surgery or SEMLS).

Children with GMFCS Levels IV and V CP do not benefit from surgery to release contractures or muscle tightness in the legs, as the children in this category are unlikely to gain the ability to walk even with surgery. However, children with GMFCS Levels IV and V CP have a high risk of gradual dislocation of the hip joint. This will require careful monitoring through regular hip x-rays.

Movement Disorder:

Spasticity is the most common movement disorder seen in CP. Muscles affected by spasticity feel tight when stretched suddenly. Slow and gentle stretching of the muscle does not evoke spasticity.

Children with spasticity as their predominant movement disorder and who are able to walk either independently or with support have a better overall prognosis with regard to walking/ standing ability compared to children with other types of movement disorders.

Children with dyskinetic movement disorders such as Dystonia, Athetosis, chorea, ataxia or hypotonia DO NOT show a predictable response to surgery.

Scientific publications also advocate non-surgical treatment options in children with Dystonia. Dyskinetic movements are caused by damage to parts of the brain (called basal ganglia). Performing orthopaedic surgery by muscle releases and tendon lengthening cannot change the damaged area in the brain.

It is highly likely that children with dyskinetic movement patterns will remain unchanged even after orthopaedic surgery. Any minor improvements noted after surgery are likely to be due to the physiotherapy provided post-operatively and these improvements will reverse once the intensive physiotherapy is stopped.

Spasticity is caused by damage to nerve fibres leaving the higher centres of the brain (cerebral cortex). Therefore, spasticity does not change after muscle release surgery. What orthopaedic surgery corrects is the permanent muscle stiffness which occurs as a consequence of spasticity. In fact, some experts believe that spasticity is beneficial in that it maintains muscle strength to a certain extent.

Orthopaedic surgery is therefore recommended only in those children who have permanent shortening of the muscle rather than pure spasticity. If regular physiotherapy and other treatments are provided at an early stage, muscle shortening does not typically develop in younger children (less than 6 years of age). Even in those younger children where contractures do develop, this can be managed without the need for surgery, through the use of Botox, serial casting, physiotherapy and use of splints.

There are treatments such as Botulinum toxin injection; Selective Dorsal Rhizotomy and Intrathecal Baclofen pump which directly reduce spasticity. More information about these anti-spasticity treatments is provided in a later section.

As the child grows, bones and muscles normally grow in almost perfect synchrony.

In children with CP, muscle growth is unable to keep up with bone growth. Therefore, muscles become progressively shorter over time. This causes joint tightness and eventually contractures (permanent joint tightness).

Bones can develop abnormal twists (called torsional problems) in children with CP.

When babies develop inside the mother’s womb, bones of the legs develop with an inward twist. This is normal and happens in all children. Typically developing children start walking by the age of 1 year. The forces applied to the legs during walking causes the inwardly twisted bones to straighten out. When walking is delayed (in conditions such as CP), the embryonic alignment of the leg bones persists. Persistent femoral anteversion and internal tibial torsion together contribute to intoeing gait (feet turned inwards) in children with CP.

The main orthopaedic issues in children with CP are:

Muscle shortening

Joint contractures

Bony torsion

Medications

Medications that can lessen the tightness of muscles may be used to improve functional abilities, treat pain and manage complications related to spasticity. It’s important to talk about the risk of drug treatments with your doctor and discuss whether medical treatment is appropriate for your child’s needs. The selection of medications depends on whether the problem affects only certain muscles (isolated) or the whole body (generalized).

Focal spasticity

Generalized spasticity

Therapies

A variety of nondrug therapies can help a person with cerebral palsy to enhance functional abilities. These include the following:

Physical therapy: Muscle training and exercises may help your child’s strength, flexibility, balance, motor development and mobility. Braces or splints may be recommended for your child. Some of these supports are used to help with function, such as improved walking. Others may stretch stiff muscles to help prevent contractures.

Occupational therapy: Using alternative strategies and adaptive equipment, occupational therapists work to promote your child’s independent participation in daily activities and routines in the home, the school and the community.

Speech therapy: Speech therapists help improve your child’s ability to speak clearly or to communicate using sign language. They can also teach your child to use special communication devices — such as a board covered with pictures of everyday items and activities. Sentences can be constructed by pointing to the pictures. Speech therapists may also address difficulties with muscles used in eating and swallowing.

Surgical or other procedures

Surgery may be needed to lessen muscle tightness or correct bone abnormalities caused by spasticity. These treatments include:

Orthopaedic surgery: Children with severe contractures or deformities may need surgery on bones or joints to place their arms and legs in their correct positions. Surgical procedures can also lengthen muscles and tendons that are proportionally too short because of severe contractures. These corrections can lessen pain, improve mobility, and make it easier to use a walker, braces or crutches.

Severing nerves: In some severe cases, when other treatments haven’t helped, surgeons may cut the nerves serving the spastic muscles. This relaxes the muscle and reduces pain, but can also cause numbness.

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Our other treatment-

Perthes disease- https://www.uprightkidsortho.com/perthes-disease/

Clubfoot – https://www.uprightkidsortho.com/clubfoot-or-congenital-talipes-equinovarus/

Leg length discrepancy- https://www.uprightkidsortho.com/leg-length-discrepancy/

#orthopedics #orthopedicsurgery #orthopedics #orthopedicsurgeon #surgery #surgeon #Doctorjayanth #Drjayanth #Doctorjayanthwhitefield

#orthopedics #orthopedicsurgery #orthopedicsurgeon #surgery #surgeon #Doctorjayanth #Drjayanth #Doctorjayanthwhitefield #drjayanth #doctorjayanth #bangalore #doctorjayanthwhitefield #pediatric

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brightlotusmoon · 5 years ago

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So hey, this happened to a friend with cerebral palsy, something I've also literally encountered, just not at this fucking level of willfully ignorant ableist...

“You don’t have a disability”

“What?”

“I mean, you don’t sound like it”

“That’s an ignorant statement coming from an ADA lawyer."

"What?"

"I have cerebral palsy."

"I don't believe you."

...

...I think someone needs a different job.

***

H'okay, so, for those who don't know! Cerebral Palsy comes in various flavors, especially combined CP, like mine, which is Spastic and Dystonic and Ataxic. I have hemiplegia. And I'm considered Very Mild. Which means that on a regular basis, nobody will look at me or listen to me and think "she has cerebral palsy" unless they recognize traits and symptoms. Unless I'm fairly tired or frustrated, I don't really slur or mangle my words or drool that much (though I do hoard napkins and tissues), my left arm and hand don't often display the usual spastic flexion and pronation, my left leg might not have such a stiff limp.

I have to concentrate to avoid "looking disabled" because I grew up not wanting to draw that attention and I was told it was better look like everyone else and I didn't meet other cerebral palsy folks until college and by then I had normalized the chronic pain and fatigue. Battling my body's instincts to be crippled was exhausting, but it helped me "fit in and save face" because Disability Pride what? LOL weirdo freak.

Anyway, doctors would tell me my speech was clear and strong, I was So Articulate, I didn't look like a shuffling drunk, yada yada yada. And after a while I started wanting to stop masking those syndromes, to let go, to Look Disabled Enough just to stop people from presuming. And then I discovered Facebook and the autistic community and social advocacy and I Found My People and I found my Voice. That actually helped me get a good disability lawyer who knew what he was doing and helped me win my SSDI case on the second appeal. The judge was kind. It was uncommon but I felt such relief and power, being believed and understood and respected for everything I was.

The fact that we have to constantly jump through hoops to prove this shit while abled folks still try to deny us because "oh no scammers and cheaters oh no" is almost as furiously rage inducing as an ADA lawyer telling a woman with cerebral palsy that she can't be disabled because Arbitrary Social Construct.

Fuck a bunch of all of you. Do better.

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thislife-onwheels · 5 years ago

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What It’s Like When Your Medical PTSD Becomes Reality

I wish I were making this up.

I wrote previously about my medical PTSD, crippling flashbacks, and other symptoms. Shockingly, it resonated with hundreds, if not thousands, of people who said that although their physical diagnoses were different, the mental scars of post-traumatic stress disorder that remained were a common thread. I struggled with right along with the strangers who read my words, and prepared my body and mind for one of the scariest surgeries I've ever had: my second baclofen pump placement for secondary dystonia associated with cerebral palsy. The surgery, one that works well for the vast majority of people, appeared a success. I responded well to the intrathecal therapy, and after close monitoring and a week in the hospital, I was sent home.

Mentally, however, I was in a different place entirely. Throughout my hospital stay and my time at home during recovery, I was in a dissociative state. Moreover, I couldn’t look down at my lower left abdomen where the hockey puck shaped internal drug pump lay. As a child, it stuck out of my skin quite significantly, leaving me in fear of myself. When I went on to overdose, there was a very real and palpable fear among not just myself, but my family and doctors, that it would kill me. This impacted me so deeply that I was working through exposure therapy to be able to look at the second pump, still sticking out of my skin, with my therapist—even if only for a few short seconds.

Eight days after my discharge from the hospital, my worst fears became reality.

"Everything is fine; don't panic," I told myself, pushing away racing thoughts as nothing more than anxiety while my legs visibly spasmed in my bathtub. I have an incredibly high threshold for pain and spells that make my body contort for hours with even the slightest of movements were a common occurrence prior to surgery. Despite the fact that this surgery was done to prevent this type of pain from occurring, I thought this spell would pass, like all the ones before it.

Needless to say, that's not what happened.

After an hour of agony and dystonic movements so severe it began to physically interfere with the ability of others to care for me, I broke down and called my hospital, barely able to get words out due to the sheer amount of pain my body was in. Speaking to the nurse that handles urgent patient needs, I told her that I had just been discharged from the hospital for pump placement the week before, in addition to the unbearable pain that was getting progressively worse.

"You don't sound good," she said. "I'm transferring you to the doctor."

My heart dropped. I held onto a sliver of hope and said a prayer.

When he answered, he told me to take my oral baclofen, and if I didn't see improvement in two hours, to come into the ER. I took my oral medication while a friend continued to pray for me.

An hour later, I was delirious; I blacked out in the car while my mother drove. When I got to the hospital, my mom proceeded to drive my power wheelchair through the emergency room, while I moaned, rocking back and forth.

Then, just like when I was a child and overdosing from the device, I fell into a coma. I woke up, but the days that followed were a mix of delirium, pain, multiple emergency surgeries, and darkness.

As it turns out, a spinal fluid leak--a complication from surgery that we tried to prevent by carefully monitoring my incisions for the previous two weeks, combined with E. coli bacteria--caused the pump, and my central nervous system, to become infected with E. coli bacterial meningitis. It's an infectious disease affecting the brain and spinal cord that can kill very quickly from the onset of symptoms.

Two weeks later, I was out of the ICU, but very, very weak, bed bound, and receiving daily IV antibiotics through my jugular vein. My PM&R physician came into my room on rounds, profusely offering her sympathies. "When I saw what happened," she said, softly, "My heart dropped into my stomach, because that's an infection that spreads fast. I don't know what your religious beliefs are..."

She trailed off.

To say my medical-induced PTSD has at times been overwhelming since this occurred four months ago is a massive understatement. One of the emergency surgeries was to remove the baclofen pump. I am now faced with the decision to have a third placed due to my pain from secondary dystonia and spasticity getting progressively worse; pain that can leave me incapacitated and that is triggered from speaking, swallowing, or even slightly contracting nearly any muscle.

Despite the fact that this is a planned two week admission to address a potential spinal fluid leak before it becomes infection, the scars--physical and mental--remain. More so than ever before, my brain views pumps as ticking time bombs, and my body remembers, too. The worst part about medical PTSD, for me, is the legitimate threat of past traumas reoccurring, over and over. Because my body and treatments are viewed by my brain as a threat, my traumas haunt my past, present, and even my future. However unlikely I am to have life-threatening complications from my next placement, my mind is always on alert, prepared to fight.

It is my ultimate wish for this type of PTSD to be more closely studied and taken seriously among researchers (I myself did a project on this as apart of my undergrad social work program). I believe this type of trauma is far more common and impactful than we currently know, among children and adults alike. All individuals who have these traumas deserve to have their fears validated, and treatment readily available. I’ll close once again with these final words.

If you’re experiencing these things, know this:

You’re real.

You’re valid.

I see you.

#Medical PTSD #Trauma #bacterial meningitis #baclofen pump #cerebral palsy #dystonia

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totrishlaortho · 2 years ago

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it is great news for the whole team of Trishla foundation that one of our girls affected with dystonic cerebral palsy Ms. Yashi got admission in the MBBS course in the oldest medical college in India ( medical college Kolkata ) through NEET 2022. She is very brilliant, strong, and has a great quality of motivating others. her father is an auto ricksha driver in Gorakhpur. lots of blessings to her from the Trishla foundation family. We pray to god that she should complete her MBBS and become a great motivator to others. News link : Aajtak news : https://intdy.in/9gzv48 Dainik bhaskar news : https://dainik-b.in/op5w1gMa1ub times of India news 1: https://timesofindia.indiatimes.com/city/allahabad/gorakhpur-auto-drivers-daughter-with-cerebral-palsy-joins-mbbs/articleshowprint/95569621.cms times of India news 1:: https://timesofindia.indiatimes.com/city/allahabad/uttar-pradesh-auto-drivers-daughter-with-cerebral-palsy-joins-mbbs-in-kolkatas-medical-college-and-hospital/articleshow/95564087.cms?from=mdr news nation news: https://www.newsnationtv.com/states/uttar-pradesh/divyang-girl-flew-in-the-sky-became-a-doctor-with-concentrated-mind-and-hard-work-319968.html?ref=whatsapp etv news: https://www.etvbharat.com/hindi/uttar-pradesh/state/prayagraj/prayagraj-girl-suffering-from-cerebral-palsy-became-a-doctor/up20221117143902031031205 times of india 3: https://timesofindia.indiatimes.com/city/allahabad/auto-drivers-daughter-with-cerebral-palsy-clears-neet/articleshow/95569247.cms ABP NEWS: https://youtu.be/Fi54To6IuR4 etv Bharat : https://youtu.be/YcNY5A5KQq4 danik bhaskar global news : https://dainik-b.in/op5w1gMa1ub nav bharat time: https://navbharattimes.indiatimes.com/good-news/good-news-auto-driver-daughter-yashi-kumar-with-cerebral-palsy-clears-neet-got-admission-in-mbbs/articleshow/95587295.cms abp online: https://www.abplive.com/states/up-uk/prayagraj-once-a-patient-of-cerebral-palsy-yashi-kumari-is-now-studying-in-renowned-medical-college-ann-2261650/amp dainik jagran : https://www.jagran.com/uttar-pradesh/allahabad-city-take-inspiration-from-yashi-who-did-not-let-dystonia-cerebral-palsy-become-obstacle-in-passing-neet-23209305.html up city news: https://www (at Trishla foundation : cerebral palsy awareness) https://www.instagram.com/p/ClFqNJWpOcu/?igshid=NGJjMDIxMWI=

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lupine-publishers-tooaj · 3 years ago

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Lupine Publishers | A Case and Cranial MRI Characteristics of Progressive Supranuclear Palsy

Lupine publisher | Trends in Ophthalmology Open Access Journal

Abstract

Progressive supranuclear palsy (PSP) is a neurodegenerative disease described by vertical supranuclear gaze paralysis, axial rigidity and postural instability involving falls in the early stage of the disease. Imaging studies present brain atrophy in especially midbrain, premotor cortex, basal ganglia and thalamus. There is no bioindicator of the disease although it is clinically identified. PSP is also classified as tauopathy. However, no specific indicator for tau protein could be identified. Hence, imaging findings, especially midbrain atrophy, functions as a biomarker in clinical practice and determination of disease prognosis. It has been shown that midbrain atrophy has a diagnostic value for PSP accompanied with the finding of “hummingbird” or “penguin” encountered by magnetic resonance imaging (MRI).

In this case report, we have aimed to review the diagnostic features of the disease based on the results of clinical and radiological results and to demonstrate the “penguin” sign and midbrain atrophy as a biomarker for clinical follow-up process. We have also detected a correlation with the results of clinical and neuropsychological tests.

We have analyzed a 61-year-old male patient who was a retired teacher for the complaints of progressive difficulty in walking since the recent year, slowness in speech fluency, forgetfulness and easy falling. Our patient was performed 1.5 Tesla Cranial MRI study due to the signs of postural instability, easy falling backward while walking, cognitive impairment, apathia, conjugate vertical gaze palsy, disinhibition and anxiety. T1W, T2W, T2 flair and diffusion sections on the axial plane were obtained in this imaging study. In addition, Mini-Mental State Examination and neuropsychological test were also performed in our patient.

The patient had particularly diffuse cerebral atrophy in predominantly frontal and parietal lobes. Peripheral CSF spaces were enlarged due to atrophy. Brainstem also showed atrophy and particularly mesencephalon atrophy was more remarkable. The appearance of brainstem in the sagittal slices due to mesencephalon atrophy were termed as “penguin” sign. A mild atrophy was also encountered in the bilateral cerebellar hemispheres. As a result of neuropsychological evaluation, mild to moderate cognitive impairment were detected.

We have evaluated with this case that atrophy of midbrain and mesencephalon which presented a significant visuality with classic “penguin” sign has an important diagnostic value in the PSP cases. Additionally, we have reviewed the fact in the light of literature data that imaging of midbrain atrophy may play a role as a biomarker in performing clinical follow-up and determination of the prognostic features of the PSP cases.

Introduction

Progressive supranuclear palsy (PSP) is a neurodegenerative disorder of primitive tauopathies [1]. It is characterized with pseudobulbar paralysis, dysarthria, dystonic rigidity of neck and trunk, akinesia, postural instability involving frequent falls and frontotemporal dementia as well as vertical gaze paralysis [2]. PSP is the most commonly seen atypical Parkinsonism. Its prevalence is 6.0-6.4 in 100,000. Its incidence is 5.4 cases in 100,000 [3]. It should be differentiated from idiopathic Parkinson’s disease or other atypical Parkinsonism cases along its natural clinical course [4,5]. The neuropathologically determinant characteristic of PSP is midbrain atrophy.

Atrophy is associated with intensity of tau-positive aggregates which are not melted in any way. These tau-positive formations are neuronal and glial fibrillar tangles and neurophil threads [6- 8]. This abnormal accumulation of tau proteins are responsible for the neuronal degeneration of basal ganglia and midbrain nuclei. Midbrain atrophy involves tegmentum, tectum, quadrigeminal layer and periaqueductal gray matter and is associated with reduced intensity of myelinated fibers, gliosis and neuronal loss. It is more commonly observed in males. Retropulsion and postural instability observed at early stage lead to frequent falls. The occurrence of the falls within the initial onset year is a typical characteristic. On the other side, supranuclear gaze paralysis usually appears due to primarily slowing of vertical saccades. Dystonia in the frontalis and procerus muscles may give a facial expression of scared or surprised in the PSP patient. Different clinical types of PSP have been recently identified [6]. In PSP patients, especially attention, executive function loss, verbal and nonverbal memory deficiencies may develop. The performance of the patient is demonstrated by verbal fluency tests, Frontal Assessment Battery and Montreal Cognitive Assessment Battery [4,9].

Case

The 61-year-old male patient was evaluated for the complaints of difficulties in starting walking since the recent year, frequent backward falls while walking, slowed speech and eye opening apraxia. He was conscious however, he had slow speech fluency and hypophonic dysarthria. His blink reflex was reduced. He had upward and downward supranuclear gaze paralysis and axial rigidity. He was able to walk independently with unsafe wide steps in the short distance. “Pull” test result was positive. His emotional state was labile and a remarkable slowing started in the executive functions. No response to the treatment of L-Dopa could be obtained.

Methods

The case was performed 1.5 Tesla MRI study. Cranial MRI was performed in accordance with T1weighted axial plane (slice thickness:5.5mm;TR:560;TE:9.5, Matrix 288x182), T2weighted sagittal plane (slice thickness: 5mm, TR: 5300, TE:82, Matrix: 384x192), T2weighted flair on the axial plane (slice thickness:5.5 mm,TR:8000, TE: 98, TI:2000, Matrix:320x224); T2weighted axial plane (slice thickness: 5.5mm,TR:3700, TE:88 Matrix: 320x256) (Figure 1). In addition, Montreal Cognitive Assessment Battery (MOCA Test) was applied. “Benton” facial recognition test and Line Direction Tests were performed.

Discussion and Conclusions

PSP is a clinical diagnosis. There is no diagnostic laboratory test. Midbrain atrophy that is frequently encountered by Cranial MRI may play a role as biomarker in determination of the prognosis. Especially, image of “penguin” encountered in the sagittal MRI slices has a diagnostic value. The progression of Parkinson’s Disease which is one of the diseases to be considered in differential diagnosis is very much slower than PSP and has no “red flag symptoms” and its responsiveness to L-Dopa is very well [1-4].

Corticobasal degeneration is a tauopathy like PSP, however, it is characterized with Parkinsonism manifested by remarkable symmetric dystonia. It is accompanied by cortical sensory signs, progressive apraxia is typically observed and “Alien Hand Syndrome” occasionally appears. It is differentiated by autonomic involvements such as Multiple System Atrophy with orthostatic hypotension, cerebellar ataxia and inspiratory stridor. Parkinson’s-Dementia complex manifested by Lewy body dementia and Parkinsonism is differentiated by fluctuating mental state and visual hallucinations appearing with onset of dopaminergic treatment [1-6].

Cranial MRI of the case encountered diffuse cerebral atrophy in predominantly frontal and parietal lobes. Peripheral cerebrospinal fluid (CSF) spaces were enlarged due to atrophy. Atrophy was present also in the brainstem and the atrophy particularly in the mesencephalon is much more remarkable. The appearance of the brainstem due to mesencephalon atrophy in the sagittal slices was termed as “penguin sign”. Additionally, bilateral cerebellar hemispheres revealed a slight atrophy [7-9].

According to MOCA Test scores, a significant decline was monitored in the copying and visuospatial functions of the patient. The patient gained no point from the subfield of executive functions. He has experienced difficulties in ordering the parameters in a correct sequence in this subfield. He could not order the parameters (1-5, A-E) as a number followed by a letter although he was a retired teacher. This result indicated a significant problem in the executive functions of this patient. In this subfield, the patient could not copy a cube and could gain no point from the subfield of clock-drawing test (Figures 2 & 3). The patient gained 5 standard deviations lower than the mean of his age and educational level according to the result of Benton Test of Facial Recognition. He was found significantly unsuccessful in Line Direction Tests. Evaluation of visual performance tests: It was observed that the patient’s cognitive processes related to orientation, spatial perception, spatial cognition, mental rotation, and face recognition were significantly impaired

https://lupinepublishers.com/ophthalmology-journal/fulltext/a-case-and-cranial-mri-characteristics-of-progressive-supranuclear-palsy.ID.000128.php

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#Lupinepublishers #Ophthalmic #Neuro-Ophthalmology

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sachkiawaaj · 3 years ago

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‘Stop it’: Sydney family’s lockdown plea The virtual fundraising challenge STEPtemper aims to raise money to support Australians with cerebral palsy like Emily Sayers.

A desperate mum has issued an emotional plea to Sydneysiders, as the Covid-19 outbreak takes a huge toll on her sick child. A Sydney family has made an impassioned plea for people to follow Covid-19 restrictions, not just for their own sake but for the lives of Australians like their seven-year-old daughter, Emily. Claire and Ben Sayers’ little girl has Quadriplegic Dystonic Cerebral Palsy, a…

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birdofmay · 2 years ago

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I understand that high support needs =/= level 3 autism and low support needs =/= level 1 autism. but I'm confused about what high support needs would look like in level 1 autism and what low support needs would look like in level 3 autism. could you possibly explain how that would work or give some examples? thank you, I appreciate your blog a lot

High support needs in someone with level 1 autism most likely would be because of a physical disability. A level 1 autistic who has "medium" dystonic and spastic cerebral palsy (without impaired speech) for example very likely isn't able to perform IADLs and BADLs without help, or a level 1 autistic whose arms and legs are paralysed and who has dysphagia.

I'm not sure if it's possible to be low support needs when you have level 3 autism, to be honest. Because when you're level 3, that's very disabling in general, many level 3 autistics have developmental delays/disabilities that make BADLs hard.

If there are level 3 autistics out there with low support needs or if you guys know some level 3 autistics who aren't at least medium support needs, let me know! ☝🏼

#anon ask

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aristotle-is-alive · 5 years ago

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Passion, bruh (not the sexy kind don’t worry)

Imma cut to the chase here, friends. My passion is ministry towards individuals who have disabilities. I almost just misspelled ‘disabilities”. That’s really sad. Oh well, I can be a bad speller but still care about a topic lol. Anyway, back to the point. I could talk all day about how happy this particular subject makes me, but it’s 11:46pm and all day only lasts 14 more minutes so I’ll have to be relatively concise.

I know quite a few people who have a disability, or multiple disabilities. My brother has cerebral palsy, and my best friend whom I’ve known since birth has dysautonomia (look it up, cuz it’s grossly unknown, so if you’re one of the few people who knows what it is, you’re a stellar human in my book. In fact, here’s a link to its wiki page https://en.wikipedia.org/wiki/Dysautonomia) I have many friends who have ASD, and/or Down’s Syndrome. Now that I’m looking at these sentences, they really sound like a flex XD. I’m just gearing up to say why I’m drawn to this ministry, don’t worry.

All these people, I have to say, are some the most happy, joyful, compassionate, and kind people I’ve ever met. They make me so happy every time I see them, and always leave me feeling loved. I hope I evoke the same feeling in them. When you think about it, it’s actually incredible that many of the folks who have any sort of disability are so happy. Think about it. Many of them struggle with learning difficulties, physical ailments, inabilities to function without significant help, depression, anxiety, stress, and so many other hurtful things that occur daily. Many, and I mean MANY of them are bullied and oppressed throughout childhood and well into adult life. They’re stigmatized, made fun of, laughed at, and made into insults. For reference, consider the use of the ‘r’ word (I hate that word with a passion), the term ‘sped’ (a term meaning special ed, and used as an insult of sorts), or ‘spazz’ (when used toward a person who has, for a specific example, cerebral palsy and struggles with muscle spasms or dystonia, or in reference to, although not directly toward, a person with such struggles).

With all these gigantic hurtful situations, people who have disabilities are. SO. HAPPY. AND NICE. AND UPLIFTING. They lift you up when they’re constantly in pain! They laugh and smile when just yesterday they were called horrible offensive names! They make an effort to be friends with you when ever since they were born no one wanted to be their friend just because they twitched, or looked different, or only talked about trees, or never actually talked at all! Isn't that incredible?!

It’s a marvel just because of that! For example, my brother is constantly choking on his own vomit, having dystonic storms which doubtless cause agonizing muscle cramps, being afflicted with almost ceaseless ear infections, chronic constipation, kidney stones, and probably numerous other physical maladies that we just don’t know about because he can’t tell us, because he’s nonverbal. He also can’t walk, eat orally, or perform most noticeable kinds of voluntary movement. But you know what? He smiles and laughs more than most people I can think of. He laughs at jokes, his favorite TV shows, and whenever anyone does something embarrassing. Now how in the holy heck is that possible?!

I can tell you for a fact, if I was in that much pain as often as he is (every stinking day), I would NOT be as sunshiny as he is. In fact, I would be a sucky person to be around. I would be a complete bitch to be quite honest (again, pardon my French, but I didn’t know how else to get my point across).

I guess the whole point of this is, people who have disabilities are so, sO, SO HECKING STRONG. I can’t even begin to describe it. I don’t want to come off as someone who’s just into this because it’s iNsPiRaTiOnAl, or I only love people who have disabilities who are also sunshiny, because believe me, I know that everyone has their Bad Days, and in fact quite a few people have disabilities that cause them to have behavior issues that aren't the most fun to be around sometimes. But they are humans, beautiful, BEAUTIFUL humans who are loved beyond imagination because they are who they are. And who they are is exactly what God intended them to be.

In the book of John, Jesus encountered a man who had been blind from birth. The town’s people around him asked Jesus why the man had been born this way, suggesting options such as it being because of the man’s sins, or perhaps his parents. Jesus in turn asserted this one, crucial, beautiful fact. He said, "Neither this man nor his parents sinned, but this happened so that the work of God might be displayed in his life.” or, in the New Living Translation, “It was not because of his sins or his parents. This happened so the power of God could be seen in him.”. This. Is. So. True. I won’t elaborate on this anymore, save to state this:

If you want to see the power of God, his glory, his love, grace, and mercy, look at the heart of a person who has a disability.

That’s all I’m gonna say cause if I talk any more about this, I’ll wind up going on and on for long enough to write a decent length fan fiction. Ugh, and I haven’t even gotten into the lives and hearts of parents of people with disabilities! There’s gonna have to be a part two.

Jeezo that took me 40 minutes to write. Probably shouldn’t have taken me that long but oh well.

If you made it to the end of this thing, Congration! You done it! Thank you for sticking it out. I hope this blessed you in some way, or maybe gave you some insight, grace, or joy.

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recklesstreacherous · 7 years ago

Video

youtube

Taylor Swift inspires Ashland boy to walk: See the adorable video

Hey, Taylor Swift, you have a lot to be proud of. Talent. Awards. Loving fans. Did you know you also helped a boy walk?

Luke Hogan Laurenson, 12, was born with cerebral palsy and although he's been inspired by your songs for years, your "Shake It Off" got him up from his wheelchair and dancing to your beat.

Incredible, right? Don't believe me. Ask the Ashland firefighters who saw it happen. Or just watch the video.

Doctors told Luke's mom that walking for him was not possible, let along dancing. He shook it off.

Your song became his personal anthem. He first started swaying to the beat while sitting on the floor. Then he found the strength to bounce a little on his knees. In December, the brave boy born with dystonic quadriplegia cerebral palsy walked a few steps

And this year, he danced for the very first time all by himself.

Having the independence to do these things on his own has improved his self esteem, says his mom, Jane Hogan. If he's having a bad day or a setback, she says, he reminds himself to shake it off.

Taylor, your image is everywhere in Luke's home: Posters, calendars, birthday gift DVDs.

When the family drove five hours to attend your Red Tour in Portland's Moda Center four years ago, Luke wore a T-shirt his big sister made for him. It read: "The best day of my life," a message inspired by your "Best Day" song and how he was feeling that day.

You see, you've been a big comfort to him. When he was really little and pain shot through his weak limbs, his mom would play your music. Sometimes, when Luke was restless and couldn't sleep, she would crack him up by pretending to talk to you over the phone.

On Friday inside their Ashland home, Jane Hogan demonstrated.

She held her hands like a phone up to her ear, and said, "Taylor, it's been a while," and Luke laughed and wiggled his feet. His speech disability, dysarthria, makes it difficult for most people to understand him, but his mom and sister get the message loud and clear.

Jane Hogan said Luke had been deprived of oxygen before or during his birth. His damaged nervous system can't produce the relaxation neurotransmitter Gaba. Your music helps him manage his stress.

But you won't see any unhappiness when meeting Luke. He smiles often, his hazel-colored eyes connecting to yours.

"He wakes up happy and spends the day that way," says his mom.

Classmates at Bellview Elementary School in Ashland treated him like a rock star. Luke now attends Ashland Middle School and looks forward to the new school year starting in August.

He works hard in the classroom, but a device that's supposed to let his communicate to teachers and friends is holding him back. The Talk Buddy device he has is old, not wired for the internet and it's heavy for him to pick up.

Still, he painstakingly types with one thumb: "I'm feeling happy" or some other positive message.

The video of Luke miraculously dancing was posted on the fundraising site You Caring to raise money to pay for a new Talk Buddy -- his health insurance won't cover a replacement for three more years -- and more medical treatments that are making him become more mobile.

Luke's mom wrote on the You Caring campaign page: "Truthfully, I would rather do almost anything in the world other than ask for help. But I have an amazing 12-year-old son who has shown that his brain can heal."

So far, the campaign has raised a third of its $34,000 goal.

Social experts estimate that each time his video is shared, it could raise $37 for his treatments.

Taylor Nation, can you help?

So far, almost 50,000 people have watched the video through Facebook and You Caring. Family friend and real estate agent Gabriel Al-Rifai volunteered to shoot the short, inspiring film. In it, a dozen Ashland firefighters strut with Luke on top of a firetruck to Swift singing:

I never miss a beat, I'm lightning on my feet I'm dancing on my own, I make the moves up as I go It's like I got this music in my mind Saying it's gonna be alright

There's another funny scene where Luke appears to be lifting heavy weights. When the camera pulls back, we see he's being aided by the firefighters.

For now, the old Talk Buddy device is doing its job, helping Luke spread his message: "I came here to teach people about love and open people's hearts."

#taylor swift #taylor nation

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theleadingphysiciansofthewo-blog · 7 years ago

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Treatment of Cerebral Palsy

Cerebral palsy is a very complex condition that can affect both children and adults. Treatment for this condition is therefore as complex as the condition is. This means there is no single approach to treat the condition since each person is affected differently. Though the brain injury that causes this condition cannot be cured or healed, the resulting physical complications caused by cerebral palsy can be managed with a wide range of therapies and treatments. There is no universal procedure developed to treat all cases of cerebral palsy but the severity of the condition and extent of impairment can help determine the type of care one should receive.

What Treatment Involves

While adaptive equipment and therapy are the primary treatment protocol for CP, the patient may also require surgical and drug therapy interventions. Other people may also go for physicians’ guidance and consider alternative and complementary medicine to help manage their conditions. Each medical specialist may have a specific care goal depending on their area of specialty and the severity of the patient’s condition. However, the treatment goal for cerebral palsy patients is to:

· Control pain

· Improve mobility

· Manage any primary conditions associated with CP

· Minimize dependence

· Prevent and also manage co-mitigating factors and other complications associated with CP

· Improve self-care

· Enhance the ability to communicate

· Improve social and peer engagements

· Improve learning abilities and

· Enhance quality of life

Cerebral palsy is a complex condition which requires long-term care with a medical team. The medical team is comprised of:

· Pediatric neurologist- Diagnoses and treats children with neural disorders.

· Orthopedic surgeon- A specialist in muscle and bone disorder treatment.

· Pediatrician or physiatrist- A specialist who oversees medical care and treatment plan.

· Occupational therapist- A specialist who helps children developdaily skills and helps them learn how to use adaptive equipment.

· Physical therapist- Helps children and adults develop strength, walking skills and also muscle stretching.

· Speech language therapist- They help in diagnosis and treatment of language and speech disorders in children and adults.

· Recreational therapist- Helps children and adults with CP participate in sports, arts and cultural programs to help them improve physical, interactive and cognitive skills and abilities.

· Mental health specialist- They help children and adults cope with mental disabilities.

· Developmental therapist- Provide therapy to help children develop interpersonal skills, social skills and age-related behaviors.

· Social worker- Assist family members of the affected to find the best care services and transitions.

· Special education worker- A teacher who identifies learning disabilities and offers educational needs for children with CP.

Medications for Cerebral Palsy

Medicine for cerebral palsy is usually meant to help reduce muscle tightness and improve functional abilities, reduce pain and manage other complications associated with this disorder. Just like in other forms of treatment, the type of medicine given depends on the complications involved and the severity of CP. Medications given also depend on whether CP has affected certain muscles in the body or muscles in the whole body. Medications given for cerebral palsy include:

1. Muscle relaxants- They include medications such as Diazepam (valium) and Baclofen that help promote muscle relaxation by simply reducing muscle spasms and stiffness. Most of these medications are administered orally unless stated otherwise by your specialist.

2. Anticholinergic medication- This medication is usually given to individuals who suffer dystonic cerebral palsy. With this condition medications such as Robinal may be given to treat drooling symptoms to help manage body movements.

3. Seizure medication- Seizure medications are meant to induce anti-convulsion effects to people with CP-related seizure. Mediations such as Lamictal and Trileptal help manage seizure effects.

It is important to discuss the drug treatment risks with your doctor to make surethe drugs are appropriate for you or your child. Each drug given to reduce muscle tightness may have harmful side effects to your child, though some specialists feel that the benefits of muscle relaxants outweigh the risks.

Therapies for Cerebral Palsy

Nondrug therapies that can help people with cerebral palsy and help improve functional abilities include:

1. Physical Therapy

Physical therapy usually involves muscle training and exercises that help CP patients improve flexibility, balance, strength, motor development and mobility. For a child, physical therapy is needed for the first 1 to 2 years after birth which involve both occupational therapist and physical therapist who help your child in support issues such as rolling, grasping and head/trunk control. Your child may also be introduced to braces and other adaptive equipment.

2. Occupational therapy

Occupational therapy is usually meant to help a person cope with daily activities independently both at home, school and in the community. It involves use of alternative strategies and orthotic devices such as walkers, quadrupedal canes, electric wheel chairs and seating systems.

3. Speech and language therapy

This therapy is meant to improve the ability to speak and communicate by use of sign language. Speech and language pathologists have the responsibility to teach children to communicate using devices such as computers and voice synthesizers. Speech pathologists may also deal with issues such as difficulty with eating and swallowing.

4. Recreational therapy

This is a therapy designed to help improve your child’s speech, motor skills, and emotional well-being. It includes activities such as therapeutic horseback riding.

Surgeries for Cerebral Palsy

Surgery is needed in some instances for people with cerebral palsy to help control pain, improve mobility, and also prevent further deformities. Surgeries used for CP treatment include:

1. Hearing surgery

It is usually meant to treat infections and ear blockage that are prone to people with CP. It also helps treat fiber damage to the inner ear, another common complication for people with CP.

2. Surgery for medicinal needs

This is usually meant for infants who rely on medications to manage chronic pain. It helps disperse pain medications to the most pain-severe areas.

3. Orthopedic surgery

It is the most common surgery for people with cerebral palsy. It is a least invasive surgical procedure which take place in multiple body parts such as ankles, arms, wrists, back, hips, spine, shoulders and feet. This surgery is aimed to control pain and help the CP patient cope with self-care and independent mobility.

4. Vision Surgery

It is meant to control eye movement as well as repair vision impairment or loss. Before this surgery, specialists have to test contacts or eyeglasses. If they don’t work and vision is still impaired, vision surgery follows.

Alternative and Complementary Treatment

Alternative and complimentary treatment options for CP have shown positives results for many people. However, they have not yet been approved by the U.S. Food and Drug Administration (FDA). Some holistic and natural ways that can help treat cerebral palsy include:

· Hyperbaric oxygen therapy

· Acupuncture

· Electrical stimulation

· Conductive education

· Massage therapy

· Energy-channeling therapy

· Equestrian therapy

Note that not all alternative and complementary treatment options work the same for each individual.

#Health #Healthcare #Cerebral Palsy

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