Cerebral palsy in adults

Cerebral palsy in adults

Cerebral palsy (infantile cerebral palsy) is a name that connects a whole group of movement disorders that occur when brain structures are damaged in the prenatal or postpartum period. In most cases, the diagnosis of cerebral palsy is made during the first year of the patient’s life and persists throughout the entire lifespan.

In cerebral palsy, paresis, impaired muscle tone, speech and swallowing disorders, unsteady gait, dyskinesia (involuntary movements), and constant falls can occur. The severity and clinical picture entirely depend on the depth of damage to specific structures of the central nervous system. Almost 40-60% of people with cerebral palsy have intellectual impairment, mental health disorders, epileptic seizures, and vision and hearing problems.

Patients with cerebral palsy must undergo rehabilitation treatment throughout their lives. In addition, pharmacotherapy, physiotherapy, and surgical treatment are carried out depending on the specific damage due to the disease.

By the localization of the affected areas of brain structures in neurological practice, cerebral palsy is classified as follows:

• Spastic tetraplegia (one of the severe forms of the disease, motor disorders, and spasticity are equally pronounced in the upper and lower extremities, cognitive disorders, speech impairment, and often epileptic seizures are noted);
• spastic diplegia (the most common form of cerebral palsy, spasticity predominates in the muscles of the lower extremities, less pronounced in the arms and facial muscles; earlier development of contractures, deformation of the spinal column and joints; moderate decrease in intelligence, delayed mental and physical development; with this form, people have all the possibilities to complete adaptation in society, especially while maintaining the intellect and the normal functioning of the hands);
• hemiplegia (one-sided spastic hemiparesis is noted – one arm and one leg, the hands suffer to a greater extent, mental and physical development is delayed in childhood);
• hyperkinetic form (the leading cause is a hemolytic disease sustained by a newborn child; the presence of hyperkinesis is characteristic, intelligence is preserved, hearing impairment and oculomotor disorders are noted);
• ataxic form (reduced muscle tone is indicated, speech disorders, tremors are possible, less often – a delay in the development of intelligence).

Causes of cerebral palsy

The leading cause of cerebral palsy is the influence on the structures of the central nervous system of various negative factors that lead to abnormalities in the development or death of brain cells. In adult patients with cerebral palsy, the impact of negative factors occurs in the perinatal period.

The leading mechanism for the development of the disease is hypoxia (oxygen starvation of the brain), which occurs under the influence of various factors.

If we talk about etiological factors, they include:

• fetoplacental insufficiency (occurs with various pathological conditions of the mother, as well as as a result of pregnancy complications);
• early and late toxicosis;
• premature detachment of a normally located placenta;
• infectious diseases (herpes, syphilis, rubella, etc.);
• Rhesus incompatibility;
• risks of abortion;
• maternal heart defects, persistent increase in blood pressure, and past traumatic situations during pregnancy.

Birth trauma is the cause of cerebral palsy in only a few cases. More often, difficult births result from pre-existing intrauterine anomalies in the development of the fetus.

The causes of damage to the brain structures of a child after birth are neonatal jaundice or oxygen starvation.

Treatment of cerebral palsy in adults

Treatment of cerebral palsy is carried out throughout a person’s life and includes various measures aimed at restoring impaired functions. When developing therapy tactics, neuropathologists consider several factors, including the results of the examination, the presence of disorders, the form of cerebral palsy, the age of the patient, and the severity of damage to the brain structures.

For the treatment of cerebral palsy in adults, the following methods are used:

• orthopedic operations;
• the use of assistive technologies;
• work with a psychologist;
• pharmacotherapy;
• speech correction;
• functional neurosurgery;
• injections of botulinum toxin preparations that block neuromuscular transmission.

Rehabilitation for cerebral palsy in adults

Cerebral palsy refers to neurological pathologies that occur in childhood. Unfortunately, the disease is incurable. However, high-quality, comprehensive, and regular rehabilitation contributes to developing a person’s intellectual abilities and motor and speech skills.

With the help of modern rehabilitation treatment, it is possible to effectively compensate for the emerging neurological deficit, reduce the severity of deformities, increase the adaptive capabilities of a person, and teach various previously inaccessible skills.

The tactics of a complex rehabilitation treatment are developed individually for each patient and may include:

• Drug therapy is prescribed to improve cerebral circulation, achieve normal muscle tone, and eliminate convulsions. If necessary, pharmaceuticals are used to reduce intracranial pressure, painkillers, and antispasmodics for chronic pain syndrome.
• Massage – techniques are used to strengthen the muscles and reduce or increase muscle tone. With the help of massage, it is possible to improve blood circulation and strengthen the muscle corset. Speech therapy massage normalizes the swallowing reflex, improves speech activity, and removes salivation.
• Therapeutic gymnastics – exercises are selected strictly individually for each patient, depending on the severity of the disease. In this case, it is essential to observe regularity and continuity, a constant increase in the load.
• Physiotherapy – has a positive effect; combined with exercise therapy and massage gives excellent results. As part of physiotherapy, laser therapy, hyperbaric oxygen therapy, electrical stimulation, acupuncture, mud therapy, paraffin baths, magnetotherapy, therapeutic baths, etc., are used.
• Synergistic reflexology – this includes methods such as manual therapy and osteopathy. This treatment is aimed at restoring the functions of the musculoskeletal system.

Rehabilitation includes work with a psychologist or psychotherapist, art therapy, occupational therapy, mechanotherapy, and many other techniques.

In Kliniken Schmieder, various severity of adult patients with cerebral palsy is rehabilitated. Our specialists have the latest expert-class equipment, modern preparations, and the most progressive, sometimes unique methods that can significantly improve the condition of patients with cerebral palsy.

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