Cerebral palsy and movement disorders
What is cerebral palsy?
Cerebral Palsy (CP) is the name given to a range of disabilities associated with movement and posture. It is a neurological disorder caused by brain damage resulting from an adverse event in the time before birth (prenatal), during birth (perinatal) or shortly after birth (postnatal). Causes include pregnancy related oxygen deprivation, metabolic or blood abnormalities, the mother having Rubella (German measles) during pregnancy, brain damage caused by illness or accidental injury.
Cerebral Palsy affects the motor skills (ability to coordinate body movements) and muscle tone. Muscles may move erratically or spasm or have a lack of tone. There may be poor reflexes and posture. Swallowing and talking may be difficult. CP can affect children in different ways, from minor motor skill problems to complete physical dependency.
Children with CP may have:
- Spasticity, the most common, characterised by increased muscle tone causing stiffness or tightness of muscles, which is most obvious when the person tries to move
- Dystonia, characterised by variable tone and involuntary twisting postures
Or they may have a combination of symptoms.
CP may effect different parts of the body
- Unilateral – one side of the body is affected, often referred to as hemiplegia
- Bilateral – both sides of the body are affected, may include all four limbs which is called quadriplegia or mainly the legs, called diplegia
Although CP is a permanent condition, children with CP can achieve greater control over movement, as they learn and practice motor skills.
How do we help children with cerebral palsy?
The Sydney Children's Hospitals Network offers services to children with cerebral palsy as part of their rehabilitation programs, Kids Rehab and Rehab2Kids. The hospitals provide programs for:
- Movement Disorder Management
- Botulinum toxin
- Hip surveillance
- Orthopaedic management
- Intrathecal Baclofen (statewide program)
- Selective Dorsal Rhizotomy (national program)
Currently, there is no cure for cerebral palsy, however, quality of life can be improved. The main goals of intervention are to increase independence and participation in the community and improve comfort and ease the burden of care for families.
Anticonvulsant medications can be used to treat seizures and medications can be used to reduce muscle stiffness and control involuntary movements. Physiotherapy can be important to maintain range of movement, improve muscle strength and help with mobility and participation. Occupational therapy can assist with seating and positioning, developing skills in activities of daily living, improving hand function and with classroom activities. Speech pathology is important to help improve communication or find alternative methods of communication and to assist with feeding and swallowing. Rehabilitation specialists, orthopaedic surgeons, nurses and dietitians may also be involved in patient care.
Resources for Clinicians
Dyskinetic Cerebral Palsy Functional Impact Scale (D-FIS)
The Dyskinetic Cerebral Palsy Functional Impact Scale (D-FIS) assesses the impact of dyskinesia on typical daily functional activities in children with cerebral palsy.
The parent-report questionnaire was designed to quantify the perceived impact of dyskinesia on daily functional activities in children aged 3 to 18 years. The D-FIS also explores families' current priorities for intervention.
Available for download. D-FIS Research Group holds the copyright for the D-FIS questionnaire. Modifications, including condensing, adapting or transforming the tool in any manner without prior agreement from the D-FIS Research Group is not permitted.
If you would like to translate the D-FIS into a community language, please email Kirsty Stewart to request the Translation Manual.