Cerebral Palsy

Cerebral palsy is actually a group of disorders that can involve brain and nervous system functions including movement, learning, hearing, seeing, and thinking. There are several different types of cerebral palsy, including spastic, dyskinetic, ataxic, hypotonic, and mixed.

Symptoms

Symptoms of cerebral palsy can vary greatly, and can range from very mild to very severe. Symptoms can also affect either one or both sides of the body, and be more pronounced in the arms or legs, or involve both the arms and the legs. Children with cerebral palsy usually start to display symptoms before the age of two years. Sometimes symptoms can begin immediately after birth. Seizure activity is often a "hallmark" of the injury.

Symptoms can include: 

  • Hypertonic (excessively stiff) or hypotonic (excessively floppy) muscles 
  • Developmental delays (rolling, sitting, crawling, walking) or poor motor skills
  • Difficulty sucking or feeding in infants, or difficulty chewing or swallowing in adults – sometimes requiring a feeding tube 
  • Seizures
  • Problems with vision, hearing or speech 

There are many other symptoms that can occur, depending on the type of cerebral palsy. If your child exhibits any or all of these symptoms, or any additional symptoms, you should seek a medical opinion and diagnosis as soon as possible.

Possible Causes & Risk Factors

Cerebral palsy is caused by injuries or abnormalities of the brain. These problems can occur as the baby grows in the womb or at any time during the first two years of life when the baby's brain is still rapidly growing and developing. In some individuals with cerebral palsy, parts of the brain have been injured due to low levels of oxygen (hypoxia) in that area of the brain. This low level of oxygen during birth (hypoxic ischemic encephalopathy) is one of the more common forms of cerebral palsy caused by birth injury from obstetric and/or hospital malpractice. Essentially, there is a failure to timely deliver the baby in an increasingly urgent, then emergency situation.

In some cases, there are early warning signs during delivery and the emergency situation could have been prevented entirely. In others, a timely c-section would have prevented the injury.

Premature infants have a higher risk of developing cerebral palsy. Cerebral palsy can also come about during delivery and early infancy as a result of other conditions, including:

  • Bleeding in the brain (especially with vacuum or forceps delivery) 
  • Brain infections (encephalitis, meningitis, herpes simplex infections) 
  • Head Injury 
  • Infections in the mother during pregnancy (rubella) 
  • Severe jaundice

Treatment

While there is currently no cure for cerebral palsy, there are treatments available to help the person be as independent as possible.

Proper treatment usually requires a team of specialists, including doctors, nurses, attendant care specialists, dentists, social workers, therapists (occupational, physical and speech), neurologists, pulmonologists and gastroenterologists. Treatment also includes education in self and home care. Many individuals with cerebral palsy also eventually require the assistance of different types of medical equipment and devices, including glasses, hearing aids, muscle and bone braces, walking aids and/or wheelchairs.

Over the course of an individual's lifetime, these costs can be substantial. Dr. Bradshaw has a proven track record of helping clients find out what went wrong and getting children the compensation they need to provide the best possible life and medical care for their loved ones. Dr. Bradshaw works with life care experts across the country to accurately determine the costs of treatment during a person's lifetime.

Defenses

Obstetricians, in conjunction with insurance companies, defense attorneys and some pediatricians, wrote a book called "Obstetrics & Gynecology (Green Journal)". This publication was written to help defend these specific type of medical malpractice cases. It sets forth criteria which must be met before a cerebral palsy/birth injury from malpractice at delivery can be proven. The studies used by this publication do not even support the authors' conclusions; and, in most cases, in order to meet the criteria, the infant would be deceased. Here are the "requirements" from this book:

  • Essential criteria (must meet all four):
  1. Evidence of a metabolic acidosis in fetal umbilical cord arterial blood obtained at delivery (pH <7 and base deficit =12 mmol/L)
  2. Early onset of severe or moderate neonatal encephalopathy in infants born at 34 or more weeks of gestation
  3. Cerebral palsy of the spastic quadriplegic or dyskinetic type†
  4. Exclusion of other identifiable etiologies such as trauma, coagulation disorders, infectious conditions, or genetic disorders
  • Criteria that collectively suggest an intrapartum timing (within close proximity to labor and delivery, eg, 0-48 hours) but are nonspecific to asphyxial insults:
  1. A sentinel (signal) hypoxic event occurring immediately before or during labor
  2. A sudden and sustained fetal bradycardia or the absence of fetal heart rate variability in the presence of persistent, late, or variable decelerations, usually after a hypoxic sentinel event when the pattern was previously normal
  3. Apgar scores of 0-3 beyond 5 minutes
  4. Onset of multisystem involvement within 72 hours of birth
  5. Early imaging study showing evidence of acute nonfocal cerebral abnormality