What Causes Cerebral Palsy (CP)?

The name cerebral palsy means brain paralysis and was it was known as Cerebral Paralysis in the mid-nineteenth century, when an English doctor, William Little, first identified it [1]. It is also known as Little's Disease. It's a term that covers a spectrum of disorders. Despite ever-increasing knowledge about how the brain functions, it continues to be a somewhat mysterious disease. The exact cause is not known, although many likely causes have been identified [3]. It is not progressive, although an individual's symptoms may change over his or her lifetime. It is not curable, although good treatment can help the person be more active in family, school, and work life [3].

Moderate to severe CP is estimated to occur about twice in every 1,000 live births. Typically, it is not diagnosed until the child is about 18 months old, although if it is a very severe case, it can be pinpointed a few weeks after birth. Usually it's the parents who first notice some kind of developmental delay in their baby's movements. Diagnosis is done using CT scans, ultrasound, or MRIs in combination with questionnaires to the parents and certain tests. [2]

Muscle tone is affected
When a baby's developing brain is injured in the area that controls muscle tone, CP is the result. What is muscle tone? It's the degree to which a muscle can resist being moved, the steady counterforce it can apply to an external force like gravity, wind, or pressure applied by another person. It allows us to maintain our posture or position.

Depending on exactly when during gestation the unborn baby's brain is damaged, and on which exact part of it is damaged (within the motor control area), different consequences are visible after birth. The child will have trouble controlling muscle movement, and it may be only in the legs, or both arms and legs, or only on one side. It may tend more towards immobility, or towards too much motion.

Some possible causes [3]
During the first six months of pregnancy:
•  Genetic conditions and blood supply problems

During later pregnancy, delivery, and the first year of life:
•  Infections such as bacterial meningitis
•  Severe jaundice
•  Bleeding in the brain
•  Head injury
•  Impaired oxygen supply to the brain

Bleeding in the brain, head injury and impaired oxygen supply to the brain are all potential complications from labor and delivery and may result in a claim of medical malpractice (or obstetrical malpractice).

Jaundice in newborn babies
Sometimes the new baby's liver cannot keep up with the rate of red blood cells dying and breaking down. This breakdown happens every day, and leaves a yellow pigment called bilirubin. It's the liver's job to get rid of bilirubin, but if it isn't up to speed yet, and too much bilirubin builds up in the child's body, it colors the skin and whites of the eyes yellow, the condition known as jaundice.

Mild jaundice is fairly common, and usually resolves as the baby's liver gets to work. More severe jaundice, if not treated, can damage the baby's brain, a condition known as kernicterus . Kernicterus causes CP, hearing loss, vision and dental problems, and sometimes also mental retardation [4].

Connections with other conditions
Although the exact cause of any given child's CP cannot usually be pinpointed, groups of babies with certain conditions have been statistically connected with those who have CP, implying a possible causal connection. The evidence so far suggests that about three-quarters of CP cases are related to prenatal factors and prematurity [2].

•  A baby will be more likely to eventually be diagnosed with CP if it:
•  Is premature
•  Weighs less than three pounds, for whatever reason
•  Does not cry within about five minutes of delivery
•  Needs to be on a ventilator for a month or more
•  Has congenital malformations in the heart, kidneys, or spine
•  Has seizures [5]

•  If the baby's mother engaged in certain behavior during pregnancy, or incurred certain conditions, the baby will be more likely to have CP:
•  Alcohol abuse (affects the baby's neurological system)
•  Heavy smoking (reduces the baby's birth weight, making CP more likely)
•  Severe malnutrition (also reduces the baby's birth weight, making CP more likely)
•  Uses cocaine or crack (affects her blood vessels, leading to many complications which can affect the baby's nervous system; this often causes mental retardation, but can also cause CP)
•  Infection of many kinds (can affect the baby's brain through the mother's circulation) [5]

Preventable birth injuries
A baby's brain can be injured at birth either by a mechanical force to the skull or by oxygen deprivation. Each birth is a unique event and the health professionals attending and assisting at it should modify their procedures to match the particular circumstances. If the baby is premature, or is a breech presentation, or if the mother's pelvis is too small or labor goes on too long, everyone involved in the birth should be aware that injury to the infant is possible [5].

Sometimes unfortunately, such injury is preventable, but occurs anyway as a result of medical negligence. In that situation, it would be advisable to contact a birth injury attorney who specializes in cerebral palsy lawsuits. In some situations, it may be possible to win a monetary settlement that will help cover the costs of medical care and long-term living assistance. Following are two resources to consider for birth injury attorneys:
[ Link I ] [ Link II ]