Cerebral Palsy Associated Disorders

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Cerebral palsy associated disorders are conditions that children with CP may develop. Almost all children with cerebral palsy have one or more health issues connected to the neurological disorder.

Seizures

Seizures are common with cerebral palsy. According to the Centers for Disease Control and Prevention (CDC), around 35% of all children with cerebral palsy will experience seizures.[1] The symptoms depend on the type of seizures a child has.

When a child experiences a seizure, it’s due to electrical activity misfiring in the brain. Some of the various reasons misfiring occurs are brain damage, head injuries, dehydration, infections, tumors, and genetic factors.

Different types of seizures include:

• Absence seizures. Children with absence seizures may stare into space and have small and subtle body movements, such as eye blinking and lip-smacking.
• Atonic seizures. Children with atonic seizures have a temporary loss of muscle control and may collapse onto the floor without warning.
• Clonic seizures. Clonic seizures are marked by jerking muscle movement in the arms, face, and neck.
• Myoclonic seizures. Children with myoclonic seizures will have temporary jerking in the arms and legs.
• Tonic-clonic seizures. Tonic-clonic seizures are the most severe type of seizures, marked by body shakes, loss of consciousness, the body stiffening, and in some instances, loss of bladder control.

Dysphagia

Dysphagia is a medical term that means difficulties with swallowing. Children with cerebral palsy are at risk of dysphagia due to poor muscle and motor function control.[2]

Symptoms may include:

• Inability to swallow and/or pain when trying to swallow
• Regurgitation
• Heartburn
• Feeling stomach acid in the throat
• Unusual weight loss
• Hoarse voice
• Food stuck in the chest area or throat
• Gagging and coughing when attempting to swallow
• Drooling
• Delayed (or sometimes absent) swallowing reflex
• Back pain
• Sore throat

It’s essential to work with your child’s physician when addressing swallowing issues. Often, it’s recommended that the child sees a team of healthcare professionals, including a dietician, occupational therapist, and in some cases, a dysphagia specialist.

Vision Problems

Children with cerebral palsy are at risk of vision problems such as cerebral visual impairment (caused by brain damage), strabismus (caused by eye issues), and hyperopia (long-sightedness).[3] Pediatricians recommend that you get your child’s vision checked early and regularly.

Vision problems can create a number of additional associated disorders, including:

• Impaired learning abilities
• Accident-prone due to vision issues
• Difficulties with learning to read and write

Cognitive and Behavioral Issues

Not all children will experience cognitive issues, but a scientific study on cerebral palsy published in Disability and Rehabilitation (Volume 28, Issue 4, 2006) states that “a large proportion” of children with CP will have some form of cognitive impairment.[4]

Cognitive impairment doesn’t mean your child lacks cognitive functioning. On the contrary, a child with cognitive impairment still has cognitive functioning but has an impairment, which can range from mild to severe.

Common cognitive  and behavioral issues associated with cerebral palsy include:

• Attention deficit hyperactivity disorder (ADHD)
• Challenges with behavior
• Emotional problems (inability to connect with others emotionally)
• Psychological issues
• Depression, anxiety, and mood swings
• Problems with comprehension and decision-making skills
• Memory and learning issues
• Recognition issues

Oral Health Issues

Cerebral palsy doesn’t cause mouth abnormalities or deformities. Still, it can cause oral issues, such as excessive gagging, problems with drinking and eating, gingivitis, involuntary cheek, tongue biting, and more.

According to the U.S. National Institutes of Health, studies indicate “that the more severe the neurological insult in children with CP, the higher is the risk of dental disease.” [5]

Other conditions associated with cerebral palsy and oral health include:

• Tooth decay and cavities
• Teeth grinding while sleeping
• Drooling
• Abnormal alignment in the upper teeth and lower teeth
• Mouth trauma

Since children with cerebral palsy have difficulty brushing, flossing, and keeping their teeth clean, it’s especially important that they see a dentist regularly. Look for a dentist with experience with special needs children.

Digestive Issues

Children with cerebral palsy may have long-term digestive issues. Common digestive issues include:

• Constipation
• Incontinence
• Issues with swallowing or sucking
• Unusual weight gain or weight loss
• Bladder infections
• Vomiting
• Unusual fatigue
• Aspiration

Skin Conditions

Skin conditions often affect children with cerebral palsy due to excessive drooling and the inability to wash their hands and faces correctly or to perform other hygiene tasks.

Accidents and injuries can also cause skin conditions, but these issues are non-infectious and will generally heal independently.

Keep your child as clean and as safe as possible to avoid potential skin issues.

Skin problems that may arise for children with cerebral palsy include:

• Skin infections and irritations
• Skin ulcers
• Ringworm
• Staph infections
• Boils and pimples
• Impetigo

Respiratory Issues

Difficulties in swallowing, low activity levels, excessive drooling, blocked airways, and the inability to cough are among a few of the various reasons that children with cerebral palsy may experience respiratory issues.

Around “30% of children with cerebral palsy [have] respiratory complications,” according to a study published by the U.S. National Institutes of Health.[6]

There are numerous respiratory conditions associated with cerebral palsy, including:

• Bronchitis
• Pneumonia
• Asthma
• Aspiration Pneumonia
• Chronic lung disease

Behavioral and Emotional Problems

One in four children with cerebral palsy will experience some form of emotional or behavioral problems. These issues depend on how severe your child’s other associated disorders are. For example, children with intellectual disabilities and severe physical disabilities are more prone to develop emotional and behavioral problems.

Examples of emotional and behavioral problems include:

• Withdrawing from social activities
• Arguing with peers
• Acting out in class
• Quick to anger
• Depression
• Anxiety

Physical and Mobility Issues

Physical and mobility issues are synonymous with cerebral palsy. The problems can range from mild spastic movements to more severe issues such as being unable to walk without assistance or needing a wheelchair to get around. Physical and mobility issues also depend on the child’s type of cerebral palsy.

Autism

Around 7% of children with cerebral palsy have an autism spectrum disorder, a much higher rate than the 1% of children without cerebral palsy who develop autism.[7] There are various forms of autism, ranging from mild to severe.

Sleep Issues and Disorders

Sleep issues are common among children with cerebral palsy, usually due to associated health problems with cerebral palsy, which are the main reason for sleep issues and disorders.

The most common health issues that disrupt sleep include muscle spasms, pain, drooling, skin ulcers, epilepsy, and gastrointestinal reflux disorder (GERD).[8]

ADHD

Children with cerebral palsy are also at risk of having attention deficit hyperactivity disorder (ADHD) compared to non-disabled children.[9] ADHD causes impulsiveness and hyperactivity, or lack of focus, forgetfulness, making careless errors, trouble turning in school work on time, and more.

Some children are impulsive and hyper, while others are chronically inattentive. Most kids with ADHD, however, are both hyperactive and impulsive, as well as inattentive.

Associated conditions present additional challenges for children with cerebral palsy, but you can manage them. Talk to your pediatrician about any symptoms or areas of concern to set up treatment plans.