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Cerebral Palsy: Can It Be Prevented?

Massachusetts attorney Thomas M. Kiley, http://www.tomkileylaw.com, concentrates on legal issues regarding cerebral palsy and birth injuries. New research on these kinds of birth injuries indicates that some injuries can be prevented. The research is being conducted by the National Institute of Neurological Disorders and Strokes, (NINDS)
http://www.ninds.nih.gov/disorders/cerebral_palsy/cerebral_palsy.htm#

In the 1860s William Little, an English surgeon, wrote the first medical descriptions of a disorder affecting children in their early years that caused stiff, spastic muscles in their legs and arms. They had trouble grasping objects, crawling, and walking. And the disabilities stayed the same over their lifetimes. The disease was called Little's disease but is now known as spastic diplegia, one of the group of disorders known as cerebral palsy. Dr. Little noticed that the children were born following premature or complicated delivers and he concluded that their condition was the result of oxygen deprivation during birth which damaged sensitive brain tissues controlling movement.

In 1897 Sigmund Freud suggested that the disorder may have happened during the brain's development in the womb. However, most doctors believed that birth complications caused most cases of cerebral palsy. In the 1980s the NINDS researchers analyzed data from more than 35,000 newborns and their mothers and discovered that complications during birth and labor only counted for less than 10% of babies born with cerebral palsy. In most cases they couldn't find one single cause. This finding stimulated research into other factors before, during, and after birth that were associated with cerebral palsy.

Researchers today are able to use imaging technology such as magnetic resonance imaging (MRI) that shows pictures of the brains of babies with cerebral palsy and highlights any structural malformations and where there is damage.

The research conducted during the past 20 years by the NINDS has:

* identified new causes and risk factors for cerebral palsy;
* increased our understanding of how and why brain damage at critical stages of fetal development causes cerebral palsy;
* refined surgical techniques to correct abnormalities in muscle and bone;
*discovered new drugs to control stiff and spastic muscles and developed more precise methods to deliver them; and
* tested the effectiveness of therapies used to treat cerebral palsy to discover which methods work best.

Approximately 10 percent of newborns are born prematurely, and of those babies, more than 10 percent will have brain injuries that will lead to cerebral palsy and other brain-based disabilities. A particular type of damage to the white matter of the brain, called periventricular leukomalacia (PVL), is the predominant form of brain injury in premature infants. NINDS-sponsored researchers studying PVL are looking for new strategies to prevent this kind of damage by developing safe, nontoxic therapies delivered to at-risk mothers to protect their unborn babies.

Cerebral palsy caused by genetic abnormalities is not preventable, but a few of the risk factors for congenital cerebral palsy can be managed or avoided. Rubella, or German measles, is preventable if women are vaccinated against the disease before becoming pregnant. Rh incompatibilities can also be managed early in pregnancy. But there are still risk factors that can’t be controlled or avoided in spite of medical attention.

Cerebral palsy from head injury is preventable using safety measures such as car seats for babies and toddlers and making sure young children wear helmets when they ride bicycles. Parents can implement common sense measures around their homes such as watching babies and young children closely when they bathe to reduce the risk of accidental injury. However, babies are still being born with cerebral palsy, despite how careful doctors and parents are.

The new American Recovery and Reinvestment Act of 2009 will provide $10.4 billion to the NIH and NINDS to stimulate more research on neurological conditions such as cerebral palsy. This new research will include finding improvements to the treatment and diagnosis of cerebral palsy. By studying normal fetal brain development, doctors hope to understand what happens when a baby's brain develops abnormally. This new research may lead to ways to prevent and cure cerebral palsy.