Cerebral Palsy, Warning Signs of a Permanent Birth Injury

Cerebral palsy is a traumatic birth injury rare in U.S. births. Only 2–2.5 of 1,000 infants born in the States are diagnosed with cerebral palsy (or about 8,000 infants and children diagnosed each year), but, this cerebral palsy rate that has not gotten better over the years.

Medical intervention and doctor negligence are to blame. Medical advances in American hospitals allow more premature infants to survive, but many of these infants are susceptible to birth injuries, including cerebral palsy, if doctors and hospitals do not provide proper care.

Cerebral Palsy: Birth Injury, not a Disease

Cerebral (referring to the brain) palsy (meaning muscle paralysis) is the result of prenatal (before birth), perinatal (during birth), or postnatal (after birth) injury. Persons suffering from cerebral palsy have muscle control and coordination difficulties. Injury to the brain’s motor centers (discussed below) causes cerebral palsy, a condition marked by muscle tightness; trouble seeing, hearing or speaking; tremors (shaking); loss of motor skill quality; and posture difficulties that can lead to bladder and bowel problems.

Doctors classify the birth injury into three main categories,

  • Spastic cerebral palsy. In people afflicted with this most common (60-80%) form of cerebral palsy, muscles are stiff and permanently contracted. Doctors describe this injury by which limbs are affected.

  • Athetoid cerebral palsy (aka dyskinetic cerebral palsy). This form of cerebral palsy (10-20% of cases) is diagnosed by slow, uncontrolled muscular movements, such as grimacing or unnatural arm or legs gestures, that tend to increase during moments of stress.

  • Ataxic cerebral palsy. The most rare (5-10%), this condition is marked by poor balance and depth perception. Coordination is also affected. Persons with ataxic cerebral palsy have difficult with quick or precise movements and may walk with an exaggerated gate.

A fourth category of “mixed form” cerebral palsy also exists. The most common combination is the spastic and athetoid cerebral palsy but other combinations exist.

Cerebral palsy has no genetic cause. It is not inherited through parental or defective genes. Cerebral palsy is not progressive (the injury does not grow worse), nor can cerebral palsy cannot be transmitted to others. Cerebral palsy is a birth injury and shouldn’t be referred to as a “disease.”

Causes of Cerebral Palsy

Cerebral palsy’s cause in most cases is unknown. Cerebral palsy is caused by postnatal birth injury in 10-20% of cerebral palsy cases, and most researchers estimate 10% of people living with cerebral palsy were affected during birth. Additionally, it is known that children born prematurely or with very low birth weights have a greater likelihood of cerebral palsy.

Causes for cerebral palsy prior to birth, during birth, and in the first few months of infancy include lack of oxygen to the brain, brain hemorrhaging (bleeding), and head injury. Other causes are exposure to toxic substances, diabetes or measles virus in the mother (prenatal), and jaundice (postnatal).

Cause 1 of Cerebral Palsy: HIE
Cerebral palsy can occur from hypoxic ischemic encephalopathy (HIE), a condition caused when blood to the brain is reduced and is thereby oxygen-deprived and suffocates (asphyxiation). HIE either occurs during birth in the hours leading to delivery from a tear in the placenta wall before birth, a pinched umbilical cord, or a uterus rupture or during labor.

Rare (0.5-1 of every 1,000 births), infants with moderate HIE have 90% chance of survival while only a 60% chance if they suffer severe HIE. Those 40% who survive almost always suffer from a major disability like cerebral palsy.

There is no direct treatment for HIE though recent studies into the condition suggested reducing the newborn’s body temp to 94 degrees reduces the likelihood of permanent birth injury.1

Cause 2 of Cerebral Palsy: Kernicterus (Jaundice)
Another brain damage-related birth injury that promotes cerebral palsy is kernicterus. This blood-based injury is caused by severe jaundice and can cause severe, lifelong disabilities such as cerebral palsy.

Most infants develop a mild case of jaundice on their second day in the world which ends after a week. The likelihood of jaundice is increased by both heredity and birth injury factors. If the infant’s brother or sister had jaundice or if the infant is of East Asian or Mediterranean decent, then the infant will most likely have jaundice.

An infant injured and bruised during birth is also likely to develop jaundice. The blood component responsible for bruising (bilirubin, which in excess levels causes kernicterus) is also responsible for the jaundice’s yellow color.

Most at risk for kernicterus are premature infants whose liver is not well-developed and cannot filter the bilirubin toxins.

Kernicterus can be prevented by using special lights (phototherapy) to treat the jaundice.2

Cerebral Palsy, Injured for Life

Cerebral palsy is not a disease that can be “cured.” Cerebral palsy doesn’t get better. Two-thirds of individuals with cerebral palsy will be developmentally (intellectually) impaired.

Signs of cerebral palsy almost always occur before three years of age. Such injured children do not achieve developmental stages on schedule. Cerebral palsied infants take longer to roll over, sit, crawl, and walk.

Doctors confirm cerebral palsy through computed tomography (or “CT scan,” formerly known as a “CAT scan”) that uses X-rays interpreted by a computer to image the brain's tissues. A CT scan reveals areas that are not developing normally and other physical problems. Magnetic resonance imaging (MRI), which uses radio waves and is more detailed and expensive, may also be used to detect signs of cerebral palsy.

 

Lawyers for Change.
If you suspect your child has cerebral palsy due to hospital negligence or doctor-caused delivery injury, contact the Consumer Justice Group. Our lawyers are experienced in taking legal action against big institutions like hospitals and insurance companies to make sure our clients receive the financial restitutions necessary to help see them through their lives.

Resources
1) National Institute of Health. 2005. Cold Treatment Protects Against Infant Disability and Death From Oxygen Loss.
2) Carter, K. MD and K. Dixon. 2001. Kernicterus in Full-Term Infants--United States, 1994-1998. Read CDC report providing additional information about how kernicterus (severe jaundice) leads to birth injuries including cerebral palsy.

 
 

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