Military Officer - November 2006 - (Page 46)

askthedoctor Cerebral Palsy Damage to the brain in childhood can cause a range of motor problems. Started early, physical therapy might help reduce long-term complications. By Rear Adm. Joyce Johnson, D.O. C Treatment Begins With a Diagnosis ■ The earlier a diagnosis of CP is made and therapy begins, the better the long-term outcome. For more information visit www.ninds.nih.gov/disor ders/cerebral_palsy. erebral palsy (CP) was ﬁrst described in the 1860s in England by William Little and for many years called “Little’s Disease.” Today, CP refers to various disorders of the brain that lead to a range of motor problems. Damage typically begins sometime before a child reaches school age, often before birth, and remains stable throughout life (though speciﬁc symptoms can change over time). Four main types of CP are recognized. Spastic CP is the most common type, characterized by limbs that don’t move much at the joints. They are contracted and seem “frozen.” One or more of the limbs is either weak or paralyzed. Athetoid or dyskinetic CP is the next most common type and involves involuntary movements of the extremities, face, or tongue. Patients with this type might drool and have difﬁculty speaking. Ataxic CP affects coordination, balance, and depth perception. These patients have difﬁculty walking. They also can have trouble with ﬁne motor coordination (e.g. writing, holding a fork) and may have an intention tremor when they reach for things. Mixed CP is a combination of two or more of the above types. There is a broad range in severity of CP symptoms. CP patients also often have disorders such as seizures and mental impairment. However, about a third of children with CP have no mental impairment. Much emphasis has been placed on preventing CP by determining its causes. For many years, neonatal anoxia (a lack of oxy- gen at the time of delivery) was believed to be the primary cause, but in fact only about 6 percent of cases are due to anoxia. Other prenatal and neonatal causes include infections during pregnancy, jaundice, and Rh incompatibility. Maternal pregnancy complications, including bleeding, protein in the urine, hyperthyroidism, and seizures, are risk factors, as are complications of delivery such as a breech birth, multiple births, low birthweight, or premature birth. (Fortunately, most infants with these risk factors do not develop CP.) About 15 percent of cases are caused by infection or head injury in early childhood. There is no cure for CP; treatment includes a range of therapies, sometimes orthopedic surgery or braces, and occasionally medication. Typically, a team of physicians (orthopedists, family practitioners, etcetera), physical and speech therapists, social workers, and psychologists work together to treat CP. It is very important to include representatives from a child’s school on the team from the beginning. There is no speciﬁc test for CP. If an infant or toddler misses developmental milestones, parents or doctors might suspect a problem and pursue a more thorough evaluation. Most cases are diagnosed before a child is 3 years old. MO — Rear Adm. Joyce Johnson, USPHS-Ret., D.O., M.A., is vice president, Health Sciences, Battelle Memorial Institute, Arlington, Va. Find more health and wellness resources at www .moaa.org/wellness. For submission information, see page 18. PHOTO: STEVE BARRETT 46 MILITARY OFFICER NOVEMBER 2006 http://www.ninds.nih.gov/disorders/cerebral_palsy http://www.moaa.org/wellness http://www.moaa.org/wellness

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From the Editor From the President Your Views MOAA Directory Rapid Fire Washington Scene Financial Forum Ask the Doctor Chapter Activities Cover Story: Financial Guidebook Got (the right) Insurance? A Penny Saved, a Degree Earned The “Y” MOAA Scholarship Recipients Pages of History Information Exchange Member Books MOAA Scholarship Donors MOAA Member Services Advertising Index MOAA Calendar Sounding Taps Encore

Military Officer - November 2006

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