Cerebral palsy is a devastating disease that most often occurs during childbirth, but can also occur during pregnancy and the first three years of a child’s life. Due to a number of reasons, the brain does not receive adequate oxygen, and the parts of the brain, which monitor motor control, are damaged.

As the child grows, the muscles and the musculoskeletal frame do not grow properly. The child will suffer developmental problems, and feel stiffness and pain in limbs. Many children with cerebral palsy have difficulty walking and performing simple activities. The lack of oxygen to the brain can also cause other defects such as problems in seeing, hearing and talking.

There Are Three Main Types of Cerebral Palsy

• Spastic cerebral palsy — this type of cerebral palsy causes stiffness in the limbs and prevents the child from being as agile in movements as others their age would be. Some children are unable to walk without support.
• Athetoid cerebral palsy — this type of cerebral palsy causes children to have little control over their movements.
• Ataxic cerebral palsy — this affects balance and sense of depth perception in children. It also causes difficulties in movement.

Cerebral Palsy unfortunately has no known cure currently, but with therapy and medical treatment, a child can live a better life. Many children require braces and walkers to help them move around. In some cases, surgery can also be used to help children walk on their own.

Selective Dorsal Rhizotomy

One such surgery that is increasingly becoming a beacon of hope for children with cerebral palsy and their parents is SDR, Selective Dorsal Rhizotomy. This type of surgery is the most researched and actively tested surgeries for patients suffering from cerebral palsy.

Selective dorsal rhizotomy involves removing or cutting of the nerve roots which are responsible for the spastic movements and disabilities that children with cerebral palsy face. This surgery has been the  most commonly used by neurosurgeons treating children with cerebral palsy since the 1980s.

The neurosurgeon first identifies and isolates the nerves that are causing the spastic movements. Each nerve root is tested with electromyography, which will lead the surgeons to know which nerve are the problematic ones. Once they have been separated, the surgeon destroys the nerves using electrical technology.

Selective dorsal rhizotomy has given hope to many children and parents living with the problems of cerebral palsy. Parenting is a difficult task, but parenting a child with cerebral palsy has more than its fair share of stresses and tensions.

With this surgery, many children have been able to take their first steps, bringing tears of joy and smiles to their parents’ faces. Due to the high cost of the surgery, much of the cost is covered through fundraising by family and friends, and through the support of local businesses.

Therapy is required after the surgery to help the child begin to walk on their own and to develop the muscles that have been restrained for so long.

Few hospitals offer the surgery, and so many families have to travel to other countries where the surgery is available. However, parents say that these sacrifices they are making are nothing compared to what the child has been going through since birth. Anything that can help their child live an easier life is worth it. Seeing their child walk on their own for the first time makes parents forget about everything; this moment is priceless for them.

Reference:

• http://kidshealth.org/parent/medical/brain/cerebral_palsy.html#
• http://www.stlouischildrens.org/our-services/center-cerebral-palsy-spasticity/about-selective-dorsal-rhizotomy-sdr

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Early Signs Of CP

Parents are an important factor in diagnosing CP at an early age. They are the ones with the infant the most and will be the first to notice when something seems to be not right in the first year. As the child develops, these symptoms may become more pronounced.

• Excessive drooling. Although common in small babies, as they get older and develop this becomes more noticeable that it may be a symptom of other issues.
• Issues sucking. One of the first signs for many infants with CP is a problem sucking or swallowing. Lack of muscle control can make this difficult for some children with CP.
• Stiff muscles or exaggerated reflexes. One of the common attributes of CP is tight or stiff muscles due to spasticity. This can often be the symptom that draws attention to the disease.
• Muscle control. This may be evident in infants when they have trouble controlling one side of their body or just are not developing motor skills as is expected as they get older.

The symptoms can vary in CP as there are many forms and levels of difficulty within the disease, so there is not a cookie cutter diagnostic test. However, even if there is a chance it may be CP, the earlier it can be diagnosed, the sooner  treatment can begin to help the child develop to their fullest potential.

Testing For CP

There are a variety of tests a physician will want to perform if CP is suspected. Since CP is due to a neurological problem, there is not a simple blood test that diagnosis CP. However, blood tests will most likely be done to rule out other diseases that can mimic CP.

The most comprehensive way to find CP is through brain imaging to look for scarring, cysts or abnormalities within the brain tissue. This can be difficult with infants as CT scans and MRI’s require the child to be able to hold still for long periods of time. Although not as accurate, cranial ultrasounds may be used on small or premature infants, as they are easier to perform and have less risk.

The doctor will also want to use observation techniques to further diagnose a child suspected of having CP. They most likely will suggest a consult with specialists such as a child neurologist or those in the eye and ear fields. Observations can confirm CP and also help narrow down the particular type and severity the child has.

Treatment will vary as much as the disease itself, but whatever therapies are recommended, they are best started as early as possible. There are many ways for children with CP to learn to cope and overcome many of their symptoms through therapy, specialized equipment and medications. By starting them on the right path for their development, they will have the chance to meet their fullest potential and have a better quality of life.

Resource:

http://www.ninds.nih.gov/disorders/cerebral_palsy/cerebral_palsy.htm

For more information about the legal aspects of cerebral palsy click here.

What is Jaundice?

Jaundice is a condition that results in yellow pigmentation of the skin and the whites of the eyes. The yellow color is caused by bilirubin— a build-up of old red blood cells. When too many red blood cells die, the liver overloads and cannot properly move dead cells from the body. Sixty percent of infants are born with jaundice, making it a common condition that usually is not harmful if noticed and treated right away.

Infants can develop the symptoms of jaundice a few days after birth, which is why it is important for the first three to five days of a child’s life to have the infant checked by a health care provider. According to the American Academy of Pediatrics, it is recommended that health care providers check for symptoms of jaundice before the baby leaves the hospital. Checking for the condition before the baby has the opportunity to leave the hospital allows doctors to treat the condition before it has the opportunity to damage the baby.

The Relationship between Jaundice and Cerebral Palsy

Cerebral palsy results when there is damage to the brain during early childhood development or soon after birth. In the event of a severe case of jaundice, high levels of bilirubin can cause brain damage if the child does not receive prompt treatment. The resulting condition is known as Athetoid Cerebral Palsy, a type of cerebral palsy that affects the entire body.

Children with athetoid cerebral palsy suffer from muscular dysfunction that varies from having muscle tone that is too tight or too loose and may have uncontrollable movements that range from slow to rapid. Facial movements, such as sucking or swallowing can be difficult for the child, making it difficult for babies with cerebral palsy to nurse. Most children diagnosed with the condition are unable to learn to control their bodies as they grow— making it difficult, and sometimes impossible to learn to sit up or walk.

Detecting Jaundice In Newborns

The signs of jaundice are not always noticeable and an infant with the condition can remain alert and continue to eat and sleep normally. If the infant has trouble waking up, is nursing poorly or develops a high-pitch cry or fever, it is important to get the child emergency care immediately. Other signs that require immediate attention are unusual movement of the eyes, arching of the back, stiffness or floppiness.

Health care professionals are required to test an infant for jaundice by performing an exam before releasing the infant from the hospital. The most obvious sign of jaundice is yellow skin or yellowing of the whites of the eyes. A skin sensor or a blood test can detect levels of bilirubin and if the levels are elevated, the doctor can treat the infant in order to prevent damage.

Medical professionals at Longview Regional Medical Center are being accused of negligence because they neglected to perform the proper exam on the Londons’ newborn before releasing the child. On Aug. 3, 2010, the baby was rushed to the emergency room because it was showing symptoms of sudden neurologic deterioration and seizures. The baby had to be transported by air to the Children’s Medical Center in Dallas, Texas.

At the Children’s Medical Center, the London’s baby was diagnosed with critical Hyperbilirubinemia— a condition caused by jaundice. Failure to detect elevated levels of bilirubin in the child’s blood resulted in brain damage and hearing loss. Tri’Micah and Joy have filed a lawsuit seeking compensation for the time, money and emotional stress put on their family as the result of negligence and a jury trial has been scheduled for this case.

Sources:

http://www.setexasrecord.com/news/244564-parents-claim-babys-untreated-jaundice-resulted-in-brain-damage’

http://www.americanpregnancy.org/birthdefects/cerebralpalsy.htm

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001259/

http://www.marchofdimes.com/baby/sickbabycare_jaundice.html

Complications with the Umbilical Cord

A nuchal cord is the term used when the umbilical cord wraps around a baby’s neck and nuchal cords are seen in about twenty-five percent of pregnancies. It rarely causes problems and fetal monitoring can detect abnormalities in the baby’s heart rate. If an abnormality is detected, doctors are able to keep a closer watch on the baby and determine whether or not the problem is cause for concern. If the umbilical cord is wrapped too tightly it can decrease the amount of oxygen the baby receives and brain damage can result.

Monitoring and Detecting Problems

Abnormalities such as a nuchal cord can be detected through an ultrasound. However, some issues cannot be detected this way and it is not until delivery that problems with the umbilical cord are discovered. A Doppler ultrasound is more accurate than a grey ultrasound and has a sensitivity of over 90 percent. If a Doppler ultrasound is ordered and it detects a problem, doctors can monitor the baby more closely.

If the problem is not detected until delivery, caretakers will need to work quickly and carefully in an effort to minimize the damage done to the child. If necessary, the mother will be asked to stop pushing while the baby’s neck is being freed from the cord— which can take a few minutes. If the umbilical cord is too tight, the attending physician will clamp and then sever the umbilical cord to unwrap it from the baby’s neck.

The Link between Complications at Birth and Cerebral Palsy

The lack of oxygen to the fetus is a major contributing factor to the development of cerebral palsy. When the umbilical cord wraps around the baby’s neck too tightly, it decreases the amount of oxygen the baby receives to the brain. If the brain is unable to receive oxygen, cells begin to die off and cerebral palsy may result. An example of improper response to a nuchal cord can be found in the delayed action taken by staff members at St. Michael’s Hospital, located in the United Kingdom, in the city of Bristol.

Physicians failed to take proper action after the discovery that a newborn was suffering from an extreme nuchal cord. The cord had wrapped itself around the baby’s neck twice and the child was unconscious due to lack of oxygen. It took health care providers about twenty minutes to resuscitate the newborn. The hospital has apologized for the incident that involved Ollie Lewis, the child of Neil Lewis and Charmaine Malcolm.

Neil and Charmaine have endured immense psychological trauma because of the lack of attention their baby was given during delivery. Doctors informed the couple that their son may only have a few months to live. Ms. Malcolm has explained to reporters just how traumatic it is to wake up every day wondering if this will be the last day she will spend with her baby. The couple has needed put their lives on hold in order to care for Ollie, creating a financial burden on the family because they are unable to work.

Mr. Lewis still wonders just what happened during the delivery and why more could not be done to prevent his son’s cerebral palsy. The University Hospitals Bristol NHS Foundation Trust is working with the couple to find out what went wrong. They will be performing a full investigation of the incident and will share their findings with Mr. Lewis and Ms. Malcolm.  Meanwhile, the couple plans to seek compensation and the NHS Trust has agreed to support them fully.

Resources concerning nuchal cords, oxygen deprivation and cerebral palsy:

http://www.bbc.co.uk/news/uk-england-bristol-18156216
http://www.bbc.co.uk/news/uk-england-bristol-18141383
http://www.bbc.co.uk/news/uk-england-bristol-17766927
http://www.marchofdimes.com/pregnancy/complications_umbilical.html
http://www.originsofcerebralpalsy.com/03-conditions/01-diagnosing.html
http://emedicine.medscape.com/article/262470-overview#aw2aab6b6
http://emedicine.medscape.com/article/262470-overview#aw2aab6b6
http://wikiparenting.parentsconnect.com/wiki/Nuchal_Cord

A settlement would decrease the hospital’s costs by offering a sum that is lower than what it would likely pay out if the case went to court. This would benefit the hospital but the settlement would fail to cover the cost of a child’s care over the course of his or her lifetime if he or she has cerebral palsy. Steve Brown, a physician at Lee Memorial Hospital, wanted to add an amendment to the pre-lawsuit settlement policy that would require cases be brought to the board for approval. His motion was denied.

Lifetime Cost of Cerebral Palsy

Cerebral palsy is a life altering condition that impairs a child his or her entire life. Parents have to make major sacrifices such as leaving their jobs, making necessary accommodations to their homes, or buying vehicles that can transport wheelchairs, if needed.  Special education or early interventions are not only costly, but eat up more of the parent’s time. This can create emotional stress that may also affect the parent’s relationship.

Special education services can be of benefit to the child, but they come at a cost. In 1981, children who were enrolled in special education from the time of birth through high school were enrolled in classes at an average annual tuition of nearly $37,000. If parents waited to enroll the child until he or she turned six years of age, the cost went up to $50,000 per year. When we consider inflation relative to today’s cost, $37,000 becomes $82,000 and $50,000 becomes $111,000.

Medical expenses are also a factor that needs to be considered when agreeing to a settlement involving a child with cerebral palsy. Examinations, surgery, medication and special equipment are required as the child grows and develops. Just as children outgrow shoes and clothing, they outgrow wheelchairs and braces, which need to be replaced eventually. The basic cost of a wheelchair begins at $300, and accessories can quickly add to the cost. Insurance companies do help with the cost of wheelchairs, but many insurance policies have coverage limits.

When a child with cerebral palsy reaches adulthood, the cost of care may not be as significant, but it costs much more for an adult to live with cerebral palsy than the cost of living for most people. Adults with cerebral palsy are more prone to illness and have shorter lifespans. One study showed that 77% of people with cerebral palsy died from pneumonia. Another study conducted in Denmark showed that the lifetime cost for an individual with cerebral palsy, was approximately $1,083,255 and does not include compensation for a life of pain and suffering.

Lawsuit Case against Lee Memorial Hospital

Mitzi Roden, mother of Aaron Edwards, who was delivered at Lee Memorial Hospital, filed a lawsuit against the hospital for malpractice that resulted in his cerebral palsy. Aaron has suffered from Cerebral Palsy since birth and has been confined to a wheelchair. Healthcare providers deny responsibility for the child’s injuries, claiming that not enough evidence was provided at the trial. She won the case and was awarded damages in the amount of $15 million.

Medical professionals are trying hard to cut their expenses by offering a settlement instead of going to court. However, medical malpractice can cause lifelong injury to individuals who will need to continue paying for the mistake of a medical professional for their entire lives. Children who suffer from cerebral palsy will suffer their whole lives and the cost of care can add up quickly over time. Victims of medical negligence should do what they need to get the proper compensation to help aid with the cost and be wary of any settlement that is offered.

When in doubt, contact a medical negligence lawyer that specializes in cerebral palsy cases to determine the true cost of your child’s injury.

Sources:

http://www.naplesnews.com/news/2012/may/24/lee-memorial-malpractice-claims-aaron-edwards-bill/
http://www.ncbi.nlm.nih.gov/pubmed/19416329
http://cerebralpalsycosts.com/adults.html

Seizure Treatments

There are several methods used to control seizures in CP. Sometimes it may take a combination of one or more options to find a treatment option that works best for the particular seizures a child is having. It often is a trial and error process to find out which method will work best for the child.

• Medications. There are many effective anti-seizure medications for epilepsy and seizures disorders associated with CP. As with most medications, there are side effects that have to be managed as well. Most parents will need to work with their doctor to find the medication that best suppresses the seizures and has the least side effects for the particular child.
• Dietary Options. If medications do not work, there are dietary options that may benefit the child with CP seizures. Some children do well on a ketogenic diet, which is a diet regimen that is higher in fat and lower in proteins and carbohydrates. This alters the body’s metabolism and increases the ketone bodies in the system that can suppress seizures.
• Surgery. In severe cases, surgery may be recommended to remove the brain tissue when the seizures originate to control the seizures and stop the spread of the problem.
• Vagal Nerve Stimulation (VNS). This is a fairly new treatment that is used for seizures that do not respond to other treatments. It involves inserting a pacemaker under the skin that delivers small pulses of electricity to the vagal nerve.

What To Do When a Seizure Occurs

Once a seizure starts, it must progress until it finishes. The old method for grand mal seizures was to give the patient something to bite down on or to suppress their tongue. This is no longer recommended. Nothing should be put in the child’s mouth when they are having a seizure. There are a few things to keep in mind when handling a seizure.

• Safety first. The most important thing you can do is to make sure the child does not harm his or her self while having a seizure. Do not try to hold the child or stop the movements. Instead, help them lie down on their side, supporting their head on a soft surface cleared of any obstacles that they could hit. Loosen any tight clothing that could be restricting.
• Watch their breathing. Make sure they are breathing and be prepared to do mouth-to-mouth resuscitation if necessary
• Call 911. If the child stops breathing, changes color, had repetitive seizures one after another, or the seizure lasts more than 15 minutes, call 911 or for medical assistance.

Controlling seizures in children with CP is challenging but there are treatments that can reduce their severity and frequency. With patience and help from a medical team that is familiar with CP and seizures, there is hope to giving the child a better quality of life.

Resources relating to control of seizures in children with CP:

http://www.caringforcerebralpalsy.com/seizures.html

http://www.childrenshospital.org/az/Site1967/mainpageS1967P4.html

http://www.ehlinelaw.com/pages/3081/CM_PracticeAreaDescriptions_BrainInjury.htm

http://www.cerebral-palsy-faq.org/questions/why-do-children-with-cerebral-palsy-commonly-have-seizures/

Whenever an accident occurs at a school or medical facility, an investigation needs to be conducted on what caused the incident and any other factors that are important to understanding why things went awry. How the child is treated can make all the difference in his or her well-being.

Overview of Cerebral Palsy

In order to understand the dangers of pushing a child with cerebral palsy too far, one must first be aware of the impact that the condition has on the body. Cerebral palsy is a group of disorders that affect the brain and nervous system.  The disorder can be broken down into several subcategories but the symptoms are similar for all of the varying types of cerebral palsy.

People with this disorder usually have problems with their muscles which are either stiff and lack mobility or stretch and contort due to abnormal moments that cannot be controlled. In addition to impairing motor function, cerebral palsy weakens the bones— making children with the disability more prone to severe injuries.

A Concerned Parent

UCP Delrey School in Halethorpe is a small private facility that is attended by children with Cerebral Palsy and other disabilities. The school receives federal grant money under the Individuals with Disabilities Education Act. A recent event has raised concern with the parent of a child who was injured during one of the school’s extra-curricular activities due to suspicious circumstances surrounding the incident.

Justin Virts, the seven year old student at UCP Delrey, was rushed to the hospital after his wheelchair fell over during a race at the school’s field day. His mother, Jeannie Virts, was called to Saint Agnes Hospital shortly after the incident and was shocked by the condition of her son. His face was scraped up from hitting the pavement and he had a broken nose and a missing tooth.

Virts was unable to get the full story behind the incident from staff members of the school. When she arrived at the hospital, Juanita Teed, the school nurse, was with Justin in the ambulance. Jeannie asked what happened and the nurse grudgingly informed her that Justin had been injured during a wheelchair race. Juanita was pushing his chair during the race and Justin’s wheelchair tipped over, causing him to fall face first into the pavement. Juanita tripped as well and fell on top of him.

Virts told reporters that she had to fight to get Justin into Delrey. The school had a good reputation and for the first three years, Virts did not have any problems. However, she noticed that in the past several months there had been a series of injuries that her son did not want to talk to her about. When she finally got Justin to talk, he told her that the teacher told him not to tell. Failing to inform a parent that his or her child has been injured is a form of negligence that needs to be addressed— which was why Jeannie chose to file a police report.

An Alternative to Physical Activities

Bob Lujano, a recreation specialist with the Lakeshore Foundation in Birmingham, Alabama has offered a suggestion to the school’s physical education program that would be safe and engaging for children with disabilities. According to Lujano, children with disabilities should be able to join in on physical activity only at their own pace. One way to allow children with disabilities to compete with able bodied children would be by allowing a child who pushes his or her wheelchair to compete against an able bodied child who would hop to the finish line.

Safety and reliability is a major concern for parents sending their disabled children to school. Children with cerebral palsy require extra care and attention to avoid accidents and injuries. While not all accidents can be avoided, it is important for parents to be informed of them when they occur. Physical activity is important and learning safe alternatives for activity can provide a safe and fun way to get children with disabilities involved.

Sources:

http://citypaper.com/news/unhappy-accident-1.1328634

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001734/

The effects of brain injury can range from temporary headaches, memory loss, and difficulty focusing to depression, personality changes, and seizures. Brain injury can stem from unexpected sources, such as a slip and fall, birth injuries, poisoning, and infections caused by the former. Symptoms can be difficult to detect immediately, and it may require an MRI or other scan to determine whether damage has occurred and to what extent.

Following any injury that causes one to be shaken, dizzy, “blacked out,” or otherwise affected north of the shoulders, a check-up can make all the difference. Speedy detection and treatment can make the difference between long-term diminishment of symptoms and possible exacerbation of problems. Even when the symptoms seem trivial, the possibility of worsening conditions is on the table. It is only by seeking medical attention promptly following an accident that you can know for certain whether the injury is, in fact, trivial or worthy of a second look.

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