Cerebral palsy. Behind this blurred term, re are in fact several disorders both motor and mental, previously grouped under terms “cerebral palsy” and “Polyhandicap”. “Cerebral palsy is not a disease but is result of brain damage that occurred in child before, during, or after childbirth,” explains Sylvain Britton, a doctor at Brest CHU in physical medicine and rehabilitation Pediatric, on occasion of World Day of cerebral palsy.
When a fetus or newborn has an accident at birth-a brain malformation, a stroke, an infection, a lack of oxygen at time of delivery, or convulsions- risk is that neurons die in certain parts of brain ( Brain damage). Depending on areas affected, child will have trouble getting around and talking, for example. About a third of children with cerebral palsy cannot walk for five years, and half of m have an intellectual disability. Although not well known, se accidents are main cause of motor handicap in children: a baby that is born every six hours will present this disorder.
Identify risk situations
To prevent this handicap, first step is to identify situations at risk: “Especially premature, which are most fragile,” recalls Dr. Sylvain Britton. Almost half of children affected by se brain lesions are se very young children, of whom 50% were born before six months of pregnancy.
In se at-risk babies, preventive actions can be put in place: for premature, it is necessary to encourage “skin to skin” contact with parents in order to “promote development of child”, explains Dr. Alain Chatelin, President of Foundation Cerebral palsy. Similarly, when a child born in term has been asphyxiated, for example by umbilical cord, medical body can put it in moderate hypormia (33 degrees) during hours following birth, which seems to delay death of neurons.
A late diagnosis
However, only magnetic resonance imaging (MRI) is used to diagnose cerebral palsy. And it is not done for every baby. “The diagnosis of this disease is often posed at onset of developmental delay: When a child does not manage to sit for example,” says Dr. Alain Chatelin.
“We try to stimulate child from onset of first symptoms with intensive re-education sessions for example,” says Dr. Sylvain Britton. The goal? “Maintain your motor skills and, if possible, improve it.”
Decrease in cases
For last ten years, number of new cases decreased by 2% per year: While in 1998, one child out of 465 was affected by se disorders, this figure fell to one for 550 in 2006. Even better, re are fewer severe cases: about 27% of children born with cerebral palsy between 2004 and 2006 had a motor attack leading to a necessary use of a wheelchair. They were about 33% for generations 1998 to 2003, notes Dr Carine Arnaud, director of Inserm Unit “Perinatal Epidemiology and Child Disability” at University of Toulouse.
“Before, in society, we were only dealing with after-effects of se children.” They were welcomed in specialized establishments, and when y became adults, y changed centres, lamented Dr Alain Chatelin, who welcomes fact that research is advancing. “Now we need to stay mobilized and move faster in research.”
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