Definition

Cerebral palsy (CP) is a group of permanent, bilateral, symmetrical, nonprogressive disorders associated with developmental brain injuries leading to motor dysfunction caused by birth trauma or hypoxia occurring during foetal development, birth, or shortly after birth.

The clinical picture may present with spasticity, involuntary movements, unsteadiness in walking, convulsions, visual and auditory problems, speech difficulties, psychological problems, learning disabilities and orthopaedic problems.

Causes

Cerebral Palsy occurs due to insult or damage to immature brain. The exact cause is sometimes difficult to determine but it can be grouped as below-

1 Antenatal causes

Infections in mother like rubella, herpes, cytomegalovirus, toxoplasmosis etc.

2 Perinatal causes

Birth injury or hypoxia occurring during birth or after birth. Preterm children and low birth weight (<1.5 gm) have increased risk.

3 Post natal causes

Injury to brain, meningitis, encephalitis and jaundice.

Types of Cerebral Palsy

1 Topographical classification

1. Monoplegia- Involvement of one limb.
2. Hemiplegia- Involvement of one side of the body.
3. Diplegia- Involvement of both lower limbs with minimal involvement of the upper limbs.
4. Paraplegia- Implies no upper limb involvement only lower limb involvement.
5. Triplegia- Involvement of one side of the body, as in hemiplegia, combined with involvement of the contralateral lower limb. The lower limb involvement is always asymmetrical.
6. Quadriplegia- Involvement of all four limbs and the trunk. The alternative name is whole body involvement.
7. Spastic or Pyramidal- Characterised by muscles and joints that are tight and inability to stretch them. Child walks on toes or legs make scissors movements.
8. Non spastic or Extrapyramidal- Characterised by twisting, jerking, or writhing of the hands, feet, arms, or legs while awake, worse during periods of stress e.g. Dyskinetic, athetoid, chorea, ataxia, hypotonia.
9. Cerebellar- Characterized by hypotonia, hyporeflexia with intention tremors.
10. Mixed- Diffused neurological involvement.

2 Classification according to movement disorders

Symptoms

The signs of cerebral palsy are usually not obvious in early infancy but become more clear as the nervous system matures.

1 Early signs

Delayed milestones such as controlling head, rolling over, reaching with one hand, sitting without support, crawling, or walking.

Persistence of infantile or primitive reflexes, which usually vanish 3-6 months after birth.

Developing handedness before age 18 months indicating weakness or abnormal muscle tone on one side.

Problems and disabilities related to CP range from very mild to very severe related to the severity of the brain damage. 

2 Abnormal muscle tone

Muscles may be very stiff (spastic) or unusually relaxed and floppy. Limbs may be kept in unusual or awkward positions. Spastic leg muscles may cause legs to cross in a scissor-like position.

3 Abnormal movements

Movements may be uncontrolled, purposeless, unusually jerky, abrupt, slow and writhing.

4 Skeletal deformities

One sided cerebral palsy patients may have shortened limbs on the affected side and may lead to tilting of the bones and scoliosis.

5 Joint contractures

Severe stiffening of the joints may appear due to unequal pressures on the joints exerted by muscles of differing tone or strength.

6 Mental retardation

In some, mental retardation is seen, the more severe the retardation, the more severe the disability overall.

7 Seizures

About one third of patients of CP have seizures which may appear early in life or years after the brain damage. The physical signs of a seizure may be somewhat masked by the abnormal movements of a person with cerebral palsy.

8 Speech problems

Some CP patients are unable to control muscles of speech and thus cannot speak normally.

9 Swallowing problems

Cerebral palsy patients are unable to control muscles of swallowing and have problems sucking, eating, drinking, and controlling their saliva. They may drool. There is also greater risk of aspiration which can cause infection or even suffocation.

10 Hearing loss

The child with CP may not respond to sounds or may have delayed speech.

11 Vision problems

Three quarters of CP patients have nystagmus or strabismus due to weakness of the ocular muscles. They are often nearsighted.

12 Dental problems

CP patients be apt to have more cavities than usual. This results from both defects in tooth enamel and difficulties brushing the teeth.

13 Bowel and/or bladder control problems

These all are caused by lack of muscle control.

Diagnosis

• Blood investigations to rule out deficiency of certain vitamins and factors.
• X Ray of affected bones or joints.
• CT scan or MRI of brain to localise the lesion.
• Electroencephalogram (EEG) for diagnosis of convulsions.
• Hearing screen.
• Vision testing.
• Development quotient (DQ) and intelligence quotient (IQ).

Treatment

Treatment of cerebral palsy needs a team of- Paediatrician, Occupational therapist and, physiotherapist, Neurologist, Ophthalmologist, Paediatric orthopaedic surgeon, Pulmonologist, Gastroenterologist, Psychiatrist, Dentist, Medical social worker at various stages.

A competent Homoeopath is the best one to treat CP as only Homoeopathy is the system of healing that deals with above all and more than above simultaneously.

Homoeopathic remedies for CP in decreasing order of similia

Bell > Hell > Zinc > Stram > Apis > Merc > Op > Phos > Rhus-t > Verat-v > Caust > Gel > Hyosc > Lach > Acon > Arnic > Aeth > Alum > Bry > Canth > Sulph > Aml-ns > Cocc > Glon > Kali-br > Nux-v > Plb > Puls > Bufo > Kali-I > Lyc > Ph-ac > Apomorph > Ars > Camph > Carb-s > Con > Cupr-act > Curare > Sulphon > Tab > Agar > Am-ph > Anac > Bapt > Cann-s > Chen-ant > Chlol > Cic > Coff > Graph > Ign > Kali-chl > Lath > Mur-ac > Nux-m > Ox-ac > Physalis-al > Pic-ac > Sang > Tarent > Verat > Viola-o > Ail > Am-c > Ant-s-pur > Atrop-pur > Aur > Bar-c > Cadm-s > Cham > Chel > Chlorpr > Cimic > Coc-c > Coffin > Corn > Croc > Cupr > Cypr > Dat-a > Dol > Dulc > Ferr-p > Ferr > Form > Hyper > Iberis > Kali-p > Lith-br > Nat-m > Pip-m > Podo > Ruta > Seneg > Sol-nig > Spig > Stann > Sumb > Ter > Visc > Zinc-s > Ziz

Short Repertory of Cerebral Palsy

Brain - CEREBRAL, palsy arn. caust. con. gels. hell. ign. lath. op.

Brain - CONVULSIONS, brain problems, from - cerebral, softening alum. Bufo Caust.

Brain - EMBOLISM, middle cerebral artery, causes aphasia Kali-br.

Brain - REACTION, lack of cerebral hell. op. zinc.

CHEST - INFLAMMATION - cerebral type, lungs acon. arn. bell. bry. cann-s. canth. hyos. lach. merc. nux-v. phos. puls. rhus-t. stram. sulph.

CHEST - INFLAMMATION - Lungs - cerebral type acon. arn. bell. bry. cann-xyz. canth. hyos. lach. merc. nux-v. phos. puls. rhus-t. stram. sulph.

CHEST - Inner - pneumonia - cerebral type acon. bell. bry. canth. hyos. lach. merc. nux-v. phos. puls. rhus-t. stram. sulph.

Chest and lungs - pneumonia - cerebral type acon. arn. bell. bry. cann-xyz. canth. hyos. lach. merc. nux-v. phos. puls. rhus-t. stram. sulph.

Clinical - Blood, general - plethora, blood - cerebral, congestion, intense Verat-v.

Clinical - blood, vessels, general - distention, blood vessels - arteries - cerebral congestion bell. glon. Verat-v.

Clinical - cerebral, palsy arn. caust. con. gels. hell. ign. lath. op.

Clinical - convulsions, general - alternating, with - cerebral, congestion bell. hyos.

Clinical - convulsions, general - brain, problems, from - cerebral, softening alum. Bufo Caust.

Clinical - convulsions, general - cerebral, softening alum. Bufo Caust.

Clinical - embolism, blood - cerebral, middle artery, causes aphasia Kali-br.

Clinical - fatty, degeneration, organs - liver, - heart disease, sequel of - dilatation of right, caused by  cerebral edema phos.

Clinical - measles, infection - cerebral, symptoms, with aeth. apis Bell. camph. coff. Cupr-act. stram. verat-v. viol-o. zinc.

Clinical - pneumonia, infection, inflammation, lungs - cerebral, type acon. arn. bell. bry. cann-s. canth. hyos. lach. merc. nux-v. phos. puls. rhus-t. stram. sulph.

Convulsions, spasms - cerebral softening, from caust.

EXTERNAL THROAT - PULSATION - bloodvessels - carotid - congestion, with cerebral atro-pur. kali-br.

EYES - DISCOLORATION - redness - congestion, with cerebral kali-br.

Eyes - PARALYSIS, eyes - optic nerve, amaurosis - transient, complicating motor palsy plb.

FACE - DISCOLORATION - red - flushes - congestion, with cerebral aml-ns. coffin. corn. iber. kali-br. lith-br. visc. ziz.

FACE - Muscles; facial – Paralysis Acon. aethi-m. alum. Am-p. bell. cadm-s. Caust. cocc. cur. Dulc. form. Gels. Graph. hyper. Kali-chl. Kali-i. physal-al. Rhus-t. ruta Seneg. zinc-pic.

FEVER - CONTINUED fever – cerebral Apis arn. Bapt. Bry. canth. cic. Gels. HYOS. Lach. Lyc. nux-m. Op. Ph-ac. Phos. Rhus-t. STRAM. verat-v. verat.

FEVER - CONTINUED fever - congestive - cerebral paralysis; with threatened hell. Lach. Lyc. OP. Ph-ac. Phos. tarent. zinc.

FEVER, HEAT - CONTINUED fever, typhus, typhoid – cerebral APIS arn. BAPT. BRY. canth. cic. GELS. HYOS. LACH. LYC. nux-m. OP. PH-AC. PHOS. RHUS-T. STRAM. sumb. verat-v. verat.

FEVER, HEAT - CONTINUED fever, typhus, typhoid - congestive - threatening - cerebral paralysis hell. LACH. LYC. OP. PH-AC. PHOS. tarent. zinc.

FEVER, HEAT - ERUPTIVE fevers - rubella, measles - cerebral and convulsive symptoms, with aeth. apis BELL. camph. coff. CUPR-ACT. stram. verat-v. viol-o. zinc.

FEVER, HEAT - ERUPTIVE fevers - scarlatina - nervous, convulsive, cerebral symptoms, with aeth. ail. am-c. apis ars. BELL. camph. CUPR-ACT. cupr. HYOS. rhus-t. STRAM. sulph. zinc.

GENERALITIES - PARALYSIS - general - congestion, from cerebral cur. zinc-phic.

GENERALITIES - WEAKNESS, enervation, exhaustion, prostration, infirmity - congestion, from  cerebral zinc-phic.

GENERALS - CONVULSIONS - cerebral softening Caust.

HEAD - ANOXIA; cerebral op. zinc-s.

HEAD - BRAIN; complaints of – Cerebrum cocc.

HEAD - CONSTRICTION - brain – cerebrum carbn-s.

Head - Drawn - forward toward frontal sinuses, lobes of cerebrum were dirc.

HEAD - IRRITATION, brain - nervous, cerebrum, extending to cerebellum dat-a.

HEAD - NOISES - beating of cerebral arteries op.

HEAD - PAIN - dull - brain - cerebrum, on waking ant-s-aur.

HEAD - PAIN - pressing - brain – cerebrum spig.

HEAD - PAIN - stitching - brain - cerebrum, left agar.

HEAD - PAIN - tearing - brain - cerebrum, as if there is no room in skull and it would press out through ear chel.

HEAD - REACTION, lack of cerebral zinc.

HEAD - WEAKNESS - brain - cerebrum, evening amel. pip-m.

Hearing - DEAFNESS, hearing loss of – cerebral chen-a. mur-ac.

Hearing - DEAFNESS, hearing loss of - palsy, complicating motor plb.

HEARING - LOST - cerebral origin chen-a. mur-ac.

HEARING - NOISES - whizzing - congestion, with cerebral sang.

Hearing - NOISES, in ears - roaring - cerebral congestion, in Aur. ferr-p. Op. Sulph. Verat-v.

Hearing - NOISES, in ears - whizzing - cerebral, congestion, with sang.

Heart - CONSTRICTION, sensation - cerebral, congestion, with aml-ns.

Heart - PALPITATIONS, general - alternating, with - cerebral, congestion Glon.

HEART & CIRCULATION - CONSTRICTION, tension, tightness - heart - congestion, with cerebral aml-ns.

HEART & CIRCULATION - PALPITATION heart - alternating with - congestion, cerebral GLON.

M - Migraine - cerebral origin stann.

MIND - DELIRIUM tremens, mania-a-potu - congestion, with cerebral chlol.

MIND - EXCITEMENT, excitable – cerebral aeth. ars. astac. carbn-s. merc. ox-ac.

MIND - EXCITEMENT, excitable - tendency – cerebral aeth. ars. astac. carbn-s. merc. ox-ac.

MIND - INSANITY, madness - cerebral atrophy, with chlorpr.

Mind - INSANITY, madness - congestion, from cerebral Bell. Stram. verat-v.

MIND - RECOGNIZE - does not - palsy, in ANAC.

NAUSEA AND VOMITING - Vomiting – cerebral aml-ns. apis apom. bell. glon. hell. merc. zinc.

NERVOUS SYSTEM - Paralysis - In – face acon. Am-p. bar-c. bell. caust. cur. gels. graph. Kali-chl. nat-m. physal-al. rhus-t. Zinc-pic.

Pulse - SLOW, pulse - cerebral disturbance, in, scarcely 60 croc.

SENSATIONS AND COMPLAINTS IN GENERAL - Reaction – cerebral Zinc.

SLEEP - SLEEPINESS - cerebral effusion, with APISIN. hell. kali-i.

SLEEP - Sleepiness - effusion, cerebral Apis Hell. kali-i.

Sleep - SLEEPINESS, general - cerebral, effusion, with Apis hell. kali-i.

STOMACH - VOMITING - general - cerebral irritation, with aml-ns. apisin. apom. bell. cyt-l. dor. glon. hell. merc. plb. zinc.

Stomach - VOMITING, general - cerebral, irritation, with aml-ns. apis apom. bell. cyt-l. dor. glon. hell. merc. plb. zinc.

Stool - FATTY, greasy, stool - oily, looking fecal - amel. cerebral symptoms pic-ac.

Stool - OILY, looking - amel., cerebral symptoms pic-ac.

TEETH - DENTITION - difficult - cerebral, nervous symptoms, with acon. agar. apis BELL. CHAM. cimic. cypr. dol. HELL. kali-br. PODO. sol-ni. ter. ZINC.

VERTIGO - CEREBRAL diseases, in alum. bell. COCC. cyt-l. gels. kali-p. sulfon. tab.

Vision - BLINDNESS, loss of vision - sudden - complicating motor palsy plb.

VISION - LARGE - objects seem - cerebral congestion, in aeth.

 

References

Radar 10

 Encyclopedia Homoeopathica

 Cerebral Palsy Tintinalli's Emergency Medicine  >  Chapter 138. The Child with Special Health Care Needs

 Congenital Abnormalities of Motor Function (Cerebral Palsy) Adams and Victor's Neurology  >  Chapter 38. Developmental Diseases of the Nervous System

 Cerebral Palsy CURRENT Diagnosis & Treatment: Pediatrics  >  Chapter 23. Neurologic & Muscular Disorders  >  Miscellaneous Neuromuscular Disorders

 Orthopedic Aspects of Cerebral Palsy CURRENT Diagnosis & Treatment: Pediatrics  >  Chapter 24. Orthopedics  >  Neurologic Disorders Involving the Musculoskeletal System

 Cerebral Palsy (Static Encephalopathy) CURRENT Diagnosis & Treatment in Orthopedics  >  Chapter 13. Rehabilitation

 Spasticity CURRENT Diagnosis & Treatment: Surgery, 13e  >  Chapter 36. Neurosurgery  >  Pediatric Neurosurgery

 Cerebral Palsy Concise Pathology  >  Chapter 62. The Central Nervous System: I. Structure & Function; Congenital Diseases  >  Congenital Diseases of the Nervous System

 Cerebral Palsy CURRENT Diagnosis & Treatment: Psychiatry  >  Chapter 47. Psychological Reactions to Acute & Chronic Systemic Illness in Pediatric Patients  >  Psychological Reactions to Chronic Physical Illness

 Cerebral Palsy CURRENT Diagnosis & Treatment in Orthopedics  >  Chapter 11. Pediatric Orthopedic Surgery  >  Neuromuscular Disorders

 Association with Cerebral Palsy Williams Obstetrics, 23e  >  Chapter 29. Diseases and Injuries of the Fetus and Newborn  >  Diseases Common in the Preterm Fetus and Newborn  >  Periventricular Leukomalacia

 Cerebral Palsy Williams Obstetrics, 23e  >  Chapter 29. Diseases and Injuries of the Fetus and Newborn  >  Diseases Common in the Preterm Fetus and Newborn  >  Brain Disorders

 Prevention Williams Obstetrics, 23e  >  Chapter 29. Diseases and Injuries of the Fetus and Newborn  >  Diseases Common in the Preterm Fetus and Newborn  >  Brain Disorders

 Clearly, for brain damage to occur, the fetus must be exposed to much more than a brief period of... Williams Obstetrics, 23e  >  Chapter 18. Intrapartum Assessment  >  Fetal Distress  >  Fetal Heart Rate Patterns and Brain Damage  >  Experimental Evidence  >  Human Evidence

 A spastic paraparetic gait is the major manifestation of cerebral diplegia (cerebral palsy), the... Adams and Victor's Neurology  >  Chapter 7. Disorders of Stance and Gait  >  Abnormal Gaits  >  Hemiplegic and Paraplegic (Spastic) Gaits

 The early detection of cerebral palsy is hampered by the fact that the corticospinal tract is not... Adams and Victor's Neurology  >  Chapter 28. Normal Development and Deviations in Development of the Nervous System  >  Delays and Failures of Normal Neurologic Development  >  Delays in Motor Development

 Clinical Box 12–4 Ganong's Review of Medical Physiology, 24e  >  Chapter 12. Reflex and Voluntary Control of Posture & Movement  >  General Principles of Central Organization of Motor Pathways

 Gait analysis is now a common tool in the treatment and evaluation of patients who have cerebral... CURRENT Diagnosis & Treatment in Orthopedics  >  Chapter 1. Basic Science in Orthopedic Surgery  >  Gait Analysis  >  Role of Gait Analysis in the Management of Gait Disorders

For Well Formatted Article, Pl. see the attached pdf.

Cerebral palsy and Homoeopathy.pdf