From the Guidelines
Pathophysiology of Cerebral Palsy
The pathophysiology of cerebral palsy is characterized by abnormal brain development or injury to the developing brain, typically occurring before birth, during birth, or in early childhood [ 1 ]. This damage disrupts the normal formation and function of motor control systems, including the corticospinal tract, basal ganglia, and cerebellum, leading to impaired motor function, muscle tone, and coordination.
- The resulting neurological deficits can manifest as various motor types, including spasticity, dyskinesia, ataxia, and hypotonia [ 2 ].
- These motor types can be further categorized based on the topographical distribution of the affected limbs, such as unilateral (hemiplegia) and bilateral (diplegia and quadriplegia) [ 2 ].
- The exact causal path to cerebral palsy is unclear in approximately 80% of cases, but risk factors such as prematurity, low birth weight, and birth complications are often identifiable [ 3 ].
- Genetic advances are likely to soon amend the diagnostic process, with evidence suggesting that 14% of cases have a genetic component [ 2 ].
- Management of cerebral palsy may involve medications such as baclofen and botulinum toxin injections to reduce spasticity and improve mobility [no specific evidence provided].
From the Research
Pathophysiology of Cerebral Palsy
The pathophysiology of cerebral palsy is complex and involves abnormalities of muscle tone, posture, and movement due to injury to the developing brain 4, 5, 6. The clinical features of cerebral palsy evolve over time and may be recognizable only after 3-5 years of age 6.
Causes and Risk Factors
The causes of cerebral palsy may not always be apparent, but various aetiological and risk factors play a crucial role in its development, including:
- Interruption in the supply of oxygen to the fetus or brain asphyxia 5
- Antenatal, perinatal, and postnatal factors 5
- Pre-term birth and low birthweight 4
- Hypoxic-ischemic encephalopathy, maternal infections, and multiple gestation 4
Brain Damage and Pathologic Findings
In most cases of cerebral palsy, the initial injury to the brain occurs during early fetal brain development 4. The main pathologic findings in preterm infants who develop spastic cerebral palsy include:
- Intracerebral hemorrhage 4
- Periventricular leukomalacia 4
- Damage to the corticospinal tract (CST) 7, 8
Impaired Motor Function
The pathophysiology of cerebral palsy also involves impaired motor function, including: