Posts Tagged ‘ cerebral palsy ’

Brain Injuries at Birth Have Many Causes, Report Finds

Tuesday, May 6th, 2014

Brain injuries suffered by newborns at the moment of their birth have long been thought to be the result of insufficient oxygen during delivery, with doctors often held responsible by parents.  But a new report by a committee of experts in obstetrics, pediatrics, neurology and fetal-maternal medicine has found that the full cause of such injuries, which can result in serious complications, are far more complex than that.  The New York Times has more:

The document, called Neonatal Encephalopathy and Neurologic Outcome, updates a version published in 2003 that focused on oxygen deprivation, or asphyxia, around the time of birth. The new report, which highlights significant advances in diagnosis and treatment in the decade since, was published by the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics. Brain injuries affect about three in 1,000 babies born full-term in the United States, but only half of these cases are linked to oxygen deprivation during labor and delivery, according to the new report. And even in those instances, a problem that occurred long before birth might have exaggerated the effects of a reduced oxygen supply that would have not otherwise caused a lasting brain injury.

According to the 2003 report, fewer than 10 percent of children with cerebral palsy, the most severe such brain injury, showed signs of asphyxia at birth. Unless certain clear-cut symptoms are present then, brain abnormalities are probably not the result of a complication during labor or delivery, the new report states.

Rather, there may be other reasons for neonatal encephalopathy, as brain disorders in full-term newborns are called. These include genetic factors and maternal health problems like hypothyroidism, placental abnormalities, major bleeding during pregnancy, infection of the fetal membranes and a stroke in the baby around the time of birth.

“We know that neonatal encephalopathy has a variety of causes, and we hope this report will enable us to provide more accurate information to affected families and devise better methods of prevention and treatment,” said Dr. Mary E. D’Alton, chief of maternal-fetal medicine at Columbia University Medical Center, who was chairwoman of the task force.

Neonatal encephalopathy is a syndrome of disturbed neurological function that occurs in full-term baby’s first days. It is characterized by impaired consciousness or seizures, often accompanied by breathing difficulties and poor muscle tone and reflexes.

To determine whether an insufficient supply of oxygen and blood during labor and delivery is the likely cause, several factors should be considered together. These include a low Apgar score at 5 and 10 minutes after birth; high acid level (called acidemia) in the umbilical artery; major organ failure; and an M.R.I. scan showing a particular pattern of cerebral injury, according to the new report.

The more of these conditions that are present, the more likely that insufficient oxygen during the birth was responsible for the injury.

Reassuringly, the report pointed out that most infants with low Apgar scores will not develop cerebral palsy. “Even in the presence of significant acidemia, most newborns will be neurologically normal,” the committee said. (A doctor evaluates a newborn on five criteria to arrive at the Apgar score, a fast way to gauge the baby’s well-being.)

The experts noted that “there are multiple potential causal pathways that lead to cerebral palsy in term infants, and the signs and symptoms of neonatal encephalopathy may range from mild to severe, depending on the nature and timing of the brain injury.”

For example, the injury might occur as a result of risk factors at the time of conception or from conditions that develop during pregnancy, like fetal growth retardation or placental lesions.

At this time, there are few effective remedies for those problems, but if certain abnormalities in the fetal heart rate are present when a woman goes into labor, the doctor may be able to prevent a serious brain injury by doing a cesarean delivery.

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Mom Creates Harness So Kids Get a Chance to Walk

Thursday, March 27th, 2014

Mom Debby Einatan was heartbroken when she first received news that her son Rotem, then 2, had no consciousness of his legs due to cerebral palsy. His condition inspired her to create a harness, called the Firefly Upsee, that allows wheelchair-bound small children to walk with a parent or adult. More from TODAY Moms:

On April 7, the Firefly Upsee Harness will be available for $540 plus shipping and fits children ages 3 to 8. Upsee includes double rubber shoes, a pair for parent and child each. The harness, which parents wear around their waists, consists of a soft material and resembles a wearable baby carrier.

Physical therapist Joseph Schreiber says the Upsee may be helpful for children to play and move more efficiently.

“It is always wonderful to see children, especially those with special needs, participating in a wide variety of fun and age-appropriate activities,” Schreiber, pediatrics president for the American Physical Therapy Association, told TODAY Moms in an email.

He recommends parents consult with physical therapists before purchasing a product such as Upsee to make sure it is safe and the right choice for the child.

Elnatan says being upright and bearing his or her own weight gives the child access to the world.

“[The child] can reach out and touch, something which is hard to do from a carriage or wheelchair,” Elnatan says.

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Life with Cerebral Palsy
Life with Cerebral Palsy
Life with Cerebral Palsy

Image via Shutterstock

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Study Examines Obesity Among Special-Needs Children

Thursday, November 3rd, 2011

Thirteen percent of American families include children with physical or developmental disabilities, but those families are left out of education and action campaigns around the obesity epidemic, a report from a special-needs advocacy group says.  The findings have led AbilityPath.org, an online resource and social community for parents and professionals serving the needs of adults and children with disabilities, to release a report called Finding Balance, with the goal of raising awareness of obesity among kids with autism, Down syndrome, and other disabilities, and offering tools to parents to help combat obesity in their families.

According to the Centers for Disease Control and Prevention (CDC), children with disabilities are 38% more likely to be obese than their counterparts.  “As a community, we must recognize the special dangers that obesity presents to our children,” says Sheryl Young, CEO of Abilitypath.org, “This is an epidemic in our own homes and we can and must find solutions.”

The report provides more startling statistics:

  • 67.1% of the teens with autism spectrum disorder were either overweight or obese.
  • 86.2% of the teens with Down syndrome were either overweight or obese.
  • 18.8% of the teens with cerebral palsy were either overweight or obese.
  • 83.1% of the teens with spina bifida were either overweight or obese.
  • 39.6% of the teens with intellectual disability were either overweight or obese.

Food aversions are common among special-needs children, among other reasons because medications often have appetite-altering side effects.  Mobility limitations also make it difficult for many children to be active enough to maintain a healthy weight. Increasing accessibility for play spaces, and including special-needs children in obesity studies and policy conversations are among the recommendation the report makes.

The report, which is in collaboration with Special Olympics and Best Buddies International, can be downloaded at the AbilityPath website.

(image via: http://stanfordmedicine.org/)

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