What Is Cerebral Palsy? (1948)

long ago it was considered a shameful disease when a mother learned of her child's Affliction she screened him from the accusing eyes of people around them who would point to the child as visible proof of a hidden disgrace a victim of ignorance more than anything else the child could only wait no help was available no treatment was known today our children need not suffer hopelessly from this Affliction as they did in the past our knowledge has increased tremendously as a result of the work and thought of many devoted people what is cereal paly to give a partial answer we must follow through a typical situation that can occur to a baby at or around the time of birth for some reason the child's head May Beed to an excessive pressure if this pressure is great enough blood vessels on the outside of the brain rupture and form a hemorrhage this pool of blood presses against the brain squeezing the tissues in the outer layer the cells in this layer and the long fibers connected to them that travel down the spinal cord gradually wither and turn into dead Scar Tissue here we have shown only a few of the countless cells and fibers whose job it is to control Muses in all parts of the body the healthy tissues continue their function but the muscles connected to the dead nerve cells no longer can be willfully controlled and this child will have some type of cerebal paly hemorrhages of the brain leading to cerebal palsy can be caused by many things and take many forms the Hemorrhage could occur directly under the place receiving the blow or pressure or it could happen in many small places at once throughout the brain it might even develop on the side directly opposite as the brain floating in its own fluid is thrown violently against the other side of the skull a hemorrhage leading to brain damage could of course develop around a deep head wound but it could also occur without without the head receiving any blow or wound whatsoever in this case it is known as a stroke and could be large or small concentrated or scattered it's obvious then that cereal palsy is not entirely a children's Affliction as is commonly believed it could occur at any time in life but there exists a more important public misconception the belief that injury to the baby's head during birth is the prime cause of cerebal Psy this misconception coupled with a natural feeling of bitterness has caused more than one parent to blame cerebal paly and her child on the person who performed the delivery the truth is that cereal paly can happen without there being any head injuries at all to understand why this is so let us recall that the brain of any living person is so dependent on oxygen supplied by the blood that should it be deprived of it for only a short period the brain would be completely and permanently damaged normally the supply of oxygen to the brain of an unborn child is carefully and smoothly regulated but in some pregnancies that is not so first the problem May lie with a mother's heart or blood vessels she may have organic heart trouble or the cord or placenta may not be functioning properly second the heart or blood vessels of the fetus may be improperly formed third the control center in the fetus that governs the flow of oxygen to its brain may be impaired by some outside cause such as an excessive pressure or an adverse reaction to medicines or anesthesia finally the baby's breathing passages may be obstructed after birth in every one of these instances the brain has been deprived of some precious oxygen areas in the brain have been damaged and the parts of the body they governed no longer can be willfully controlled the doctors call this anoxia a major cause of cerebal fsy at one time all cases of cerebal palsy were lumped Under The Heading of Little's disease whatever treatment these children received was always identical then during the past 25 years doctors established the fact that there are a number of distinct types of cerebal palsy this was a big step forward for now each child could receive treatment that was designed for his particular type to bring order out of Chaos a system was needed to classify the many types of cereal paly doctors now group them according to which part of the brain contains the damaged tissue first is the [ __ ] paralysis group The two types of cerebal palsy in this group result from damage to the cerebrum such patients have muscles which are continually stiff and tight and show certain exaggerated reflexes premature birth German Measles toxemia of pregnancy in addition to injuries at Birth all help to bring on [ __ ] types of cerebal palsy in the athetosis group are 12 different subtypes all resulting from damage to midbrain most patients in this group display the same gross jerky involuntary movements of certain parts of their bodies we can trace many of these cases back to sit situations where the mother being an Rh negative blood type may possibly have developed an incompatibility of her blood with the RH positive blood of the fetus many other patients in the group also suffered from anoxia as we saw earlier together the [ __ ] paralysis group and the aoid group make up about 80% of all cereal paly cases let's look briefly at the other major divisions the group labeled Tremors and rigidities is linked up with damage to the basil ganglia as the name of the group implies these cases suffer either from Tremors or show some extreme rigidities of an arm or leg Axia means the loss of balance scense a condition shared by all py patients in this group it results from damage to the cerebellum the brain's coordinating Center how soon after an injury will a child show signs of cerebal paly if the damage is large cerebal paly will show itself quickly if it is small it may not make its appearance until weeks months or years after the injury has occurred when the signs do show themselves however here are the more important forms they take hemiplegia that is a paralysis of an arm or a leg mental retardation delay in crawling standing and walking purposeless movements cross-legged walking or the tendency to walk with one or both elbows always at a right angle and extreme turning out of both feet so that the ankle bone is prominent or the ability to bend the foot back until it touches the leg as we see here usually as we've seen the signs of cerebal paly in children are only too apparent but can the hidden blight be detected when perhaps the child's appearance is perfectly normal as we might suspect x-rays can reveal hidden conditions leading to cerebal palsy this plate shows the front view of a normal brain these two dark areas are cavities in the brain made more visible by the simple but delicate process of inserting air into them from the spine here the cavities are centered and roughly symmetrical however the pressure of a hemorrhage could do this to the cavities a condition which x-rays will quickly reveal in keeping with the electronic age a more startling way of proving into the hidden brain has been devised and is symbolized by this pattern of wavy lines these lines are an actual recording of tiny currents of electricity that flow continually through the brain of any living creature they can be obtained in an extremely simple fashion a number of small metal contacts are placed on the scalp at various points and connected by wire to a highly sensitive recording machine a normal brain will have a normal pattern of electric currents flowing but a diseased brain will have a different distorted pattern so far a help in diagnosis these recordings suggest only the faint outlines of that infinitely complex diagram a blueprint of the human brain this has been a brief glance at some of the modern aids to diagnosis but but what about treatment and cure what is being done to help these victims it is reassuring to know that cerebal paly is being attacked on many fronts internal medicines external medicines and surgery itself are all doing their share on the various fields of battle for many years now internal medicines have been used to treat cerebel paly their number continues to increase until today a fairly wide choice is available while their present use is somewhat limited more research is being done to Define their role in treatment in the field of external medicine progress continues uninterrupted at the present time the victim of cerebal paly may have at his disposal an imposing array of devices that can soothe him warm The Afflicted parts of his body stimulate the circulation strengthen the weakened muscles and relax those that are continually tense the most helpful is physiotherapy like exercise massage and manipulation ultrasound ultraviolet and hydrotherapy are also part of the growing Arsenal upon which Medical Science can draw today surgery is also lending its powerful support here we have a boy who has been wearing a brace because of marked Towing in or pigeon toe it was due to a twisting of the tibia or leg bone following a prolonged imbalance of his leg muscles the brace was only partly successful for when it was removed the towing in of his foot again occurred here is the situation that existed before a surgery was attempted though the kneecap pointed straight ahead the foot was turned inward a series of cuts were then made in the upper part of the leg bone and a wed shaped section was removed to close the gap the bone was rotated the proper amount then held in its new position with stitches the effect of this was to unwi twist the leg and make the foot Point straight forward after the bone healed in its new position the boy no longer needed his brace whose very weight tended to throw him off balance he can look forward now to a happier future with other children part of that happy future will be spent in swimming pools like this where Recreation and physical therapy take place at the very same time for some of the children it hardly seems worth the effort of pulling themselves slowly into the water especially when we see them alongside the more fortunate ones but after watching this we understand a little better what a swimming pool can mean to a crippled child to gain a partial freedom from the immutable law of gravity even for a little while is a pleasure to which these young people look forward eagerly every everyone who has felt the buoyant effect of water on the body knows what a pleasant experience it is but to the victims of cerebal py it's a special blessing for some it's the happiest part of the day and it always ends too soon but for many of these youngsters even the closing of school and the start of summer vacation doesn't bring an end to Recreation and fellowship this camp and others like it around the country supported by United cable paly gives a boy a chance to compete against children with handicaps similar to his possibly it's the first time he's on his own without members of the family hovering over him if at this age he has adjusted well to the world around him it's in large part due to the healthy normal environment he enjoyed at an earlier age that's why Nursery schools like this one with its unique sloping ramp are so very important in Years Gone by children with cereal paly were kept out of school when others their age began obviously they were not on the same level as healthy children and forcing them to compete with the others could have had only harmful results but education particularly for the handicapped must begin as early as possible these children learned from the very start to take off their own hats and coats and to hang them up properly a minor task for an ordinary child but not so minor for one suffering from cereal paly notice how this little girl's lack of coordination though not severe is just enough to make a simple operation quite complicated in addition to her lack of muscle coordination she has other disability as many patients with teral paly have and as so often happens the other problem was not detected for several years no one knew that she was partially deaf now her hearing aid held in its protective harness has brought her into full contact with the world around her she listens to a few more words of advice from the teacher and tries again to finish the job by herself the other children too go about their business without the teacher interfering finally her determined effort brings success and a smile of Victory to her face seeing this happy child one would never suspect that during the time she was partially cut off from the world of sounds and music she was a totally different child morose and uncooperative now the sound of a children's record in the adjoining room brings a quick response she knows she can join the others in playing a game of train to to the [Music] zoo fortunately simple treatment like this doesn't require expensive equipment and highly trained Specialists a photograph a few toys and a sympathetic volunteer worker are all that [Music] needed as the little girl tries to keep time with the music her muscles learn to answer more quickly to her wishes the special Nursery School plays an indispensable role in our present day Concepts we know that if the handicapped child is socially and emotionally [ __ ] when he enters a special school School his education has not started early enough in this group The Children vary widely in the extent of their difficulties some have relatively simple and limited problems and could soon enter regular schools others like this child will need individual attention for a much longer time in a separate group are those with special problems this child is blind a result of severe difficulties at the time of birth and this child has almost no muscle coordination and has to be fed entirely by hand for these children the road ahead is a difficult one for the others they wonder if the day will ever come when arms and hands not only keep time to music but make things things they can show for others to admire for many of these youngsters it's just something to dream about when the lights go out but in a few years it will be a dream no longer for the victims of cereal paly occupational therapy is unsurpassed in its ability to bring about improvements of the body as well as the mind looking at what these formerly incapable fingers produced makes us realize the heart and soul of the handicapped has gone into each peace this is the work of their hands it's a testimony of their effort and devotion a sort of indicator of their success yet in a similar way the children themselves are Testaments for their success their pride of achievement is the work of other hands we see them again the hands of the workers teachers doctors the men and women who have devoted themselves to this vital task what is cbble paly an afflictor of of the young and not so young a crippler a mind Destroyer Invincible no for in addition to the Arsenal described we have two powerful weapons medical research and the willingness to fight what is cble FY then the answer is a challenge a challenge that we accept for the sake of everyone for the happiness of our children l