Cerebral+Palsy

elz44@wildcats.unh.edu University of New Hampshire - Manchester
 * Emily Lukasiak**

**__ Background __** Cerebral Palsy (CP) refers to a collection of disorders that arise from abnormal development or damage to the brain. This damage can occur prenatally, at birth, or postnatally up to about the age of 3. CP is caused by a brain lesion in the developing brain called an upper motor neuron (UMP) lesion. The primary lesion in CP is in the central nervous system and is “static”. This means that CP is a permanent, nonprogressive condition (Ducan, B. et al., 2008). There are many potential pathways that can be affected by the damage and lead to CP in infants, but a lot of these pathways are not completely understood. Some may be the result of oxygen deprivation during labor/delivery, and some may be the result of maternal health problems that directly affect the baby during development (Brody, J. E., 2014). Depending on the extent of the damage, CP can range from mild to severe.
 * What is Cerebral Palsy? **

CP is often described as the most common physical disability in children because it affects between 2 and 3.6 per 1,000 live births (Peterson, M. D. et al., 2012). The permanent neurological damage found in individuals with CP results in an overall decrease in function, mobility, and balance. Muscle spasticity and reduced muscle mass are two hallmark symptoms seen in those with CP.

There are 4 major subtypes of CP. They are: spastic, athetoid, ataxic, and mixed (Kothari, R. et al., 2010). Their definitions are as follows:
 * 1) **Spastic**: Muscles appear stiff and movements may look stiff/jerky
 * 2) **Athetoid**: Slow, uncontrolled movements of extremities and trunk; hypertonia (abnormally high muscle tone) and hypotonia (low muscle tone)
 * 3) **Ataxic**: Hypotonic muscles with poor coordination and balance
 * 4) **Mixed**: Includes symptoms of all 3 above

Spastic CP is the most common and is seen in about 65% of cases.

Even though CP is a nonprogressive disorder, individuals with CP are faced with numerous secondary effects of the condition. These secondary conditions can greatly interfere with important aspects of quality of life. Secondary conditions may include:
 * What are the secondary effects of Cerebral Palsy?[[image:CP Pic.JPG width="160" height="210" align="right" caption="Photo available for use from the Google Public Domain."]] **
 * Intellectual impairment
 * Epilepsy
 * Muscle contractures
 * Speech defects
 * Hearing and vision disorders
 * Educational and behavioral abnormalities (Kothari, R. et al., 2010).

Depending on the severity of the damage/disease, individuals may exhibit one, some, or all of these secondary conditions. As a result many individuals with CP do not have independence, participation, or employment opportunities.

Cerebral Palsy is a nonprogressive disorder and as a result, the damage to the brain that was done to produce the disorder, cannot get worse. However, once the damage on the brain occurs, there is no way to make the disorder go away or get better. Therefore, there is no cure for CP. There does exist a wide variety of treatments designed to minimize the effects of the secondary conditions that arise with the disorder. Some of these treatments include:
 * Therapies and Treatment **
 * Physical therapy
 * Aqua therapy
 * Oral medications
 * Intrathecal medication such as baclof

Most treatments focus on decreasing the amount of spasticity seen in CP patients. While these therapies have in some cases shown improvement in muscle control, contractures still often times develop and require surgery to be corrected (Smith, L. R., et al., 2012). The etiology of the development of deformity in muscle tissue is seeming to be more complex than researchers once thought. It will not be until researchers have a better understanding of the adaption of muscle tissue in CP patients that there will exist novel medical treatments or therapies (Smith, L. R., et al., 2009).

1. Even though Cerebral Palsy is a “non-progressive” disorder, can the secondary impacts it has on an affected individual’s body, such as muscle spasticity, seizures, etc., essentially make the condition a progressive one?
 * Research Questions **

2. Even though CP is caused by damage to the brain, is there a gene(s) that play a role in the severity/degree of CP in an individual?

3. If there is such a gene that plays a role in CP, is it conserved in humans and other various species?

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