Cerebral Palsy (CP)- Classic view

CP is a symptomatic diagnosis, which points the brain damage. It is placed by neurological examination which locates the defect, eliminates the possibility for progressive type of the condition and reveals the necessity of treatment and intervention on its secondary conditions which can be changed in the time with improvement, deterioration or stabilization.

All children with cerebral palsy are with brain damage, but not all children with brain damages are with cerebral palsy.

The brain damage whose symptoms correspond to the picture of CP represents a damage of the functions of the motor centers of the brain. The location of the damage defines the types of the disease and respectively complete or partial loss of functions. The children with cerebral damages and the corresponding lack of motor functions are often misdiagnosed for long time after birth. Although the damage is present at the time of birth the problem often does not appears till the time when the child's activities do not reach its level.

CP has to be considered as a diagnosis of children aged at least 2 years old, as diagnosis before the age of 1 year 6 months is known to be unreliable. The presence of neurological and motor signs of developmental delay before the age of 1 year 6 months is defined with different terms as: “CP-risk” infants ; “Central Motor Disturbance” ; “Transitory Dystonic Syndrome” ; “Central Koordination Storung" or “Durchgang Syndrome”. Al these terms indicate the transitional identity of that status, which could be normalized 100% or to cultivate CP.

The “CP-risk” infant has the chance to reach full normalizing of its motor development before the age 1 year 6 months, but after that age the primitive and pathological reflexes and movements destroyed the normal locomotion and fixed the picture of CP.

The treatment of the child with diagnosed “central motor disturbance” should be directed to organization of the brain functions, i. e. toward creation of cerebral connections. The destroyed brain cells can not be restored and these, which are damaged, can not be repaired. Trough stimulating the creation of new bonds between the healthy cells becomes possible the healthy parts of the brain to take the functions of the damaged or destroyed cerebral cells. The more bonds there are between the neurons the better is the working ability of the system, which in its turn means better functional level.

Although the CP is "untreatable" in the common sense of the word the therapy, the training, the interventions and the education can help for improving the brain functions, which is more significant when these activities have started earlier.

The perspective for children with brain damage diagnosed symptomatically is not good since their treatment is symptomatic. The symptomatic treatment alleviates the symptoms but it does not reach the problem, which for CP is the brain but not the spastic or rigid extremity or the involuntary movements. Looking to the past due to the inappropriate treatment these children failed to reveal significant improvement and they were often considered as "untreatable".

Therefore instead of "treatment of CP" much more suitable is to speak about “management" of the CP.

Management of CP means "to engage resources and professionals, to construct team, tactic and strategy and to organize purposeful actions" instead of "to do an action for the action itself".

The final point of CP management must to be the socialization of the child with its motor, speech or cognitive difficulties, which have to be checked and supported all over its lifetime.

Chavdarov I. - ROBOT-ASSISTED THERAPY FOR GAIT TRAINING IN CEREBRAL PALSY, ALGORITHMS AND OUR 10 YEARS OF EXPERIENCE; Physical Medicine Rehabilitation Health Journal; vol.22, No.3/2023, 27p.
Chavdarov I. - REPETITIVE TRANSCRANIAL  MAGNETIC STIMULATION (RTMS) FOR CHILDREN WITH CEREBRAL PALSY; Physical Medicine Rehabilitation Health Journal; vol.22, No.3/2023, 32p.
VII - th Congress of Physical Medicine and Rehabilitation with internetional participation -
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