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Pathophysiology of cerebral palsy: General Information

Cerebral palsy can be termed as a static encephalopathy caused by an insult to the brain of the newborn baby during the prenatal, perinatal, or postnatal period. Cerebral palsy is a group of chronic disorders impairing control of movement. Cerebral palsy is generally caused by the faulty development or damage to motor areas in the brain that disrupts the brain's ability to control movement and posture. The symptoms of the cerebral palsy vary in terms of severity. The main
symptoms of the cerebral palsy include difficulty with normal motor tasks such as writing or using scissors, difficulty in walking and imbalanced pasture. Cerebral palsy normally do not get worsen over the time. Cerebral palsy can lead to global dysfunction but always includes motor problems.

Pathophysiology:

There are mainly four types of cerebral palsy based on the movement dysfunction. First is Spastic cerebral palsy in which the sudden, involuntary movements are seen in the patient. These movements are stiff and difficult. The second is Athetoid characterized with uncontrolled, slow, writhing movements. The third type is Ataxic cerebral palsy in which irregular muscle coordination and lack of balance can be noticed. The fourth and final type is mixed cerebral palsy, which is a combination of two or more types. The cerebral insults have a wide range and include vascular, hypoxic-ischemic, metabolic, infectious, traumatic, and genetic causes. There may be some other causes also.

The spasticity results because of too much facilitatory input from the spinal reflex arc. This spinal reflex arc is generated by a stretch put on the muscle spindle. The spindle sends information to the spinal cord that generally is controlled by the descending tracts. If these tracts are injured, then an uncontrolled facilitation occurs that causes the muscle to contract. The muscle takes up the length on the spindle. The basal ganglia are a contributor to the extra pyramidal system of the muscles. It is an important center for movements related to posture, automatic movements and skilled volitional movements. Injuries or insults in this area often results in the difficulty in stopping motion, rigidity, tremor or chorea. These symptoms are medically known as akinesia. Inability to control the range of motion in an activity also results due to the insult to cerebellum.

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