What Causes Cerebral Palsy and Its Main Types?

TL;DR

Cerebral palsy is a permanent, nonprogressive neurodevelopmental disorder caused by injury or malformation of the developing brain. Premature birth is presented as the most common cause, while other causes include infection, hypoxic-ischemic injury, hemorrhage, stroke, kernicterus, trauma, and possible genetic susceptibility.

Transcript

what's up Ninja nerds in this video today we're going to be talking about cerebral paly before we get started in this video guys if you guys enjoyed this video you benefit from it please continue to support us by subscribing hitting that like button and commenting down in the comment section all right Engineers let's get get into it all right engin... Read More

Key Insights

• Cerebral palsy is a permanent, nonprogressive neurodevelopmental disorder caused by injury or malformation of the developing brain. The original brain damage generally does not worsen, but it can produce lasting abnormalities of movement, posture, muscle control, and other neurologic functions.
• Premature birth is presented as the most common cause associated with cerebral palsy. An incompletely developed brain is vulnerable to inadequate blood supply, white matter injury around the ventricles, and bleeding from fragile vessels, all of which can damage motor pathways.
• Periventricular leukomalacia is an injury in which inadequate blood supply causes tissue, particularly white matter around the ventricles, to die. Because this white matter contains descending pathways from upper motor neurons, its destruction can contribute to the motor abnormalities of cerebral palsy.
• Intrauterine infection is a prenatal cause of brain injury associated with cerebral palsy. The TORCH framework includes toxoplasmosis, rubella, cytomegalovirus, herpes simplex viruses, and other infections such as syphilis, Zika, and varicella-zoster virus.
• Hypoxic-ischemic injury is caused by inadequate oxygen or blood delivery to the fetal brain. Placental abruption, placenta previa, placental insufficiency, prolonged umbilical cord compression, and complications during labor are identified as circumstances that can impair fetal oxygen delivery.
• Postnatal brain injury is another pathway to cerebral palsy. Potential injuries include intracerebral hemorrhage after trauma, acute ischemic stroke, meningitis, and encephalitis, each of which can damage developing brain tissue and produce persistent neurologic impairment.
• Kernicterus is brain injury caused when high levels of unconjugated bilirubin accumulate, cross the blood-brain barrier, and damage brain structures, particularly the basal ganglia. The bilirubin buildup described in the lecture can follow extensive breakdown of the infant's red blood cells.
• Cerebral palsy is classified into spastic, dyskinetic, ataxic, and mixed forms. Spastic disease is the most common and causes hypertonia and stiffness, dyskinetic disease produces involuntary movements, and ataxic disease causes impaired coordination and balance.

Questions & Answers

Q: What is cerebral palsy?

Cerebral palsy is a permanent, nonprogressive neurodevelopmental disorder resulting from injury or malformation of the brain during early development. It is associated with impaired movement and posture and may present as an upper motor neuron type of lesion. Nonprogressive means that the original brain injury does not generally worsen over time, although its resulting problems can remain persistent.

Q: What is the most common cause of cerebral palsy?

Premature birth is presented as the most common cause associated with cerebral palsy. The premature brain has not had adequate time to develop and is especially vulnerable to periventricular leukomalacia and intraventricular hemorrhage. These injuries can damage white matter and descending motor pathways around the ventricles, producing the brain injury responsible for cerebral palsy manifestations.

Q: How does periventricular leukomalacia cause cerebral palsy?

Periventricular leukomalacia occurs when the incompletely developed brain receives an inadequate blood supply, causing tissue around the ventricles to die. The affected tissue includes white matter containing descending pathways from upper motor neurons. Damage to these motor pathways creates the type of brain injury that can later appear as the abnormal movement, posture, and muscle control of cerebral palsy.

Q: Which prenatal infections are associated with cerebral palsy?

Prenatal infections associated with cerebral palsy are organized using the TORCH framework. It includes toxoplasmosis, rubella, cytomegalovirus, and herpes simplex viruses. The other category can include syphilis, Zika, and varicella-zoster virus. These infections can injure the developing brain during the intrauterine period and produce the persistent neurologic lesions underlying cerebral palsy.

Q: How can oxygen deprivation lead to cerebral palsy?

Inadequate oxygen or blood flow can cause a hypoxic-ischemic insult to the fetal brain. Placental abruption, placenta previa, placental insufficiency, prolonged umbilical cord compression, and complications during labor can interfere with oxygen delivery. When deprivation is sufficient to injure the developing brain, the resulting permanent damage can produce the movement and posture abnormalities associated with cerebral palsy.

Q: How does kernicterus cause cerebral palsy?

Kernicterus develops when a large amount of unconjugated bilirubin accumulates in the blood, crosses the blood-brain barrier, and damages brain structures, particularly the basal ganglia. The described bilirubin accumulation can result from extensive red blood cell breakdown when the liver cannot conjugate it quickly enough. This brain injury can produce a cerebral palsy presentation, including dyskinetic features.

Q: What are the main types of cerebral palsy?

The main classifications are spastic, dyskinetic, and ataxic cerebral palsy, with mixed cerebral palsy combining features from multiple types. Spastic cerebral palsy is the most common and features hypertonia and motor stiffness. Dyskinetic cerebral palsy involves involuntary movements associated with basal ganglia injury. Ataxic cerebral palsy causes poor coordination and balance associated with cerebellar damage.

Q: What complications can occur with cerebral palsy?

Cerebral palsy can involve more than impaired movement and posture. Associated complications identified in the description include seizures, intellectual disability, vision loss, hearing loss, and feeding difficulties. Because different areas of the developing brain can be injured, affected individuals may show different combinations of motor, cognitive, sensory, and feeding problems rather than one uniform clinical presentation.

Summary & Key Takeaways

• Cerebral palsy is defined as a permanent, nonprogressive neurodevelopmental disorder involving brain injury or malformation during early development. The underlying damage does not generally worsen over time, although affected individuals can experience persistent problems with movement and posture. Its causes may occur before, during, or shortly after birth.

• Premature birth is emphasized as the most common cause. It can be associated with periventricular leukomalacia, in which inadequate blood supply damages white matter around the ventricles, or intraventricular hemorrhage caused by fragile vessels. Other causes include intrauterine infections, oxygen deprivation, trauma, stroke, meningitis, encephalitis, and kernicterus.

• Cerebral palsy is classified as spastic, dyskinetic, ataxic, or mixed. Spastic cerebral palsy features hypertonia and stiffness, dyskinetic cerebral palsy causes involuntary movements associated with basal ganglia injury, and ataxic cerebral palsy impairs coordination and balance through cerebellar damage. Associated complications can affect cognition, sensation, feeding, and seizure control.