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Symptoms of cerebral palsy:

Cerebral palsy is the most common developmental disorder in children that affects movement and body posture throughout life.
Until now, there has been a change in the cause, diagnosis, classification, and treatment of cerebral palsy.
Cerebral palsy is a non-progressive (does not increase, does not worsen) disease that develops as a result of a lesion or damage to the brain in a developing fetus or in the first months of a baby’s life.
At this time, motor and movement disorders appear.

Along with motor retardation, mental (intellectual) retardation, problems in sensory organs (lack of sight and hearing), perception, behavioral disorders, epilepsy, and secondary muscle and bone problems appear.
Cerebral palsy is a motor disorder caused by damage to the brain, cerebellum and brain stem. Spinal cord, peripheral nerves are not damaged during cerebral palsy. Motor retardation begins before 18 months. Symptoms change with age, but the cause of the disease does not. Causes of cerebral palsy.
Prenatal, birth, and postnatal factors play a role. Risk factors play a role before birth in 70-80% of cases, and after birth in 10-20% of cases. The most common risk factor we see is prematurity.
Prenatal risk factors include intrauterine infections, brain development anomalies, intrauterine stroke of the fetus, multiple pregnancies, maternal and fetal coagulation problems, increased bilirubin (kernicterus), etc. Perinatal asphyxia is the most common cause of cerebral palsy. Hypoxia in cerebral palsy is formed before birth.
Forms of cerebral palsy:
Bilateral spastic paralysis (quadriplegic or tetraplegic)
Spastic diplegia (paralysis of the lower limbs)
Unilateral cerebral palsy (hemiplegic)
Dyskinetic cerebral palsy (choreoathetosis, dystonia)
Atactic cerebral palsy
Depending on the form, a patient with cerebral palsy:
It can walk freely on all sides
He can walk without help, but he gets bored in a social environment.
He can walk with the help
They walk in a wheelchair or with the help of adults. Totally in need of help.
Bilateral infantile cerebral palsy (quadriplegic or tetraplegic form) is the most severe form of spastic paralysis. Tendon reflexes are increased, and pathological reflexes are taken.
In severe cases, the arms are turned inward, the hands are clenched into fists.
As the child grows, contours appear due to spasticity.
Voluntary movements are limited, even in the early lactation period, as babies are opisthotonus (turned backward).
In such children, there is a sudden movement or jump in response to the sound. In most cases, they are mistaken for myoclonic epilepsy.
Half of the patients have mental retardation, and 30% have epilepsy. Vision and eye symptoms include microcephaly, speech disorders, squinting.
Damage to the corticonuclear pathways causes swallowing and speech problems. Saliva flows from the mouth of the sick child. Aspiration pneumonia is formed.
Due to excessive spasticity, spastic diplegia also occurs in the hip joint.
The lower limbs were more involved in the process than the upper limbs. One of the main causes of cerebral palsy in a child with spastic diplegia is hemiplegia. Most preterm infants show PVL periventricular leukomalacia on brain MRI. An enlarged and cystic appearance is observed in the adjacent ventricle.
Tendon reflexes are high in the lower limbs. Pathological reflexes are noted. Typically hip and knee flexions are noted during gait.
When walking, walking on paws is noticeable. Due to the incomplete opening of the lower limbs, there are difficulties in changing the diaper. Abnormal crawling is noted. They crawl and jump like rabbits with their arms outstretched.
Visual disturbances and strabismus are also noted in this form of cerebral palsy. Mental retardation and epilepsy appear to be rare.
Hemiplegic infantile cerebral palsy:
The arms and legs of one side of the body are involved in the process. A hemiparetic baby is not felt before 3-5 months. In early infancy, touching objects with one arm attracts attention. An arm on one side of the body and a leg on the other side
is twisted. When starting to walk, walking on the paw on the weak side, pulling on one side of the body is felt. Tendon reflexes are high, and pathological reflexes are noted. He may be late to his place. There are disturbances in his fine motor skills. The most common cause is occlusion of the spinal artery. Epileptic seizures are observed in half of such cerebral palsy cases. 1/4 of patients have mental retardation.
Dyskinetic infantile cerebral palsy:
It is in the form of choreoathetosis and dystonia. At this time, involuntary movements appear. The baby seems to be spinning around its axis.
Muscle tone is variable. Tendon reflexes are normal or increased. Involuntary movements (twists, rotations) increase during excitement, fatigue, hunger, and movement.
During sleep, these movements disappear. Hypotonia during Sudamar later turns into dystonia. Involuntary movements are more common at 1-3 years of age. Asphyxia in the form of choreoathetosis appears in premature babies due to an increase in the amount of bilirubin.
Chorea is rapid, involuntary movements. Athetosis is slow movements.
Worm-like movements are variable. Speech delay is noted due to incoordination in the tongue and respiratory muscles.
As a result, saliva flows from the mouth, and difficulty swallowing. Their intelligence is normal. He is late to my place. In the rare but severe dystonic type, muscle tone is increased. They have an abnormal posture and are constantly stretched. The body appears to be rotating or twisting. The cause of this type is perinatal asphyxia. Lesions appear in the basal ganglia (hypoxia). In the etiology, there is a role of premature birth, and prolonged jaundice. 50% hearing impairment appears. Epileptic seizures are rare.
Ataxic form of infantile cerebral palsy
Along with motor retardation, there are coordination disorders (staggering) due to hypotonia in limbs and trunk at an early age. Neurological examination shows nystagmus, Romberg +. They walk at the age of 3-4.
The mixed form is the joint appearance of spasticity and choreoathetosis symptoms of cerebral palsy.
Complications of cerebral palsy:
During cerebral palsy, motor damage is not the only problem. At this time, sensory organs experience confusion, epilepsy, delays in perception, and behavioral disorders.
Mental Retardation: Cerebral palsy is seen in children, mostly in low birth weight and premature babies. Spastic quadriparesis is seen in 75% of cases and spastic diplegia in 25% of cases. The dyskinetic and hemiparetic form is rare in cerebral palsy. In cerebral quadriparesis, the brain is more extensively damaged.
Epilepsy: Appears in 15-90% of cases depending on the form of spinal paralysis. Hemiparetic SP 34-60%. Dyskinetic SP appears in 23-26% of cases. SP with mental retardation has a high risk of developing epilepsy. Seizures are tonic, myoclonic, atonic, focal, and tonic-clonic. Focal seizures and secondary generalized seizures are more frequent in spastic hemiparesis. Seizures are resistant to treatment when they start at an earlier age.
Nutritional disorders and oral motor deficits: Malnutrition, spasticity, immobility, intervening infections, nutrition, and growth are hindered during cerebral palsy. 90% of cerebral palsy patients are spastic, hypotonic, and motor retarded, and loss of primary reflexes leads to difficulties in oral motor skills. .Mainly in the spastic quadriparetic form, feeding difficulties such as difficulty in swallowing and chewing, and drooling occur.
Improper bite of the teeth, and lack of attention to oral hygiene, lead to tooth decay and the development of an infectious process. During spastic paralysis, throwing the head back, difficulty in swallowing, lack of chewing, and sticking out the tongue makes feeding difficult.
Gastroesophageal reflux is also seen in infants with cerebral palsy. Difficulties in feeding Südemar SP with milk cause vomiting and aspiration.
Eye and vision disorders: Eye and vision disorders are common in SP patients. Half of the patients have vision problems. Most of the patients develop cataracts. Weakness in vision, and atrophy of the optic nerve depend on the severity of the lesion in the brain.Hearing loss: 10-15% of cases appear in patients with cerebral palsy. The etiology of hearing loss is half-birth, kernicterus, ototoxic drugs, meningitis, and severe hypoxic ischemic encephalopathy.Language and speech disorders: Dysarthria and speech defects appear in SP patients as a result of a lack of oral motor skills. Articulation disorders, difficulty in making sound, and lack of breathing control cause difficulties in speech.Orthopedic problems: hip spasticity, scoliosis, contractures develop in SP patients.Behavioral disorders: Aggressiveness, hyperactivity, attention deficit, and autism appear in patients.