Introduction
Cerebral Palsy is a condition that disturbs movement and posture, muscle tone, and the capability to move in a purposeful and coordinated way. The disorder is caused by abnormal development of the brain or brain injury while a child’s brain is still developing i.e. before, during, or after childbirth. In an article, Cerebral Palsy the authors, Johnston and Hoon defined CP as a group of disorders affecting the development of posture, movement, and motor skills in a developing fetus or newborn. The most important causes of CP have acquired lesions such as trauma, metabolic/endocrine disorder, infection, and hypoxia-ischemia. In 1843, William, an English orthopedic surgeon describe the condition for the first time which was known as “Little’s disease” for many years.
Discussion
The major factors associated with the cause of CP are premature birth, white matter injury, hypoxic-ischemic injury, and stroke. In 70-80% of infants who develop CP, have prenatal risk factors, and 10-20% have intrapartum complications such as trauma, infections, and asphyxia. Along with low birthweight and prematurity, other conditions that have been involved are placental abnormalities, signs of inflammation/intrauterine infection, hereditary fetal blood clotting disorders, male gender, intrauterine viral infection, and multiple gestations. Studies also suggest maternal thyroid dysfunction as a hypothetically significant cause of Cerebral Palsy. In the early gestation period, maternal thyroid hormone is vital for brain development but the fetal thyroid does not secrete hormone until 20 weeks of development. In certain geographic areas, during pregnancy, the deficiency of Iodine is related with CP and mental retardation. An extensive range of growth factors, soluble receptors, and chemokines in cerebrospinal fluid (CSF), amniotic fluid, and cord blood have been associated with the development of CP.
Review
In the article, Johnston and Hoon studied the work of several researchers on the factors associated with Cerebral Palsy in fetuses and infants. They defined CP as a set of disorders that affects movement and motor skills. The risk of developing this disorder is greater in less-weight birth (infant with <1500 g) or premature birth. Periventricular leukomalacia (PVL) referred to as injury to the deep white matter of the premature brain, has been associated more common brain deformity responsible for Cerebral Palsy. The author describe the most important causes of white matter injury in premature infants as infection and ischemia-reperfusion. According to the study conducted by Nelson and Ellen in 1986, brain injuries in full-term infants, responsible for CP are more prevalent in underdeveloped countries as compare to developing countries.
The three potential research areas that inspired me are the brain injuries associated with the sex as males are more vulnerable to CP, the use of the experimental model of CP to develop therapies to salvage brain tissue in newborns who have hypoxic-ischemic encephalopathy (HIE).
