Cerebral Palsy

What is cerebral palsy (CP)?

Cerebral palsy (CP) is a group of neurologic disorders that cause problems with movement, balance, and posture. The first part of the name, cerebral, means having to do with the brain. The second part, palsy, means weakness or problems with using the muscles.

CP can range from mild to severe. The brain damage and the disabilities it causes are permanent. But treatments can improve the lives of people who have the condition. For example, treatments can help to improve their motor skills and ability to communicate.

What are the types of cerebral palsy (CP)?

There are different types of CP:

• Spastic cerebral palsy, which is the most common type. It causes increased muscle tone, stiff muscles, and awkward movements. Sometimes it only affects one part of the body. In other cases, it can affect both arms and legs, the trunk, and the face.
• Dyskinetic cerebral palsy, which causes problems controlling the movement of the hands, arms, feet, and legs. This can make it hard to sit and walk.
• Ataxic cerebral palsy, which causes problems with balance and coordination.
• Mixed cerebral palsy, which means that you have symptoms of more than one type.

What causes cerebral palsy (CP)?

CP is caused by abnormal development or damage to the developing brain. When this development or damage happens before birth, it is called congenital CP. Most CP is congenital, and its causes may include:

• Gene changes (variants)
• Brain malformations
• Infections or fevers in the pregnant parent
• An injury to the developing baby

CP can also happen during or after birth. CP that happens more than 28 days after birth is called acquired CP. Its causes can include:

• Brain damage in the first few months or years of life
• Infections, such as meningitis or encephalitis
• Problems with blood flow to the brain, for example from a stroke or abnormal blood vessels
• Head injuries, for example from a car accident, a fall, or child abuse

In some cases, the cause of congenital or acquired CP is unknown.

Who is more likely to develop cerebral palsy (CP)?

Certain medical conditions or events that can happen during pregnancy and delivery may increase a baby's risk of congenital cerebral palsy. These may include:

• Being born too small
• Being born too early
• Being born a twin or other multiple birth
• Being conceived by in vitro fertilization (IVF) or other assisted reproductive technology (ART)
• Infections
• Health problems in the pregnant parent, such as thyroid problems and seizures
• Severe newborn jaundice
• Having complications during birth
• Rh incompatibility
• Exposure to toxic chemicals during pregnancy

What are the signs of cerebral palsy (CP)?

There are many different types and levels of disability with CP. So the signs can be different in each child. These signs usually appear in the early months of life. They may include:

• Developmental delays. Your child may be slow to reach developmental milestones such as learning to roll over, sit, crawl, or walk.
• Abnormal muscle tone. Your child may seem floppy, or they may be stiff or rigid.
• An unusual posture or favoring one side of the body when reaching, crawling, or moving.
• Stiff or tight muscles and exaggerated reflexes (spasticity).
• Shaking (tremor) of arms, legs, hands, or feet.
• Sudden, uncontrolled movements.

It's important to know that children without CP can also have these signs. Contact your child's health care provider if your child has any of these signs, so you can get a correct diagnosis.

How is cerebral palsy (CP) diagnosed?

Diagnosing CP involves several steps:

• Developmental monitoring (or surveillance) means tracking a child's growth and development over time. If there are any concerns about your child's development, they should have a developmental screening test as soon as possible.
• Developmental screening involves giving your child a short test to check for motor, movement, or other developmental delays. If the screenings are not normal, the provider will recommend more evaluations.
• Developmental and medical evaluations are done to diagnose which disorder your child has. To make the diagnosis, your provider:
  • Will check your child's motor skills, muscle tone, reflexes, and posture
  • Will ask about their medical history
  • May order lab tests, genetic tests, and/or imaging tests

What are the treatments for cerebral palsy (CP)?

There is no cure for CP, but treatment can improve the lives of those who have it. It is important to begin a treatment program as early as possible.

A team of health professionals will work with you and your child to develop a treatment plan. Common treatments include:

• Medicines
• Surgery
• Assistive devices such as braces and walkers
• Physical, occupational, recreational, and speech therapy

Can cerebral palsy (CP) be prevented?

You cannot prevent the genetic problems that can cause CP. But it may be possible to manage or avoid some of the risk factors for CP. For example:

• If you are pregnant, make sure that you are vaccinated against infections that could cause CP in your developing baby.
• Get regular prenatal care, which can reduce the risk of preterm birth or having a low birthweight baby. It can also help you manage any health conditions that could raise the risk of CP.
• Use car seats for your baby to prevent head injuries that could cause CP.

Chest Injuries and Disorders

What is the chest?

The chest is the part of your body between your neck and your abdomen (belly). The medical term for your chest is thorax.

Your chest holds many important structures for breathing, digestion, blood circulation, and other important body functions. These structures include your:

• Ribs and breastbone
• Esophagus, the tube between your mouth and stomach
• Trachea, your windpipe
• Bronchi, the tubes that carry air from your windpipe to your lungs
• Lungs
• Pleura, a thin layer of tissue that covers the lungs and lines the inside wall of the chest space
• Heart and large blood vessels
• Thymus, a gland that's part of your immune system
• Nerves

What are chest injuries and disorders?

Chest injuries and disorders are problems that affect any of the organs or structures located in your chest.

There are many types of chest injuries and disorders, for example:

• Broken ribs
• Esophagus disorders
• Swallowing disorders, also called dysphagia
• Tracheal disorders
• Bronchial disorders
• Lung diseases and collapsed lung
• Pleural disorders
• Heart diseases
• Mediastinal diseases, which are tumors, inflammation, and other problems with the structures in the mediastinum, which is the space between your lungs, breastbone, and spine
• Thoracic aortic aneurysm
• Thoracic outlet syndrome

Chest injuries may happen from the force of car accidents, falls, or sports injuries. Or the chest may be pierced by a bullet or sharp object. Because your chest holds so many important structures, certain chest injuries may be life-threatening.

How are chest injuries and disorders diagnosed?

Diagnosis of chest injuries or disorders depends on the type of symptoms you're having and whether you've had a chest injury. Injuries are usually obvious, but in most cases, you'll need tests to know how serious an injury is.

There are many types of tests for diagnosing different types of chest injuries and disorders, for example:

• Diagnostic imaging tests
• Heart tests
• Lung function tests
• Bronchoscopy
• Pleural fluid analysis
• Dysphagia tests
• Biopsy

Treatments will depend on the type of chest injury or disorder you have.

Chronic Kidney Disease

You have two kidneys, each about the size of your fist. Their main job is to filter your blood. They remove wastes and extra water, which become urine. They also keep the body's chemicals balanced, help control blood pressure, and make hormones.

Chronic kidney disease (CKD) means that your kidneys are damaged and can't filter blood as they should. This damage can cause wastes to build up in your body. It can also cause other problems that can harm your health. Diabetes and high blood pressure are the most common causes of CKD.

The kidney damage occurs slowly over many years. Many people don't have any symptoms until their kidney disease is very advanced. Blood and urine tests are the only way to know if you have kidney disease.

Treatments cannot cure kidney disease, but they may slow kidney disease. They include medicines to lower blood pressure, control blood sugar, and lower cholesterol. CKD may still get worse over time. Sometimes it can lead to kidney failure. If your kidneys fail, you will need dialysis or a kidney transplantation.

You can take steps to keep your kidneys healthier longer:

• Choose foods with less salt (sodium)
• Control your blood pressure; your health care provider can tell you what your blood pressure should be
• Keep your blood sugar in the target range, if you have diabetes
• Limit the amount of alcohol you drink
• Choose foods that are healthy for your heart: fruits, vegetables, whole grains, and low-fat dairy foods
• Lose weight if you are overweight
• Be physically active
• Don't smoke

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

College Health

College life involves excitement, along with new challenges, risks, and responsibilities. You are meeting new people, learning new things, and making your own decisions. It can sometimes be stressful. You have to deal with pressures related to food, drink, appearance, drugs, and sexual activity.

There are steps you can take to stay healthy and safe while you're in college:

• Eat a balanced diet
• Get enough sleep
• Get regular physical activity
• Maintain your health with checkups and vaccinations
• If you decide to have sex, practice safe sex
• Make smart choices about alcohol and drugs
• Get help if you are stressed or depressed

Centers for Disease Control and Prevention

Concussion

A concussion is a type of brain injury. It involves a short loss of normal brain function. It happens when a hit to the head or body causes your head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in your brain. Sometimes it can also stretch and damage your brain cells.

Sometimes people call a concussion a "mild" brain injury. It is important to understand that while concussions may not be life-threatening, they can still be serious.

Concussions are a common type of sports injury. Other causes of concussions include blows to the head, bumping your head when you fall, being violently shaken, and car accidents.

Symptoms of a concussion may not start right away; they may start days or weeks after the injury. Symptoms may include a headache or neck pain. You may also have nausea, ringing in your ears, dizziness, or tiredness. You may feel dazed or not your normal self for several days or weeks after the injury. Consult your health care professional if any of your symptoms get worse, or if you have more serious symptoms such as:

• Convulsions or seizures
• Drowsiness or inability to wake up
• A headache that gets worse and does not go away
• Weakness, numbness, or decreased coordination
• Repeated vomiting or nausea
• Confusion
• Slurred speech
• Loss of consciousness

To diagnose a concussion, your health care provider will do a physical exam and will ask about your injury. You will most likely have a neurological exam, which checks your vision, balance, coordination, and reflexes. Your health care provider may also evaluate your memory and thinking. In some cases, you may also have a scan of the brain, such as a CT scan or an MRI. A scan can check for bleeding or inflammation in the brain, as well as a skull fracture (break in the skull).

Most people recover fully after a concussion, but it can take some time. Rest is very important after a concussion because it helps the brain to heal. In the very beginning, you may need to limit physical activities or activities that involve a lot of concentration, such as studying, working on the computer, or playing video games. Doing these may cause concussion symptoms (such as headache or tiredness) to come back or get worse. Then when your health care provider says that it is ok, you can start to return to your normal activities slowly.

Centers for Disease Control and Prevention