Cerebral Palsy and Spina Bifida: Causes and Types

Cerebral palsy (CP) is the most common childhood disability, a disorder that permanently affects psychomotor function. Cerebral palsy describes a group of psychomotor development disorders, causing a limitation of patient activity, attributed to problems in brain development of the fetus or child. Psychomotor disorders of cerebral palsy are often accompanied by sensory or cognitive problems, communication and perception difficulties, and, on some occasions, developmental disorders. Brain injuries that cause CP occur from the fetal period up to age 3 years (brain maturity).

Causes of Cerebral Palsy

• The causes of cerebral palsy vary from case to case and should not be attributed to a single factor. All cases develop from a common determinant: poor central nervous system maturation.
• Cerebral palsy can occur in the prenatal, perinatal, or postnatal periods.

Prenatal Period

• Injury is caused during pregnancy, and adverse conditions can affect the mother.
• Maternal infections (mainly rubella), radiation, anoxia (oxygen deficiency), toxemia, and maternal diabetes.

Perinatal Period

• Injuries often occur at the time of delivery.
• The most common causes are: anoxia, asphyxia, trauma, forceps delivery, prematurity, multiple births, and, in general, any birth that causes suffering to the child.

Postnatal Period

• Injury is caused by diseases after birth.
• May be due to head injuries, infections, vascular accidents, anesthetic accidents, dehydration, etc.

Types of Cerebral Palsy

According to the distribution of neuromuscular disorder, or the qualifying criteria of topography (which indicates what portion of the body is affected), we distinguish between:

• Hemiplegia: Affects one hemisphere (right or left).
• Diplegia: Lower half more affected than the upper.
• Quadriplegia: All four limbs are paralyzed.
• Paraplegia: Involvement of the lower limbs.
• Monoplegia: A single limb, top or bottom, is affected.
• Triplegia: Three affected limbs.

While the literature refers to bedside neuromuscular disorders with the suffix "plegia," paralysis is not always complete. In reality, it is often a weakness or decrease in nerve impulse conduction, causing muscle paresis.

According to Muscle Tone

• Isotonic: Normal tone.
• Hypertonic: Increased tone.
• Hypotonic: Decreased tone.
• Variable: Inconsistent tone.

Spina bifida occurs at the spinal cord level during embryonic development, causing a strain in the vertebral arches (not closing at all).

Types of Spina Bifida

• Hidden (Occulta): No protrusion of organic tissue (mild).
• Cystic: Soft tissue protrudes.
• Meningocele: Protrusion of only the lining of the nerve bundle.
• Myelomeningocele: Protrusion of membrane and nerve tissue (serious, often requiring a wheelchair). Is often associated with cerebral palsy or mental retardation.