Cerebral Palsy: A Case Study

Cerebral Palsy is one of the most common movement disorders, especially in children. Approximately 2.1 per 1000 births are diagnosed with this disorder (CDC 2013). Causes of cerebral palsy range from preterm birth and birth complications to poor genetics to hypoxia or inflammation in the newborn brain. Since many causes of cerebral palsy occur prenatally rather than postnatally or perinatally, and given that it is hard to isolate any one of these factors as the cause, it is very difficult to determine whether medical negligence or asphyxia during labour play a role (Perlman, 1997). (It should be noted that intrapartum asphyxiation is responsible for an estimated 1.6 out of 10,000 cases of neonatal encephalopathy (American College… 2003)). While
Babies that encounter a lack of oxygen prenatally, suffering from hypoxic-ischemic encephalopathy, can be treated with either whole-body cooling (WBC) or selective head cooling (SHC) as a means to prevent brain injury (Rutherford et al., 2005; Perlman, 2006; Jacobs et al., 2013; Shah, 2010). Post-birth hypoxic-ischemia is a dangerous condition that accounts for 15% to 28% of all cerebral palsy cases in children (Hagberg et al., 2001). With the use of SHC, a decrease in severe cortical lesions was observed (Rutherford et al., 2005). By temporarily inducing mild hypothermia (-34º C) in the head of a newborn, the negative impact of hypoxia can be reduced. Again, selective head cooling is not without its adverse effects. A recent review by Geurts et al. (2013) found that “therapeutic hypothermia” may lead to an increased risk of pneumonia and sepsis. Others have stated that selective head cooling in patients with brain injury can lead to electrolyte abnormalities (Polderman et al., 2001). The efficacy of this method is also dependent on the severity of the hypoxic-ischemia. There was a significant decrease in brain lesions to those infants who had minor hypoxia, but not in those who had a more severe form (Rutherford et al.,