History of Cerebral Palsy
In the 1860s, an English surgeon named William Little wrote the first medical descriptions of a puzzling disorder that struck children in the first years of life, causing stiff, spastic muscles in their legs and, to a lesser degree, in their arms. These children had difficulty grasping objects, crawling, and walking. Unlike most other diseases that affect the brain, this condition didn’t get worse as the children grew older. Instead, their disabilities stayed relatively the same.
The disorder, which was called Little's disease for many years, is now known as spastic diplegia. It is one of a group of disorders that affect the control of movement and are gathered under the umbrella term of “cerebral palsy.”
Because it seemed that many of Little’s patients were born following premature or complicated deliveries, the doctor suggested their condition was the result of oxygen deprivation during birth, which damaged sensitive brain tissues controlling movement. But in 1897, the famous psychiatrist Sigmund Freud disagreed. Noting that children with cerebral palsy often had other neurological problems such as mental retardation, visual disturbances, and seizures, Freud suggested that the disorder might have roots earlier in life, during the brain's development in the womb. "Difficult birth, in certain cases," he wrote, "is merely a symptom of deeper effects that influence the development of the fetus."
In spite of Freud’s observation, for many decades the belief that birth complications caused most cases of cerebral palsy was widespread among physicians, families, and even medical researchers. In the 1980s, however, scientists funded by the National Institute of Neurological Disorders and Stroke (NINDS) analyzed extensive data from more than 35,000 newborns and their mothers, and discovered that complications during birth and labor accounted for only a fraction of the infants born with cerebral palsy — probably less than 10 percent. In most cases, they could find no single, obvious cause.
This finding challenged the accepted medical theory about the cause of cerebral palsy. It also stimulated researchers to search for other factors before, during, and after birth that were associated with the disorder.
Advances in imaging technology, such as magnetic resonance imaging (MRI), have given researchers a way to look into the brains of infants and children with cerebral palsy and discover unique structural malformations and areas of damage. Basic science studies have identified genetic mutations and deletions associated with the abnormal development of the fetal brain. These discoveries offer provocative clues about what could be going wrong during brain development to cause the abnormalities that lead to cerebral palsy.
Much of this new understanding about what causes cerebral palsy is the result of research spanning the past two decades that has been sponsored by the NINDS, the federal government’s leading supporter of neurological research. These findings from NINDS research have:
- identified new causes and risk factors for cerebral palsy;
- increased our understanding of how and why brain damage at critical stages of fetal development causes cerebral palsy;
- refined surgical techniques to correct abnormalities in muscle and bone;
- discovered new drugs to control stiff and spastic muscles and developed more precise methods to deliver them; and
- tested the effectiveness of therapies used to treat cerebral palsy to discover which methods work best.
Click here for more information about Cerebral Palsy from the National Institute of Neurological Disorders and Stroke
