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Assistive devices help children with CP learn to walk.
Amos Morgan/Photodisc/Getty Images
Neurological injuries affect motor abilities, often leading to palsy, or paralysis in the affected muscles. A variety of palsy disorders affect infants and children. According to the Centers for Disease Control and Prevention, cerebral palsy is the most common disorder affecting the ability to move during childhood. Erb's palsy is a rare injury that occurs during childbirth, typically in high-risk situations. Cerebral and Erb's palsies are distinctly different from each other.
Cerebral palsy is a nonprogressive neurological condition that affects children anytime from before birth through the first five years of life. CP is a result of brain damage, and symptoms vary based on the area damaged. Bacterial infections, trauma, genetic mutation and decreased oxygen to the brain can cause cerebral palsy, though the cause is not always known. The four types of CP are spastic, athetoid, ataxic and mixed. Spasticity -- excessively tight muscles -- in the arms and legs limit mobility. Athetoid and ataxic CP involve involuntary movements affecting balance and coordination. Although CP is primarily a movement disorder, extensive brain damage can cause mental retardation, learning disabilities and vision, speech and hearing deficiencies.
Although symptoms of CP do not worsen, functional abilities are affected by the disease throughout life. Treatment for CP is based on individual symptoms. Oral medications are sometimes prescribed to decrease spasticity, but they are associated with significant side effects that often prevent long-term use. Physical therapy interventions address functional mobility with the use of assistive devices such as gait trainers and walkers. Orthotics -- splints -- are sometimes used to hold joints in proper position to improve alignment and decrease muscle tightness. Occupational therapy interventions improve a person's ability to perform daily tasks, sometimes by using adaptive equipment such as large-handled eating utensils. Speech therapists assist with communication deficits and swallowing function.
Erb's palsy is a rare neurological injury that occurs during childbirth due to excessive traction on the infant's head. Erb's palsy is one type of injury to the brachial plexus -- a group of nerves that travel from the neck through the front of the armpit. Nerves leaving the spine in the neck are stretched -- specifically C5 and C6 -- leading to motor issues in the shoulder and forearm muscles. The infant's arm rests next to his body, rotated inward and the elbow is straight. Hand function is normal. Symptoms of Erb's palsy do not worsen over time, but they might become more apparent as the infant ages and develops new motor skills.
Erb's palsy is treated based on the severity of nerve damage. Neurapraxia -- stretching of the nerves -- may resolve as soon as three weeks, restoring normal movement and strength in the arm. Nerve avulsion is the most serious injury, causing the nerves to become detached from the spine or torn at the top. Physical therapy interventions are prescribed early to stretch tight structures to prevent contractures and to strengthen muscles powered by the injured nerves. Severe cases of Erb's palsy require surgical intervention. Severity of nerve damage is typically determined at 3 months of age. Surgical consultation is indicated for children who cannot bend their elbows. Primary surgical intervention is performed to reconstruct damaged nerves. As the child ages, additional surgeries may be performed. Tendon transfers use tendons from nearby healthy muscles and connect them to muscles that are not working so functional abilities improve. Physical therapy interventions address range of motion and strength after surgery.
Cerebral palsy and Erb's palsy are neurological disorders with distinctly different characteristics. Erb's palsy causes movement disability in the arm only and typically affects only one side of the body. CP affects one or more extremities and, in some cases, the entire body. Erb's palsy only occurs from injury during childbirth, while CP can develop in the womb, during childbirth or in the first five years of life, and the specific cause is not always known. CP affects the brain, part of the central nervous system, which sends signals to peripheral nerves, telling the body how to move. Erb's palsy damages the peripheral nerves, affecting only the muscles directly supplied by these nerves. This disorder does not cause mental disabilities because the brain is not injured.