Understanding Spastic Cerebral Palsy from Our Oregon Birth Injury Lawyers

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Spastic Cerebral Palsy From Oregon Birth Injuries


Understanding spastic cerebral palsy starts with understanding cerebral palsy in general.  While there are many things on the mind of parents, the health and well-being of their child is at the forefront. Parents spend countless hours of their time and money trying to make sure their child is healthy and happy. What happens though when they are told their child is sick? What if their child has a condition that is permanent? This can cause untold emotional pain and suffering as well as financial strain on their bank accounts. One of the most difficult diseases that can hit a family is cerebral palsy.


Cerebral palsy can affect every aspect of daily life not just for the child but for the caregivers as well and depends on the severity of the condition as well as the type. Cerebral palsy is classified into four categories, the most common of which is spastic cerebral palsy. This guide is intended to provide an overview of spastic cerebral palsy and outline some treatment options. It is not meant to replace medical advice of a doctor or be used to diagnose cerebral palsy.


How is Cerebral Palsy Defined?


To better understand the overall picture, it is important to begin with this question: What is cerebral palsy? Cerebral palsy is a group of disorders that affects movement, posture, or muscle tone. It is the most common disability in childhood affecting the ability of children to move independently. If you break down the name, “cerebral” refers to the brain and “palsy” refers to decreased strength of difficulty using muscles. So essentially this is a pathology where damage to the brain has taken place and that damage causes weakness or difficulty using certain muscles.


The damage done to the brain is most often permanent and may be mild to severe. Signs and symptoms of cerebral palsy may not become apparent until months after birth when the child fails to achieve significant milestones such as sitting independently or walking independently. It is important to monitor the child’s progress with these milestones because the sooner any deficiencies are identified the sooner a possible diagnosis can be made and treatment can be rendered.


Prevalence of Cerebral Palsy in the United States


Cerebral palsy is one of the more common pathologies affecting movement in children. It occurs to children all over the world and much research into the epidemiology of cerebral palsy has been performed. According to research, children born with cerebral palsy account for every 1.5 to 4 per 1000 live births worldwide and around 3.1 to 3.6 per 1,000 live births in the United States.

The most common type of cerebral palsy is spastic cerebral palsy. According to research, spastic cerebral palsy accounts for roughly 80% of all cases and occurs in every 1.3 to 2 per 1,000 live births. When broken down even further, bilateral spastic cerebral palsy accounts for 0.8 to 1.5 per 1,000 lives births while unilateral spastic cerebral palsy accounts for 0.1 to 0.6 per 1,000 lives births. There is no significant difference between rates of cerebral palsy in males versus females. However, there is data to suggest that race may play an issue. Non-hispanic black children are 80% more likely to have cerebral palsy than among non-hispanic white children, and 50% higher than among hispanic children.


What are the Known Causes of Cerebral Palsy?


While there is no direct cause of cerebral palsy, there are many factors that can lead to its development. The most important thing to consider is whether the damage to the brain occurred during or before birth, or if it happened after birth. If the damage happened prior to birth or during birth it is considered to be congenital. If the damage took place 28 days after birth, it is said to be acquired. The majority of the cases of cerebral palsy are congenital in nature and while there is no specific cause, many risk factors have been identified. They include:


  • Birth complications such as detachment of the placenta, uterine rupture, and problems with the umbilical cord disrupting blood supply to the baby can result in CP
  • Multiple births – having twins increases the risk of CP, but triplets or more greatly increases the risk.
  • Premature birth – There is a high risk of CP for births before week 37 of pregnancy.  This risk significantly increases for a child born before 32 weeks.
  • Low birthweight – Children who are born less than 5.5 pounds and especially for those who weigh less than 3 pounds 5 ounces at birth are at a higher risk for having cerebral palsy.
  • Infection during pregnancy – These can lead to inflammation and brain damage to the unborn child. Viruses such as chickenpox, rubella, and cytomegalovirus as well as bacterial infections of the placenta or fetal membranes may also cause cerebral palsy.
  • Assisted reproductive technology infertility treatments – Because infertility treatments increase the risk of premature births and multiple births, both which carry increased risks of CP, IVF treatments similarly increase the risk.
  • Jaundice and kernicterus – Jaundice is a medical problem when a chemical called bilirubin shows higher than normal levels. If left untreated, jaundice causes kernicterus which has been linked to cerebral palsy as well as other conditions due to damage to the brain from the caustic bilirubin.


Cerebral palsy that develops 28 days following birth is classified as acquired cerebral palsy. occurs when there is damage to the brain that. The most common causes of acquired cerebral palsy are head trauma such as that caused by a  motor vehicle accident or child abuse, disruptions of blood supply to the brain for reasons such as stroke or abnormal clotting, and infections that target the brain such as meningitis or encephalitis.


Understanding the Different Types of Cerebral Palsy

Cerebral palsy is classified according to how it impacts the child’s movement. Three characteristics are taken into account when making a diagnosis, these are spasticity, dyskinesia, and ataxia. These characteristics are then used to classify cerebral palsy as:


  • Spastic cerebral palsy
  • Dyskinetic cerebral palsy
  • Ataxic cerebral palsy
  • Mixed cerebral palsy

Understanding Spastic Cerebral Palsy Due to Oregon Medical Malpractice


Spastic cerebral palsy is the most common type of cerebral palsy and is characterized by high muscle tone, referred to as spasticity, which makes movements difficult. Movements may appear constrained or over-exaggerated due to the muscle tightness. Depending on where the damage is in the brain, the child may exhibit spasticity in different regions and the severity may vary. 


There are three major categories of spastic cerebral palsy, they include:


  • spastic diplegia
  • spastic hemiplegia
  • spastic quadriplegia


Depending on what subset of cerebral palsy a person has, it could affect treatment and how that person will have an ability to function.  More information about the three subsets includes the following:

Spastic Diplegia


Spastic diplegia is a very common type of cerebral palsy and occurs when only the child’s legs are affected. Symptoms of spastic diplegia include tightness in bilateral leg muscles, most notably hip adductors and hamstrings. These deficits may not be noticed until the child begins to crawl or walk. 


Early warning signs include the child preferring to sit in a “W” position because this puts less pressure on the tight muscles as well as the child pulling his or herself by using their arms instead of their legs when crawling. Children with spastic diplegia often have difficulty with walking and many require assistive devices such as pediatric walkers or braces.


Spastic Hemiplegia


Spastic hemiplegia is not as common as diplegia but still accounts for approximately 20-30% of cases. Usually, this type of cerebral palsy affects one side of the body, for example the right arm and right leg, and usually the upper body is more affected than the lower body.  Common issues seen with this type of cerebral palsy include tightness in the biceps and hand muscles. 


Children with spastic hemiplegia often have difficulty holding and manipulating objects with their affected arm and often times prefer to use their non-affected arm for all activities, which can further decrease the function of the affected arm.


Spastic Quadriplegia

This is arguably the most severe type of cerebral palsy as it has the largest impact on the health and function of the child. Spastic quadriplegia is characterized by the presence of high muscle tone all 4 limbs as well as the trunk and face. 


Children with spastic quadriplegia often fail to progress through the normal childhood milestones such as independent sitting, crawling, and walking. The majority of them are confined to a power wheelchair and require assistance for even the most basic activities such as feeding and bathing. These children also have a much higher risk of having intellectual disabilities and a shorter life expectancy, along with other complications.


If you believe your child was diagnosed with cerebral palsy due to an incident of Oregon medical malpractice by a doctor, nurse, hospital, or practice group, ask our Oregon medical malpractice lawyers to take a free review of your case.  Even if you are not sure why your child developed cerebral palsy, or if a hospital or doctor told you why they believe it happened, always have our Oregon medical malpractice lawyers review what happened.


Treatment for Spastic Cerebral Palsy


It is important to note that there is no cure for cerebral palsy. Treatments are designed to optimize physical and mental function and to address secondary issues that arise from the effects of cerebral palsy. 


Medication Use


One line of treatment for spastic cerebral palsy is pharmacologic treatment. Medications such as baclofen can be used to decrease the tone and therefore improve the ease of movement. In some cases, doctors may choose to implant a device that can provide a steady drop of baclofen when taking it orally is not feasible or effective. 


Other medications such as botox can be injected locally to cause tight muscles to relax.  Some children may require surgeries such as tendon lengthening procedures which can increase the flexibility of tight muscles when all else fails.


Physical Therapy, Occupational Therapy, and Speech Therapy


The mainstays of treatment for spastic cerebral palsy are physical, occupational, and speech therapy. Physical therapy and occupational therapy usually begin as soon as the diagnosis is made and aim to restore the normal flexibility and strength to muscles. Services usually take place 2-3 times each per week and last for many years as the child grows. Therapists work on stretching exercises and strengthening exercises as well as practicing walking, balancing. 


For example, a child with spastic diplegia may demonstrate a scissoring walking pattern which is caused by tight hamstrings, hip adductors, and calves. In this case, therapy would be targeted at stretching of the hamstrings, adductors, and calves as well as strengthening muscles including the quadriceps and hip abductors which are important for normal walking.  


In children with spastic quadriplegia, the deficits are more severe and therapy must address more factors. Usually, these children have similar deficits in their legs as children with spastic diplegia, however they also have spasticity in their arms, trunk, and neck. Tightness in the biceps, forearm, and hand muscles are common as well as tightness in neck muscles such as the sternocleidomastoid which can cause difficulty turning the head. Stretches would be targeted at these muscles and strengthening of the gripping muscles and neck muscles would be indicated. 


It’s also important to work on balance and ambulation with these children. The life span of an individual with spastic quadriplegia drops significantly and complications/co-morbidities increase drastically when they are non-ambulatory so anything that can be done to promote independent walking is very important to their well being. Families are taught how to perform certain stretches and exercises on a daily basis to maximize the benefit of therapy. Oftentimes, therapists practice and educate in the use of assistive devices like walkers and braces.


Speech therapists help to improve the child’s ability to speak or can train the child and parents in use of communication devices when necessary. Many children have speech deficits associated with cerebral palsy and benefit from speech therapy.


These therapies are available through a national law called the Individuals with Disabilities Education Act (IDEA). It provides for services from birth through 21 years of age to and is open to children who have cerebral palsy as well as other pathologies. For children from birth through 3 years old, early intervention services provide physical, occupational, and speech therapies usually in the home. From ages 3 to 21, these services are usually performed in the school setting either at a mainstream school or a specialized school for children with disabilities.


Frequently Asked Questions About Spastic Cerebral Palsy


1) When should I go to a lawyer if my child has been diagnosed with spastic cerebral palsy?


As soon as you can.  While there really is no direct cause for cerebral palsy, one thing is certain: Oregon medical malpractice could cause cerebral palsy.  So even if a doctor or healthcare provider explains why your child may have developed spastic cerebral palsy, that could just be a coverup.  And often times it is.  Cerebral palsy cases are very significant types of cases which could lead to multi-million dollar settlements or awards.  This is because the CDC estimated the lifetime costs of a child with cerebral palsy is over a million dollars—that is just the costs!  The pain and suffering is another huge factor and, depending on the subset of spastic cerebral palsy, this pain and suffering could be massive as well.  Insurance companies and healthcare providers know this and will do everything in their power to make you believe that your child’s cerebral palsy was caused by a “natural” consequence of birth, or due to genetic.  Do not believe that at face value.  Ask our law firm for help and we will conduct an investigation what happened, possible with an expert if we accept your case.  This is particularly true if you had any complications regarding your labor and delivery.


2) How long do I have to file a spastic cerebral palsy case in Oregon?


Two years from the date of discovery of the medical malpractice malpractice, but in no event more than five years after the medical malpractice.  While there are some exceptions to this rule, particularly when a defendant fraudulently hides the medical malpractice, the extensions are not something to rely on.  Always ensure that your rights are protected and ask our Oregon medical malpractice lawyer for assistance.


3) How much does a spastic cerebral palsy lawyer cost?


Nothing upfront at Kuhlman Law!  We understand how expensive it is to have a child with cerebral palsy.  Our law firm will begin your representation and cover costs for medical records, experts, and court fees.  We only get paid attorney’s fees and get reimbursement for what we paid once we recover compensation from you in a settlement or court award.


Have More Questions About Spastic Cerebral Palsy?  Ask Our Oregon Cerebral Palsy Lawyer


If you or a loved one have been seriously injured or killed as a result of medical malpractice contact the Oregon Medical Malpractice Lawyers at Kuhlman Law at our number below or fill out the intake form.  We offer a free initial case evaluation and handle cases on a contingency fee which means that you pay no money unless we recover. 


Our law firm handles cases throughout the state including Bend and Portland Oregon, Redmond, Central Oregon, Sisters, Madras, Multnomah County, Deschutes County, Salem, Eugene, Corvallis, Lane County, Medford, Gresham, La Grande, Albany, Medford, Beaverton, Umatilla, Pendleton,  Cottage Grove, Florence, Oregon City, Springfield, Keizer, Grants Pass, McMinnville, Tualatin, West Linn, Forest Grove, Wilsonville, Newberg, Roseburg, Lake Oswego, Klamath Falls, Happy Valley, Tigard, Ashland, Milwakie, Coos Bay, The Dalles,  St. Helens, Sherwood, Central Point, Canby, Troutdale, Hermiston, Silverton, Hood River, Newport, Prineville, Astoria, Tillamook, Lincoln City, Hillsboro, and Vancouver, Washington.  


We also have an office in Minneapolis, Minnesota and take medical malpractice cases throughout the Twin Cities, including St. Paul, Hennepin County, Ramsey County, Dakota County, Washington County, Anoka County, Scott County, Blaine, Stillwater, and Saint Paul Minnesota.  


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