The Story So Far… (PVL and CP)

So, Charlie has CP as a result of PVL damage.  What does this mean… (the world according to wikipedia)?

PVL- PeriVentricular Leukomalacia

Damage, normally due to hypoxia (lack of oxygen) to the brain, specifically the

Ventricles
Ventricles

white matter around the ventricles.  This damage process consists of stages- necrosis (cell death), resorption (removal) and finally scarring or cysts (space left behind).  The dura (part of the brain) is ‘bathed’ in oxygen rich blood- when that oxygen is ‘cut’ whole areas are unable ‘breath’- hence the cellular death.  Unfortunately premmie babies are most at risk of this condition.  As the process occurs over time it often means that the condition itself is not actively seen but the effect of it are surely felt.  It often leads to epilepsy or CP…

CP- Cerebral Palsy

CP refers to a group of movement problems due to brain injury.  It is a spectrum referring to a whole host of issues, it can be devastatingly catastrophic to mild functional disability.  It can be glaringly obvious to unbelievably hidden- in fact some individuals don’t even know they are affected until much later in life when age starts to bear its weight.

There are different types; spastic, ataxic and athetoid.

Spastic; quadriplegic, diplegic or hemiplegic, cerebral palsy refers to something that Charlie deals with every day- spasticity, or high muscle tone.  It can affect all limbs (quadriplegic), legs more than arms (diplegic) or one side of the body (hemiplegic). Charlie has spastic diplegic CP as all his limbs are affected although his legs are worse than his arms.

Ataxic; damage to the cerebellum- the coordination centre.  Ataxic CP tends to reduce tone rather than increase it.  However, as the ‘control centre’ is damaged it tends to create ‘noise’ on the movement pathways- this is often apparent as a tremor and tends to intensify the longer the movement is performed.

Athetoid; damage to the basal ganglia (control of voluntary movement and planned thought).  Athetoid CP tends to through both high and low muscle tone into the mix- it often shows as uncontrolled movement.

CP is generally a movement disorder- it can affect cognitive function (particularly in ataxic and athetoid CP where the ‘planning’ of action and thought is disrupted) but it does not necessarily restrict intellengence.  It may appear that someone with CP has learning disabilities in a broad sense but actually it may just be the facilitation of learning is not the same as someone with a disability.  Individuals may actually be ‘trapped’ within their condition- do them a favour, don’t disregard them- it may be that the method of communication may need altering but you might be surprised to know that those children prognosed as ‘will not be able to learn much or communiate’ can actually come good with the right method of communication- whether it be makaton, assistive technology or something else.  Try everything!

Neuro-plastisity shows us that we should not ‘write off’anyone too quick…

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