Cerebral palsy is a catastrophic injury that alters the lives of the child and his or her families forever. In many cases of congenital cerebral palsy, it is difficult to determine its cause and sometimes the cause may never be determined. Babies who suffer from a congenital malformation of the brain may suffer cerebral palsy unrelated to the birthing process. In some cases, the events leading to cerebral palsy are caused by unpreventable factors during fetal development. In other instances, cerebral palsy is the result of improper and untimely medical response to fetal distress.
Cerebral palsy is a neurological disorder that permanently affects an infant's nerves that regulate body movements and muscle coordination. Cerebral palsy is the abnormal control of movement and posture as a result of abnormal development or damage to the area of the brain that controls movement and posture. Four main categories of cerebral palsy include:
spastic cerebral palsy
athetoid cerebral palsy
ataxic cerebral palsy
mixed cerebral palsy
Spastic cerebral palsy involves abnormal stiffness and contraction of groups of muscles; Athetoid cerebral palsy involves the involuntary slow and uncontrolled movement of muscles; Ataxic cerebral palsy involves the loss of coordination and balance; and the mixed cerebral palsy involves a combination of spasticity and athetoid movements.
Prematurity, intrauterine growth restriction, intrauterine infection, coagulation disorders, multiple pregnancies, breech presentation and infants suffering from oxygen deprivation prior to birth (acute intrapartum hypoxic insult) are more susceptible to develop cerebral palsy after birth. Current criteria used to define 'acute intrapartum hypoxic insult' that may be the cause of cerebral palsy include:
Evidence of metabolic acidosis
Early onset of neonatal encephalopathy
Spastic quadriplegic cerebral palsy
Dyskinetic cerebral palsy
Exclusion of unrelated identifiable etiologies
One of the indicators commonly used to assess the infant's condition at birth is the 'Apgar Score'. The Apgar score evaluates the baby's heart rate, breathing, muscle tone, reflexes and skin color at 1 -5-10 minutes after birth. A low Apgar score indicates a potential underlying problem which is often associated with intrapartum ischemic encephalopathy. Babies diagnosed with cerebral palsy more often than not have a low Apgar score at birth.
Fetal asphyxia or intrauterine asphyxia is a common cause of long-term neurologic dysfunction. Prolonged and uncorrected fetal asphyxia leads to progressive cellular and tissue damage resulting in organ failure and ultimately fetal death in-utero or severe disabilities if the fetus is born alive. Damage to the fetal brain depends on the severity and duration of hypoxemia. Long term morbidity associated with Hypoxic-Ischemic Encephalopathy includes permanent neurologic damage such as cerebral palsy. Severe degrees of fetal asphyxia resulting from decreased cerebral perfusion is called 'Hypoxic-Ischemic Encephalopathy'. Uncorrected Hypoxic-Ischemic Encephalopathy can cause 'Neonatal Encephalopathy' which is a syndrome defined by disturbed neurologic function after birth. This syndrome includes:
Difficulty in initiating respirations
Difficulty in maintaining respirations
Depression of muscle tone
Depression of reflexes
Poor or absent Moro's reflex
Subnormal level of consciousness
Abnormal cry and suck
Stupor that develops within 72 hours after birth
Seizures (quite often within the first days of life)
Most families simply don't have the financial resources to cover all the expenses associated with caring for an injured child over his or her lifetime. If the child's injury was diagnosable, avoidable or preventable, or plainly resulted from a medical provider's mistake in handling an obstetrical condition, the parents and the child are entitled to receive compensation. If your child's condition was the result of medical negligence, we can help you assert your rights and get the compensation you deserve.
If the child's injury was the result of intrauterine fetal hypoxia (asphyxia), it was diagnosable, avoidable, preventable and treatable. The injury may be the result of a medical provider's mistake in handling an obstetrical condition. Your child and you as parents of the child are entitled to receive compensation. If your child's condition was the result of medical negligence, allow Dr. Borten and the Boston area medical malpractice attorneys at Gorovitz & Borten help you assert your rights and get the compensation you deserve.
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