Glossary of Terms and Definitions

Cerebral Palsy Terms and Definitions

Anoxia – This is the acute stage of asphyxia, or the complete lack of oxygen to vital organs and/or tissue. Anoxia may cause the heart to stop beating, the lungs to stop working, as well as cell death, hemorrhages, or strokes in the brain.

Asphyxia – This means the lack of (or cutting off) of oxygen, leading to organ distress and/or failure. Birth asphyxia is commonly caused by constriction of the child’s neck or umbilical cord.

Aspiration – This is the entry of foreign material (such as solids and liquids) into the airway and lungs of a newborn child. This leads to choking and respiratory distress as the child begins breathing on their own. If not mitigated, aspiration may lead to respiratory failure, loss of consciousness, or even brain damage.

Assistive Technology – This can include items, equipment, or products that help to increase, maintain, or improve the functional capabilities of a disabled individual. Common assistive devices include wheelchairs, walkers, crutches, prosthetic limbs, orthotic devices, scooters, and canes, as well as devices such as hearing aids, computers used for communication, and more.

Ataxia – This refers to the lack of coordination with regard to body movements. Individuals with ataxic cerebral palsy may find it hard to walk properly or at a correct rhythm, as well as coordinate limb movement.

Baclofen – This is a medication that is used in the treatment of spastic cerebral palsy, which is characterized by stiff and uncontrollable muscle tone. It is a central nervous system depressant, and can help relax muscles as well as ease pain and inflammation. It must be prescribed with care (usually through the use of ) due to its propensity to cause respiratory distress.

Benzodiazepines – This is a class of medications that are used in the treatment of anxiety, insomnia, as well as the inability to relax. They are thought to be addictive, so doctors are encouraged to prescribe them prudently to people with cerebral palsy given the lifelong nature of this condition.

Botulinum Toxin (BOTOX) – BOTOX is a toxic byproduct produced by the bacterium Clostridium botulinum. While toxic, it can be used to help improve muscle tone in children with certain types of cerebral palsy. It may be used to ease the symptoms of blepharospasm or uncontrollable blinking, align misaligned eyes, relieve migraines, bring back some sense of control to a person’s shoulder and neck movements, as well as help with an overactive bladder.

Breech birth – This refers to a type of delivery where the baby is born presenting bottom (or feet) first, rather than the head. This usually affects anywhere from 3-5 percent of all pregnancies. A breech birth is considered potentially dangerous because there is an increased risk for the occurrence of fetal distress, asphyxiation, and umbilical cord prolapse.

Cephalopelvic disproportion – This is a term used to refer to childbirth where the baby’s head is too large to safely pass through the mother’s pelvis. This condition generally always necessitates a cesarean section delivery in order to avoid serious injuries.

Chorea – This refers to a series of unpredictable and irregular movements (often affecting the shoulders, hips, and face) which are due to permanent damage or malformation in an area of the brain known as the basal ganglia.

Claim – This is used to describe your right to seek compensation for your losses following any injury that a person suffers. Claims can be settled between parties, or can be litigated in court.

Clonus – This refers to a form of muscle contraction and relaxation with involuntary, jerky calf muscle movements that can be seen in children with cerebral palsy when asked to place their toe on the floor without having their heels touch the ground.

Cognitive – This refers to neurological activities connected with the brain, or any aspect of brain function. Cognitive impairment is usually a hot-ticket issue with people living with cerebral palsy, given the brain damage that they suffered which preceded their condition. It may manifest in forgetfulness, erratic and unpredictable mood swings, sadness, depression, anxiety, and diminished social skills.

Contingency Fee – Attorneys who handle cerebral palsy birth injury cases operate on a contingency fee basis. Under this type of fee agreement, the plaintiff (victim) never pays their attorney out of pocket. If the case is successful, attorneys fees are taken out of the settlement amount. If the case is unsuccessful, the plaintiff walks away without owing a penny in attorneys fees.

Contracture – This refers to the shortening of muscles due to a number of factors such as poor muscle development or an increase in muscle tone due to a brain injury. This causes limited range and movement, and is seen mostly in those that suffer from spastic cerebral palsy.

CT Scan – This is a type of imaging procedure where doctors use X-rays as well as a specialized computer to look at what’s going in your body. It can be done on any part of the body, and it is more detailed than an X-ray.

Defendant – This refers to the negligent party (as opposed to the plaintiff [i.e., the victim]) in legal claim such as a birth injury lawsuit. There may be many defendants, and they may have varying levels of blame or responsibility with regard to the negligent act.

Dorsal – This refers to the back of an object or person. In regard to cerebral palsy, dorsal may refer to a type of surgery (Selective Dorsal Rhizotomy) where surgeons make incisions into the back and cut specific sensory nerve fibers near the spinal cord. This surgery is done to help improve a person’s range of movement.

Dysarthria – This refers to a speech disorder that is seen in children who have poor muscle tone, such as in those with cerebral palsy. It presents as poor word formation and pronunciation, slurred speech, slow speech and tone, as well as poor breathing.

Dyskinesia – This refers to involuntary, abnormal, or uncontrolled movements that can either affect a single body part (such as the head or arm), or spread in a wave-like fashion to affect all facets of the body.

Epilepsy – This is a condition that presents with seizures due to abnormal and excessive brain activity. There is no known cure for epilepsy, but it can be treated and managed successfully with anti-seizure medication. Individuals with epilepsy may be prone to falling, so it is important that they are monitored closely at any given time.

Gait – This refers to a person’s manner of walking. In those with cerebral palsy, gait may be irregular due to stiff and/or shortened muscles, or slow due to loss of muscle tone.

Gross Motor Function Classification System (GMFCS) – This is a system which seeks to categorize the fine motor skills displayed by a newborn child. The GMFCS has 5 levels of severity.

Hemorrhage – This refers to any form of uncontrolled internal bleeding. The cavities between biological tissue are supposed to remain clear, but blood vessel trauma can lead to unintended blood flow into these spaces. Hemorrhages may cause irreversible brain damage that can lead to cognitive and motor function complications.

Hippotherapy – This is a form of therapeutic play involving equine animals such as horses or ponies. Unlike basic horseback riding, hippotherapy uses the movement of the horse in order to effect neuromuscular development by having the child adhere to or match the horse’s rhythm, tempo, gait, and repetition. If done for a sustained amount of time, it can improve endurance, control, strength, coordination, balance and visual cues.

Hydrocephalus – This is fluid buildup which occurs deep inside brain cavities. It causes an enlarged head and constant headaches, and may cause brain damage if left untreated. However, hydrocephalus may resolve on its own in a few months.

Hypertonia – This refers to a form of cerebral palsy which manifests in stiff muscle tone. Individuals with hypertonic CP usually have outstretched or awkwardly bent limbs due to excessive muscle tone caused by the mix-up of neural messages from the brain. This condition can make it difficult to impossible for individuals to clench their fist, walk and bend their knees, as well as have a good amount of balance while standing or walking.

Hypotonia – This refers to the lack of muscle tone seen in children who develop a certain type of cerebral palsy. Children who have hypotonic cerebral palsy exhibit decreased muscle tone to the point where they appear “floppy” and may have difficulty holding their hands up, standing, and/or walking in coordinated movements.

Hypoxia – This is the insufficient supply of oxygen to brain tissue, leading to brain cell death. Hypoxia is usually caused by fetal distress as a result of delivery room trauma or the failure of doctors to act promptly to prevent complications.

Hypoxic-Ischemic Encephalopathy (HIE) – This is a type of brain damage in newborns caused by a lack of oxygen reaching the brain, compounded by low blood flow to vital organs. It causes tissue death, and may result in irreversible brain damage.

In Utero – This literally means “in a womb,” but it can also be used to refer to the state of a fetus or embryo. Children born with cerebral palsy may have developed the condition while still in the womb by way of an infection, or on their way out of the womb due to things like hypoxia or the use of excessive force during delivery.

Intraventricular Hemorrhage (IVH) – This refers to bleeding into structures found in the brain known as ventricles. These are usually grooves found within brain tissue, and an intraventricular hemorrhage can kill off brain cells that are needed for the transmission of impulses that tell limbs to move in a certain way. This kind of bleeding can occur in arteries or veins, with the former being much harder to stem or control.

Jaundice – This is the yellowing of the skin and the eyes due to the buildup of bile metabolites (known as bilirubin) in one’s blood. Jaundice may be due to an infection, a blood disorder, or certain medication. In addition, it may be caused by birth injury, causing the blood to release this compound in dangerous amounts.

Kernicterus – This is a brain disorder that occurs when jaundice is not treated quickly enough. It literally means “yellow kernel,” a reference to the yellow staining of brain tissue that is seen in children with the condition. It is usually diagnosed shortly after a baby develops jaundice, and it is usually caused by the buildup of a chemical known as bilirubin. Kernicterus has been shown to lead to intellectual disabilities, vision problems, the yellowing of teeth, as well as hearing problems.

Klumpke’s Palsy – This is a type of pareses (usually temporary) resulting from a birth injury involving the brachial plexus nerves. It usually develops due to a stretching injury such as in the case of doctors using clamps to pull the baby out of the womb or odd positioning of an arm during labor. It occurs in around 4 in every 1,000 births, and may resolve before the baby reaches its second birthday.

Lawsuit – This refers to a legal complaint that has progressed to litigation. Cerebral Palsy lawsuits may be resolved via settlement negotiations, through mediation, or by being heard by a judge and jury.

Liability – This is a legal term that essentially translates to fault, or more-accurately, responsibility. Liability can be assigned to multiple parties, often by assigning an percentage of fault to each party.

Magnetic Resonance Imaging (MRI) – This is imaging technology which uses giant magnets, through which currents pass, in order to create a computerized image of what’s going on inside a person’s body.

Malpractice – This refers to the improper, illegal, or negligent professional activity or treatment (see medical malpractice).

Monoplegia – This is a form of cerebral palsy which affects a single limb (usually one arm). Monoplegia is considered to be a relatively-mild form of cerebral palsy with an excellent prognosis going forward.

Necrotizing Enterocolitis – This is a disease which causes the death of intestinal tissue in babies that are born prematurely. Necrotizing enterocolitis presents as colon inflammation, bloating, and the vomiting of bile, and is thought to be due to the invasion of certain bacteria that cause a localized infection.

Negligence – Negligence can be thought of as someone’s failure to use reasonable care, and frequently results in injury or other damages.

Neonatal – This is a term that is used to refer to the first month after the birth of a child. During this period, children must receive appropriate and specialized care to prevent potentially life-threatening health complications.

Neuroplasticity – This is the ability of the brain to rewire itself to compensate for faulty neural pathways that have become obsolete due to injury, infection, or genetic causes. It is seen as brain matter growth, the growth of blood vessels in a particular region, as well as the proliferation of cells within a certain area of the brain.

Nuchal Cord – This refers to the wrapping of the umbilical cord around a fetus’ neck in utero. Nuchal cords can be deadly as they can occur during delivery, potentially cutting off vital blood and oxygen supply, leading to fetal distress and brain cell death.

Paralysis – This refers to the inability to move a muscle or muscle groups due to muscle function loss. Individuals experiencing paralysis may be unable to control muscle movement, and may also suffer loss of feeling.

Perinatal – This refers to the weeks leading up to (and after) birth. This can be anywhere from the 20^th to the 28^th week before the baby’s delivery, and up to a month after birth.

Periventricular leukomalacia (PVL) – This refers to white matter trauma due to certain types of injuries such as a blow to the head, an infection, brain hemorrhage, or blood clot. This form of brain trauma affects the spaces in one’s brain which contain cerebrospinal fluid, and is diagnosed by the presence or observance of white matter tissue death followed by its necrosis. Periventricular leukomalacia often leads to the development of spastic cerebral palsy.

Placenta previa – This is a condition that causes the placenta to cover the opening of the mother’s cervix, making it difficult or impossible for the baby to pass through the cervix and into the birth canal during delivery.

Placental abruption – This is the detachment of the placenta from the uterine wall during labor. This type of injury usually leads to the baby being deprived of oxygen-rich blood, which may lead to brain damage.

Plaintiff – This refers to the person bringing forth a claim (i.e., the person who was injured by the negligent actions of the defendant).

Preeclampsia – This is a condition that affects some women after the 20^th week of pregnancy, characterized by high blood pressure as well as swelling of the hands and feet. If left unchecked, preeclampsia may lead to kidney or liver damage, as well as health risks to the unborn child.

Prognosis – This is a medical term which attempts to provide an expectation on the foreseeable course and scope of a disease or medical condition.

Rh Incompatibility – This refers to the differences in blood Rh type between the mother and the baby. This may cause hemolytic disease in a newborn (also known as Rh disease) which may cause anemia or the death of the child shortly after birth if severe.

Selective Dorsal Rhizotomy – This is a type of surgery that involves the severing of nerves found in the lower or upper back in order to improve an individual’s mobility. It is the most-studied surgery as far as pediatric CP surgeries go.

SEMRALASS – This is a type of surgery that is performed to enhance range of motion and better limb control in children with cerebral palsy. SEMLARASS stands for Single Event Multilevel Lever Arm Restoration and Anti Spasticity Surgery, and is generally performed before a child is over the age of 12.

Serial Casting – This is a procedure that is performed to help children and adults living with movement disorders such as cerebral palsy improve their movement range as well as flexibility and strength. Serial casting uses a number of casts which , over time, stretch and pull an individual’s contracted muscles/tendons in a gradual manner.

Stem Cell Therapy – This is a type of treatment which involves the harvesting, culturing, and eventual reintroduction of specialized stem cells which can grow into any organ or biological agent under the right condition. Scientists and doctors are looking into stem cell therapy to help regrow new cells in areas of the brain where individuals with cerebral palsy have suffered some kind of trauma or infection, leading to the development of their condition.

Strabismus – This is a condition that causes both eyes to look in different directions. It is thought to be caused by poor eye muscle control, a phenomenon that is often seen in children born with cerebral palsy. Children who develop this condition may need to wear an eye patch to train the weak eye’s muscles to work more-efficiently.

Tetraplegia – This is a form of cerebral palsy that results in partial or complete loss of function of all limbs, but less-so with the head or neck.

Tremor – This refers to the uncontrolled shaking of a body part. Tremors are typically seen in those with ataxic cerebral palsy, and affected individuals may find it hard to perform activities such as tying their shoelaces or holding a spoon.

Ultrasound – An ultrasound is a form of medical imaging which uses sound waves moving at a high frequency to transmit live images from within a person’s body. In medical lingo, an ultrasound is also called sonography, and comes from radar or sonar technology.  One advantage of an ultrasound is that it does not use radiation, making it safe for pregnant women wanting to see the development of their baby in the womb.

Uterine rupture – This refers to the tearing of uterine tissue, causing its contents to spill out into the body. This is a dangerous complication which can lead to blood loss as well as birth complications where the baby doesn’t receive sufficient oxygen for the duration of the delivery.

White matter – This is a part of the brain that consists of myelinated nerve fibers, which are usually white in color. White matter is responsible for information processing, the transmission of nerve impulses, as well as the regulation of axonal nerve signals. White matter lesions or cell death leads to behavioral and neurological issues such as the development of cerebral palsy.