Cerebral Palsy

Cases involving Cerebral Palsy are extremely complex due to the number of issues that need to be investigated and considered. We recognise that parents of children with Cerebral Palsy come to us for a variety of reasons and that when things go wrong during the birth, the days, weeks and months following can be a confusing and traumatic time. It is common for parents not to be able to remember very much about what happened during the labour and delivery. But that does not matter as we will do all we can to help you to find out what may have gone wrong and to ensure that regardless as to whether there is a legal claim or not, you have a greater understanding of what happening during and after your child's birth. This will involve our specialists reviewing and analysing the medical records, CTG traces and scans available to find out when things started to go wrong and what was or was not done. The Bond Pearce team has both midwives and lawyers experienced in Cerebral Palsy cases and as such they have the expertise to help you each step along the way.

Time limits
Unlike many other cases involving medical accidents and personal injuries, time limits for children such as those with Cerebral Palsy run from the child's birth date. Because the case is brought on behalf of the child, the usual 3 year time limit does not start until the child's 18th birthday. They therefore have until the age of 21 to bring a claim. However there are exceptions to this too. Where a person does not have the mental capacity to understand the process and who will never be capable of managing or administering their own affairs then time limits do not apply. This can be the case in Cerebral Palsy cases where the damage to the brain has resulted in severely diminished mental capacity.

Funding
With clinical negligence cases involving Cerebral Palsy public funding is available. This was previously known as Legal Aid.

What is Cerebral Palsy?
Cerebral Palsy is a term used to describe damage to the brain which usually occurs before, during or shortly following birth. "Cerebral" refers to the brain and "Palsy" to a disorder of movement or posture.

Cerebral Palsy is caused by damage to the part of the brain which controls our motor functions and muscle tone. Symptoms of Cerebral Palsy differ from person to person and can depend on which part of the brain has been affected and how badly it has been affected. The main symptoms of Cerebral Palsy involve the tone of the muscles. Muscle tone in children with Cerebral Palsy may be too tight, too loose or floppy or a combination of both. Symptoms can include muscle spasms or full seizures of the body, involuntary movement of limbs and muscles, inability to walk or move the body independently, difficulty with fine motor tasks, difficulty maintaining balance or walking and impairment of basic communication abilities such as sight, speech and hearing.

In addition to disorders of movement, children with Cerebral Palsy often have other medical disorders caused by more widespread damage to the brain. These include such things as learning impairment, visual impairment and squints, hearing and speech problems, behaviour problems and epilepsy. Early signs of Cerebral Palsy usually appear before three years of age. Infants with Cerebral Palsy are frequently slow to reach developmental milestones such as learning to roll over, sit, crawl, smile or walk.

Types of Cerebral Palsy
Cerebral Palsy can range from mild to severe. There are three main types of Cerebral Palsy:

Spastic Cerebral Palsy:
Children with spastic Cerebral Palsy have stiff and jerky movements caused by muscles which are too tight. This causes particular difficulties when moving from one position to another or letting go of something held in their hand. More than half of those children with Cerebral Palsy have this form making it the most common type.
Ataxic Cerebral Palsy:
Poor coordination of movements and low muscle tone are the main characteristics of Ataxic Cerebral Palsy. Children with this particular form of the condition look very unsteady and shaky. They experience a lot of shakiness the majority of the time, like a tremor. This can become more pronounced when they are trying to perform fine movements such as turning the page of a book or writing. Poor balance and unsteadiness when walking are also characterised by this form of Cerebral Palsy.
Athetoid or Dyskinetic Cerebral Palsy:
This is a mixture of muscle tone where the muscles are sometimes too tight and sometimes too loose. Children with athetoid Cerebral Palsy tend to make involuntary movements as their muscles change from floppy/loose to tight in a way that is difficult for them to control. They may have trouble holding themselves in an upright, steady position for sitting or walking, and often show lots of involuntary movements of their face, arms and upper body that they don't mean to make.
Mixed Cerebral Palsy:
This occurs when the muscle tone is too low in some muscles and too high in other muscles.

The areas of the body that are affected by Cerebral Palsy depend on the damage to the brain and the severity of that damage. These are classified as:

Quadriplegia: When Cerebral Palsy affects all four of limbs. This will mean that children with quadriplegia have trouble moving all the parts of their bodies, their face and trunk as well as their arms and legs, and may need a wheelchair to get around. Because of the problems controlling the muscles in their face and upper body, they also have trouble talking and eating
Hemiplegia: Hemiplegia means that the Cerebral Palsy affects only one side of the child's body. For example the right arm and leg or the left arm and leg are affected. The other side of the child's body works isn't affected.
Diplegia: With Diplegia only the two lower limbs are affected and the arms are either slightly affected or not at all. Those with diplegia often have good upper body control and are ably to hold themselves upright with good use of their arms and hands.

What causes Cerebral Palsy?
There are many causes of Cerebral Palsy most of which occur before birth or during pregnancy. However the majority of Cerebral Palsy cases with which we deal involve damage to the baby's brain during childbirth. This is usually as a result of a lack of oxygen supply to the baby, trauma to the head during labour and delivery or poor flow of blood reaching the fetal or newborn brain. Poor pre-natal care can also be a factor.

Some of our cases have involved the following medical errors which have led to Cerebral Palsy:-

Medical staff failing to respond appropriately to changes such as dips in the fetal heart rate which can indicate the baby in distress
Failure to perform a caesarean section where there are clear signs of fetal distress
Failure to detect a prolapsed umbilical cord where the umbilical cord has slipped out through the opening cervix and down into the birth canal before the baby has left the womb cutting off the blood and oxygen supply to the baby
Baby left in the birth canal for too long resulting in a lack of oxygen to the brain
Excessive use of vacuum extraction which can also cause trauma to the baby's head and face
Improper and/or aggressive use of forceps causing nerve damage, bruising and head injuries
Failure to plan a caesarean section for a potentially large baby - a large baby can cause problems for a vaginal delivery and delays in delivery can result in oxygen starvation as previously mentioned
Failure to respond to the mother's changing medical conditions such as high blood pressure or any infections
Not treating appropriately or recognising a baby's seizures following delivery
Not diagnosing or treating jaundice
Failure to diagnose meningitis and then treat appropriately
Failure to diagnose and treat hypoglycaemia

Sometimes the cause of Cerebral Palsy is not identifiable. But we aim to ensure that as a result of our investigations you have a greater understanding of what happening during and after your child's birth.