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Cerebral Palsy is a medical condition resulting in disorders of movement because of an injury to the brain. It is usually caused by problems at birth or by a severe infection. If you or your child suffers from cerebral palsy you may be able to claim substantial financial compensation if there has been sub-standard medical care that has led you or your child to suffer from an avoidable injury.
What is Cerebral Palsy?
Cerebral palsy is a condition that covers a wide range of symptoms stemming from an injury to a baby’s brain resulting in disorders in movement. Such an injury can, for example, affect muscle control and coordination, muscle tone, reflex, posture and balance. Patients with Cerebral Palsy may also suffer from visual, hearing, and developmental problems with intellectual impairment. It is usually a permanent and lifelong disability that requires specialist medical treatment and care.
Is Cerebral Palsy common?
With an increase in birth-related concerns lodged against the NHS (1,100 in 2015) more children are being diagnosed as suffering from Cerebral Palsy. Our specialist medical negligence team are expert Cerebral Palsy solicitors with substantial experience investigating and setting very high value claims.
Why we can help you.
The key for our clients is that Minton Morrill’s expert solicitors understand how devastating a diagnosis of Cerebral Palsy can be to the family of a young baby or child. Our team of Cerebral Palsy solicitors provide a bespoke and sensitive legal service working closely with clients and their family.
Minton Morrill’s expert medical negligence team of solicitors are recognised as leaders in Cerebral Palsy work. The practice is top-ranked in both Legal 500 and Chambers and Partners and all of our senior lawyers are panel members of the gold standard Action Against Medical Accidents (AvMA) accreditation scheme, which is a must-have for solicitors handling complex Cerebral Palsy cases. AvMA is the leading patient safety and justice charity in the UK.
Case studies setting out the types of Cerebral Palsy our solicitors have resolved are below. Of most importance to us is the feedback our clients have given about the service they have received. You can view these reviews by clicking here.
What causes Cerebral Palsy?
Cerebral palsy can be caused by a problem in the antenatal period, during the labour and delivery or after the birth in the neonatal phase. The most common (but not all) causes of cerebral palsy are:
If the mother of a baby is suffering from an infection (Group B Streptococcal or Herpes, for example) this can be passed onto to the baby before or during the labour. If infection is suspected, the mother may be given antibiotics to try and stop the baby acquiring the infection. If, after the delivery, the baby has contracted the infection it is crucial that this is diagnosed and treated as soon as possible. Without early treatment the infection is likely to worsen and cause serious damage to the baby’s brain.
- Oxygen starvation of the brain at birth.
This can happen for a number of different reasons; for example, the baby becoming stuck and squeezed in the pelvis just before delivery or the umbilical cord becoming twisted and wrapped around the baby’s neck. Monitoring of the baby’s heart rate should detect any distress associated with oxygen starvation of the brain. If this is identified, delivery of the child may be brought forward with an assisted delivery (forceps) or caesarean section.
Statistics suggest that around 70% of Cerebral Palsy brain injuries occur in the antenatal stage of the pregnancy, 20% during the labour and delivery and 10% caused by problems developing after birth.
Infection during pregnancy can have a devastating impact on a fragile foetus. German measles (Rubella) or Cytomegalovirus are just two examples of infections linked to the antenatal development of Cerebral Palsy brain injury. These viruses trigger the Mother’s immune system to attack the infection but this may also cause inflammation in the baby’s brain causing damage.
There are a number of different known causes of Cerebral Palsy that can occur after the baby is born. Meningitis, another infectious disease, is the most well known. Other causes are:
This is where a baby suffers from severe jaundice that, if left untreated, leads to a build up of unsafe levels of bilirubin in the blood that can result in permanent brain damage.
- Head Injury
Blunt trauma to a baby’s delicate head can cause permanent brain damage.
- Brain Haemorrhage or Stroke
Appropriate monitoring should identify the risk of a brain haemorrhage or stroke after a baby is born, particularly if the delivery was difficult, given both are high risk factors.
What are the different types of Cerebral Palsy?
- Dyskinetic (or Athetoid) Cerebral Palsy
Dyskinetic cerebral palsy causes involuntary and uncontrollable movement because of damage to the basal ganglia of the brain. This part of the brain is responsible for interpreting messages between the movement centre and the spinal cord. Different parts of the basal ganglia control different movements in the body and injury can cause different types of involuntary movements:
- Dystonia – twisting and repetitive movements caused by involuntary muscle contractions that often result in awkward postures and painful movements.
- Athetosis – slow, continuous, involuntary writhing movements, present at rest and made worse when attempts are made to move. Maintaining posture (i.e. sitting) is difficult.
- Chorea – brief, abrupt, irregular and unpredictable involuntary movement. This can affect various parts of the body including speech and swallowing.
Common symptoms associated with Dyskinetic Cerebral Palsy can include:
- A stiff or rigid body.
- Floppiness in the limbs.
- Problems with posture.
- Feeding difficulties.
Developmental delay and learning difficulties may also be seen to occur with this condition.
A video with an example of children with Dyskinetic cerebral palsy can be found here:
- Spastic Cerebral Palsy
The other more common type of cerebral palsy is called spastic cerebral palsy and is caused by damage to the motor cortex of the brain. The motor cortex is involved in the planning, control and execution of voluntary movements and injury to it, in this context, results in people suffering from hypertonia, or increased muscle tone, causing movements to look stiff and jerky. Spastic Cerebral Palsy accounts for around 70-80% of all children diagnosed with this condition.
The damaged motor cortex cannot properly control muscle movements and cannot turn the correct muscle groups on and off as required. It might, for example, turn different groups of muscles on at the same time (whereas a motor cortex without damage would turn off one group of muscles) or turn two muscle groups on simultaneously. Movement, therefore, becomes extremely difficult and, dependent on the damage to the motor cortex, can affect the arms and hands, legs and speech.
Developmental delay and learning difficulties may also be seen in some babies and children diagnosed with Spastic Cerebral Palsy.
A video showing an example of a child with Spastic cerebral palsy can be found here:
Spastic Cerebral Palsy is further sub-divided into different categories depending on the number of limbs and areas of the body it affects:
- Quadriplegic Cerebral Palsy
This condition is when all four limbs (both arms and legs) are affected. It is marked by stiff or permanently contracted muscles and largely affects the facial and core muscle groups.
The severity of Quadriplegic Cerebral Palsy will vary from child to child. Some are able to sit by themselves, walk short distances (possibly with an aid) and perform simple tasks whereas others may sadly require around the clock care for their lives.
Symptoms of Quadriplegic Cerebral Palsy usually become apparent from 3 months to 2 years of age. Parents may notice their baby suffering with limited control of their head and falling behind with developmental milestones: first crawling and walking, for example. The condition can also result in bowel and bladder problems because of muscular problems.
A video showing an example of a child with Spastic cerebral palsy can be found here:
- Diplegic Cerebral Palsy
This condition, also known as Spastic Diplegia or Bilateral Cerebral Palsy, causes tense muscles and spasms mainly affected the legs. The leg muscles become very tight, which, over time, causes a child’s joints to stiffen, meaning they cannot move very efficiently.
Common symptoms and characteristics of Diplegic Cerebral Palsy may include:
- Inability to crawl and reliance on upper limbs rather than legs to move.
- Unable to stand without assistance by aged 3 years of age.
- “Pigeon-Toed” walking.
- A “Scissor Gate” walk.
- Developing spastic hip disease.
- Inability to walk long distances.
- Muscles in the leg quickly going from stiff and rigid to floppy.
Most children with this condition are diagnosed at around 3 years of age.
A video showing an example of a child with Diplegic cerebral palsy can be found here:
- Hemiplegic Cerebral Palsy
Hemiplegia means paralysis on one half of the body. With Hemiplegic Cerebral Palsy a child will suffer paralysis on one side of the body opposite to the side of the brain where the injury occurred; left sided brain injury will, for example, cause right-sided paralysis.
Common symptoms and characteristics of Hemiplegic Cerebral Palsy may include:
- Stiff and weak muscles on one side of the body.
- One hand on the affected side constantly bunched up into a fist.
- Difficulty with walking and balance.
- Delay in fine motor skills developing.
- Delay in reaching milestones: sitting, crawling and walking.
- Higher risk of developing scoliosis (curvature of the spine).
A video showing an example of a child with Hemiplegic cerebral palsy can be found here:
- Ataxic Cerebral Palsy
The least common form of cerebral palsy is ataxia, which is caused by injury to the cerebellum, the balance centre of the brain that fine tunes movement. Ataxic cerebral palsy causes clumsy and jerky movements when attempting to perform voluntary movements, such as picking up objects, because of the interruption of smooth muscle control. It can also cause shaky movements and a tremor.
Common symptoms associated with Ataxic Cerebral Palsy can include:
- Walking with feet spread far apart.
- Difficulty bringing hands together.
- An unsteady gait.
- Trouble grasping objects.
- Over correcting movements.
- Difficulty with repetitious movements.
- Trouble with speech.
- Slow eye movements.
Most children are not diagnosed with Ataxic Cerebral Palsy until aged around 18 months old.
A video showing an example of a child with ataxic cerebral palsy can be found here:
Some children may suffer from mixed type cerebral palsy with some or all of the above conditions.
Are there any risk factors for Cerebral Palsy?
Yes, the following factors can sometimes increase the risk of a baby suffering from Cerebral Palsy:
- Premature birth – particularly if the baby is born before 32 weeks.
- Low birth weight – particularly if the baby weights less than 5.5 lbs at birth.
- When twins or multiple babies are delivered.
- Maternal age – particularly if the mother is over the age of 35 years of age.
- Maternal health – particularly if the mother has very high or low blood pressure.
- A complicated birth such as when the baby is in the breech position.
What treatment is available for Cerebral Palsy?
There is unfortunately no cure for Cerebral Palsy because the condition originates from a serious brain injury. Treatment instead focuses on managing the condition under the following broad aims:
- Controlling the main movement problems and preventing further deterioration.
- Alleviating pain.
- Encouraging independence and, where possible, self care.
- Optimising mobility.
- Encouraging social interaction with other children / adults.
- Help with communication and learning.
- Utilising technology.
A team of medical specialists are likely to be involved in the management of an individual with Cerebral Palsy. Whether or not there is a claim for compensation stemming from sub-standard medical care, it is likely that some of the following medical specialists will be involved in care:
- A Paediatrician to oversee care and treatment to a child.
- A Neurologist to input on the injury to the brain and the treatment this necessitates.
- An Orthopaedic doctor to help provide treatment for the bones and muscle groups.
- Physiotherapists to help exercise and strengthen muscle groups.
- Occupational Therapists to help utilise aids and equipment.
- Speech Therapists to help improve and maintain good communication.
- Special Education Teachers / Professionals to help with educational development.
- A case manager to implement and oversee a bespoke care and therapy regime.
With the input of a range of professionals, it may be that the child undergoes surgery to try and alleviate and improve their condition, for example, to lessen muscle tightness or correct bone abnormalities (scoliosis of the spine, for instance). Two types of operations are often considered:
- Surgery to bones or muscle groups, particularly for children with severe deformities that cause pain and hinder movement. Bones, joints, muscles and tendons can be shortened or lengthened with the aim of minimising pain and distress and promoting mobility.
- Surgery to nerves such as a selective dorsal rhizotomy. This procedure is utilised when other treatments have not worked so the nerves are cut to relax the muscle groups and to reduce pain. There are risks of numbness associated with these types of procedures so they are usually only considered in older children (3-12 years old) on a strict criteria basis.
Medication & Therapy
Some children may benefit from taking medication to reduce pain and help alleviate tight muscle groups affecting their movement. Paediatricians and treating medical teams will consider this.
Therapy is particularly important in children with Cerebral Palsy and often results in significant progress, both in terms of physical development and mobility, but also psychological well-being.
There are a number of different therapies. Examples include:
- Physiotherapy to strengthen and stretch muscle groups to help with and improve balance, co-ordination, flexibility and mobility. With a very young child, the focus will be on head and trunk control and rolling and collecting objects. As the child gets older, physiotherapy will then likely focus on strength and conditioning for walking and/or wheelchair control.
- Occupational therapy to utilise technological aids and equipment to help promote independence and work towards full participation at home, school and in the community.
- Speech and language therapy to help a child with limited muscle group control improve their ability to communicate with their family and peers. If spoken speech is not possible, focus will instead be directed at utilising computers and /or voice synthesisers.
- Recreational therapy such as horse-riding or art therapy to help a child’s motor skills (fine and gross), speech and language and crucially their emotional well being.
Can my child pursue a Cerebral Palsy Compensation Claim?
If you, your child or a child you know suffers from Cerebral Palsy and there are concerns about the standard of care at their birth or when they were a young child, we can help you.
Our expert Cerebral Palsy lawyers will investigate your concerns about poor medical care and assess whether any failings caused or led to the child suffering Cerebral Palsy. If we can establish failings in treatment we will liaise with the Hospital and seek a full admission of liability for their wrongdoing.
We will then look very carefully at the needs of the child and with input from you and the assistance of independent experts very carefully assess the needs of the child going forward. We call this stage of the medical negligence investigation quantum because we are quantifying what compensation should be paid to the injured child to make sure they have the requisite treatment and care to support them for the rest of their lives, including when parents are no longer able to provide this.
What compensation will be received?
Each case is different but Cerebral Palsy claims usually result in medical negligence compensation in excess of £1 million pounds, typically, somewhere in the region of £2 – £10 million pounds. The level of compensation is, however, increasing. Our specialist team are currently working on a circa £50 million claim where the child has a very high level of disability coupled with a long life expectancy.
When assessing the level of compensation we usually look at the following needs of the child/family:
- Professional Care (Past and Future)
- Occupational Therapy Needs
- Physiotherapy Needs.
- Speech and Language Therapy Needs.
- Accommodation (whether the family home needs adaption or a complete new house).
- Transport Needs (adapted vehicle, for example).
- Assisted Technology Needs (computers for communication, for example).
- Future medical treatment.
- The child’s loss of earnings.
- Court of Protection Costs.
- Case Management Costs.
A lifetime of such much needed extensive professional input, care and treatment like that described above underlines why Cerebral Palsy claims result in such high value compensation claims.
Click here to read our case studies for further information about compensation received.
Why should we pursue a Cerebral Palsy Claim?
A child with Cerebral Palsy is likely to require intensive support for the duration of their life. Sadly, this level of professional care is often unavailable through the NHS and many parents are unable to provide this level of care indefinitely, especially when they have work and other family member commitments. There is also the delicate question of who cares for a child when parents get older.
With successful Cerebral Palsy claims, there will be a system of care in place to help the child as they grow up. This network will be extensive and is likely to be run by a professional Case Manager who will liaise with all of the health care and other professionals in the network (rather than the child or their parents) to set up and organise treatment and therapy appointments. A Court of Protection deputy may also be involved to manage the compensation money received for the benefit of the child. This again takes the burden away from the family (if they prefer) from this task. Click here to read more information about our specialist Court of Protection department at Minton Morrill.
Making sure that the injured child has every opportunity to enjoy their life, pursue their goals and effectively manage their disability is crucial. Compensation can help them achieve this.
Finally, obtaining the truth about a medical error and making sure lessons are learnt from it is often one of the key objectives for pursuing a negligence Cerebral Palsy claim. Doctors and Hospitals rightly need to be held accountable to prevent the same mistakes happening to someone else.
Cerebral Palsy Compensation Claim Case Studies.
How can we pay for a legal investigation?
Legal Aid Agency public funding is available to investigate Cerebral Palsy claims. There are strict criteria to access this public funding. It must be shown that a baby suffered a severe neurological injury within the first 6 months of life and this has led to them suffering from a severe disability.
Our team of medical negligence experts will be able to review whether public funding is likely to be available and, if so, are vastly experienced at successfully applying for and obtaining legal aid.
If legal aid is not available, we offer No Win No Fee Agreements that can pay for the investigation of a medical negligence claim. Click here for further information about Medical Negligence funding.
If you, or someone you know, is suffering from Cerebral palsy because of negligent medical treatment and would like to speak with a member of the Minton Morrill clinical negligence team, please call on 0113 245 8549 or contact us via the form below.
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