BBC News reported yesterday that a young boy has received a £10 million compensation package as a result of medical errors at the Harrogate Hospital in 2008 resulting in dyskinetic cerebral palsy.
The Claimant, now 6-years-old, suffered distress for a long period of time during his delivery and was born in poor condition requiring resuscitation. He is likely to have suffered from a period of hypoxia (oxygen starvation) before birth which the Harrogate Hospital medical team should have identified through, amongst other methods, electronic fetal monitoring (commonly described as CTG). As a result of this poor care, the Claimant is unable to sit without help, has no independent mobility, cannot feed himself and is unable to speak. The damages are for his lifelong care and rehabilitation.
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 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.
A video showing 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.
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.
A video showing an example of a child with spastic 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.
A video showing an example of a child with ataxic cerebral palsy can be found here:
In addition, some children may suffer from mixed cerebral palsy with some or all of the above types.
Clinical Negligence and Cerebral Palsy
Like dyskinetic cerebral palsy, both spastic and ataxic cerebral palsy can be caused in the period before a baby is born because of a period of hypoxia. In some situations, cerebral palsy can be avoided if a problem with the baby is identified before any injury is caused. CTG monitoring will, for example, provide information to the midwives and doctors about a baby’s heart-rate. If it is beating too fast (tachycardia) or too slow (bradycardia) for some time, without recovering to a normal level, it may be in distress, which should alert staff to at the very least consider expediting the delivery, for example, by proceeding to a forceps or caesarean section delivery.
If you think you, or your child, may have suffered an injury as a result of negligent medical treatment and would like to speak with a member of the Lester Morrill clinical negligence team, please call on 0113 245 8549 or contact us by email firstname.lastname@example.org .