Paralysis from non-congenital causes: malpractice and injury

Cerebral palsy and brachial plexus palsy

Cerebral palsy consists of a wide range of neurological damage caused by an injury to the developing brain. The injury, which is not progressive and is irreversible, may occur before, during or after birth.
The causes are manifold. Prenatal paralysis, i.e. before birth, may be due to genetic malformations, ischaemia and hypoxia, i.e. reduced blood and oxygen supply to the foetal brain, maternal bacterial or viral infections and various toxic or chromosomal factors. Perinatal causes, i.e. those occurring between one week before and four weeks after birth, are usually due to cerebral haemorrhage or hypoxia and ischaemia in the fetal brain. Finally, postnatal paralysis can be due to head trauma, ischaemia and meningo-encephalitis.
The symptoms of cerebral palsy emerge during the first two or three years of life and affect motor function and posture. However, the severity of these disorders varies from case to case, as it depends on the extent of the brain damage. In some cases, there is only slight difficulty in walking or moving a limb; in other cases, it may become impossible to carry out normal acts of daily living.
Cerebral palsy can also cause other problems of varying degrees: speech disorders, intellectual deficits, sensory problems and swallowing disorders. In some cases, cerebral palsy leads to serious emotional damage, making interpersonal relationships difficult.
Cerebral palsy due to non-congenital causes can be the result of human error, i.e. negligence or incorrect manoeuvres on the part of medical staff during a very difficult labour or delivery. A macrosomic foetus, i.e. with an estimated weight of more than 4.5 kg, can become stuck in the birth canal; this can lead to hypoxia and ischaemia, with disabling consequences for the newborn.
Among birth-related diseases, brachial plexus palsy, also known as obstetric palsy, can occur during labour and difficult births. The brachial plexus is a bundle of nerves located in the neck and shoulders, which is responsible for the movement and sensitivity of the upper limbs. Damage to the brachial plexus impairs the motor function of the arms, leading to loss of sensation and partial or complete paralysis.