Getting Answers About Your Child's Cerebral Palsy
There are many causes of cerebral palsy. In some unfortunate cases an identifiable cause will never be found. But one of the most common causes is from hypoxia (reduced oxygen flow) and/or ischemia (reduced blood flow) during the labor and delivery process. This website from NYU lists “Injury or complication from birth” at the top of their list of potential causes.
What happens is that too much hypoxia and ischemia can result in a build-up of lactic acid, which can in turn destroy brain tissue. When a baby’s central nervous system is damaged as a result of injurious hypoxia and ischemia it often results in a baby being born with hypoxic-ischemic encephalopathy or HIE. Another common term used to describe this condition is birth asphyxia.
A common allegation in cases of obstetrical negligence is the failure of the obstetrical team to identify warnings signs on an electronic fetal monitor that shows a baby is suffering from hypoxia and/or ischemia.
When we meet with families to investigate whether their child’s cerebral
palsy is a result of negligence, we always ask what the treating doctors
have had to say about the cause. The most common response is, “We
asked, but we could not get a straight answer.” Or the family says,
“At first they said it was genetic, but then that was ruled out,
and then they focused on infection, and that was ruled out too. And then
we just gave up trying to figure it out.”
Because the words “hypoxic-ischemic encephalopathy” and “birth asphyxia” can have certain legal implications, health care providers often shy away from those diagnoses. Treating doctors will then try and search for alternative causes such as genetic disorders or infections. It is true that some cases of cerebral palsy result from genetic disorders. However, it would be extremely rare to have a child develop cerebral palsy solely from genetics, especially if there was also strong evidence of hypoxic-ischemic encephalopathy or birth asphyxia. And even though infection can play a role in the development of cerebral palsy, some infections just increase the risk of hypoxia and ischemia causing cerebral palsy as opposed to there being a direct one-on-one correlation.
So, what can be done if your child has cerebral palsy and you are looking for answers. The following questions might be helpful in the early newborn period and beyond. Ask the neonatologist or the pediatric neurologist:
- What were my child’s Apgar scores?
- Did my child have metabolic acidosis?
- Did the obstetricians mention any abnormalities on the fetal heart rate monitor?
- Ask for them to list the most common causes of newborn encephalopathy or newborn depression and ask them to evaluate which cause seems the most likely in your child’s case.
- Were there problems with the placenta?
- If MRIs or CT scans of the brain have been taken, ask if the findings are consistent with HIE/birth asphyxia versus genetics versus infection.
If you feel like you are not getting straight answers to your questions ask for a second opinion or to see the chief of a particular department. Even if the doctor tells you that your child’s condition is not from the labor and delivery process, you still might want to investigate further. Not all doctors have access to the important records that would help answer that question.