CP twin, one normal...?

alphafe · Dec 17, 2004

Hi everyone,

My 15 year old daughter just got her first job as a personal care assistant for a 5 y/o girl. This is what I know: Child is developmentally 9 mos -- wears diapers, crawls, has feeding tube, and has active seizures. No speech, just code sounds for various things. She is *happy* and has a gorgeous smile.

Mom says she gets sick more and more, colds, etc.

Her twin is normal! My dd is being paid through the CP Association but the mother said her dd does not have CP.

Is this a situation where one baby had CP from conception and the other didn't? Is it a case of failure to thrive in utero? I don't know much terminology -- just in prenursing, but I found it interesting that this little girl's twin is so robust.

Thanks for any insights! Perhaps I'll post this on OB/L/D board as well.

VizslaMom · Dec 17, 2004

My cousin has Cerebral Palsy. He was normal in utero but had the cord around his neck during delivery causing hypoxia and resulting brain damage (CP).

I'm no Peds RN, but CP is usually caused by hypoxia. It's not a congenital/inherited disorder like Downs.

In the case of the twins, it sounds like one had no interruption in blood/oxygen supply while the CP twin did. Separate cords/sacks - separate supplies of oxygen is my guess.

VizslaMom · Dec 17, 2004

My cousin has Cerebral Palsy. He was normal in utero but had the cord around his neck during delivery causing hypoxia and resulting brain damage (CP).

I'm no Peds RN, but CP is usually caused by hypoxia. It's not a congenital/inherited disorder like Downs.

In the case of the twins, it sounds like one had no interruption in blood/oxygen supply while the CP twin did. Separate cords/sacks - separate supplies of oxygen is my guess.

prmenrs, RN · Dec 17, 2004

Search Cerebral Palsy on google. There can be many causes. Lack of oxygen is one, but not the only. Sometimes, w/twins, there is a connection in the placenta between one and the other, one gets more blood, one gets less, both are at risk. Preterm babies can have intraventricular hemorrhages causing hydrocephalus, which can cause CP. A child can have a normal pregnancy and birth, and still have CP. CP can have different presentations, too. Severe motor involvement, nl IQ, nl motor, affected IQ, both....

Might also look for the United Cerebral Palsy website.

prmenrs, RN · Dec 17, 2004

Search Cerebral Palsy on google. There can be many causes. Lack of oxygen is one, but not the only. Sometimes, w/twins, there is a connection in the placenta between one and the other, one gets more blood, one gets less, both are at risk. Preterm babies can have intraventricular hemorrhages causing hydrocephalus, which can cause CP. A child can have a normal pregnancy and birth, and still have CP. CP can have different presentations, too. Severe motor involvement, nl IQ, nl motor, affected IQ, both....

Might also look for the United Cerebral Palsy website.

BeenThereDoneThat74, MSN, RN · Dec 20, 2004

I've seen this with multiple births. I took care of a girl (who recently died at age 16), one of triplets. One died at birth, this one had severe MR/CP, the third is absolutely normal. It's all about oxygenation during birth. BTW, don't know the order of the triplets (that probably makes a difference).

alphafe · Dec 20, 2004

Thanks everyone, for helping me understand this. Can this be evident at birth - obviously if there is great discrepancy in weight or birth trauma there would be but some of my online reading said that CP sometimes manifests at anytime during the first year, delayed milestones, etc.

Is there no way to detect this before birth? I'm so taken by this family -- they suffer so much. I'm a little concerned about my 15 yo working for them, this child gets sick **a lot** has had many hospitalizations so I worry about everything from my dd getting colds, etc., to her having to deal with this little one's death...

What can I do to make sure my 15 yo is healthy (physically and emotionally) thoughout the time she cares for this girl?

Why would a CP child have such low immunity? Sorry for all the questions, but everything is a learning experience.

BeenThereDoneThat74, MSN, RN · Dec 21, 2004

I din't notice at first that it was your daughter caring for these kids. I think that's great, it will show her about different kinds of children (most 15 y/o's could care less about special needs kids).

Can this be evident at birth - obviously if there is great discrepancy in weight or birth trauma there would be but some of my online reading said that CP sometimes manifests at anytime during the first year, delayed milestones, etc.

You may not see it at birth, depending on the severity. There's a lot suspicion about theses types of disorders being related to certain vaccinations. I've cared for some kids whose parents swore the baby was fine until they got their shots. But I think it's hard to make that determination, because most babies are not 'doing much' for the first few months anyway. It's really sad when you know the baby has this condition, and it's not so obviious, and as they get older, they don't get better.

I would think the immunityissue has to do with the decreased muscle tone, and their ability to use their respiratory muscles are not as good as the rest of us. I've been working in this field for almost 5 yrs, and am embarrrassed to say I don't know the rationale, but I just know they are compromised.

prmenrs, RN · Dec 21, 2004

http://www.ucp.org/

jeepgirl, LPN, NP · Dec 23, 2004

its not always birth trauma or lack of O2. CP is VERY complex and can have many, many causes!