Many parents facing their child’s cerebral palsy diagnosis have no grasp of the impact the disorder will have on their child’s physical and cognitive development. I remember when our daughter was first diagnosed with cerebral palsy at 3 weeks of age. The physician explained to us the extent of her brain injury and how it may impact her life. He explained that it may impact her growth but not her cognitive abilities, or it may impact her cognitive development but physically, her growth would be normal.
Since Danielle was our first child, I had no knowledge of normal infant development, either physically or cognitively. As it turned out, she did grow relatively normally but was severely neurologically delayed. However, many other cerebral palsy children do experience retarded growth. What causes this and are there steps a parent can take to correct it?
In order to understand why some children with cerebral palsy experience growth retardation, we need to first understand growth hormones.
Endocrine glands, which are special groups of cells, make hormones. The major endocrine glands are the pituitary, pineal, thymus, thyroid, adrenal glands and pancreas. Hormones are your body’s chemical messengers. They travel in your bloodstream to tissues or organs and affect many different processes, including:
- Growth and development
- Sexual function
The pituitary is the “master control gland” – it makes hormones (including growth hormones) that affect growth and function of other glands in the body. When the pituitary gland is compromised, it can have strong effects on the rest of the body.
Growth Hormones and Cerebral Palsy
Most children with cerebral palsy exhibit a short stature and grow at a progressively slower rate from birth to puberty. Scientists have begun studying several possible causes of growth retardation in cerebral palsy kids, including growth hormone deficiency. A 2010 study tested whether a lack of normal growth might be due to impaired or deficient growth hormone secretion. The study found that 70% of the children studied lacked normal growth hormone secretion. The researchers then began to investigate the link between cerebral palsy and growth hormone deficiency.
Scientists have discovered a number of growth receptors in the brain and central nervous system, including the hypothalamus and hippocampus part of the brain. It’s believed that memory and cognitive functions may be closely linked to growth hormone receptors in the hippocampus. In cases of severe brain damage, such as cerebral palsy, the neurotransmitter pathways involved in GH control may be impaired, affecting the normal secretion of the hormone.
There are other possible causes of growth hormone deficiency in cerebral palsy children, including psychosocial deprivation and suboptimal nutrition. In all cases, growth hormone deficiency can cause stunted growth.
Symptoms of Growth Hormone Deficiency
Not all children with cerebral palsy experience growth hormone deficiency. To determine whether your child may have a deficiency, look for one or more of these symptoms:
- Slow or flat rate of growth, usually less than 2 inches per year. The slow growth may not become apparent until the child is 2 or 3 years old.
- Child is much shorter than most or all children of the same age and gender.
- Face appears younger than children of the same age. They may also have a chubby body build.
- Puberty may come late or may not come at all, depending on the cause.
If your child exhibits these symptoms and you suspect growth hormone deficiency, consult an endocrinologist. Endocrinologists evaluate and treat pituitary disorders, such as growth hormone deficiency. Because the diagnosis and treatment of such disorders require special expertise, primary care physicians who suspect patients have growth hormone abnormalities should refer them to an endocrinologist.
Growth Hormone Replacement Therapy
Hormone replacement therapy is one method used to treat the symptoms of growth hormone deficiency. To learn more about growth hormone replacement therapy, read next week’s article, “Is Growth Hormone Replacement Therapy Right for Your Child?”
About CP Family Network
CP Family Network offers comprehensive information about cerebral palsy along with practical resources for parents like Care Guides: Medical and Emergency Information to organize and update medical records, and Survival Guides, listing available disability services in all 50 states.
Hormone Health Network – http://www.hormone.org/Growth/overview.cfm
Medline Plus – Growth Disorders – http://www.nlm.nih.gov/medlineplus/growthdisorders.html
Costa Rica Study: Current indications for indications for growth hormone therapy for children and adolescents – http://www.ncbi.nlm.nih.gov/pubmed/20523020
MAGIC (Major Aspects of Growth in Children) Foundation – http://www.magicfoundation.org/www
Johns Hopkins Children’s Center – Growth Hormone Deficiency – http://www.hopkinschildrens.org/growth-hormone-deficiency.aspx
U.S. Department of Health and Human Services – National Endocrine and Metabolic Diseases Information Service – Human growth Hormone and Creutzfeldt-Jakob Disease Resource List http://www.endocrine.niddk.nih.gov/pubs/creutz/creutz.aspx
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