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From congenial paralysis to post-early brain injury developmental condition: Where does cerebral palsy actually stand?

S. Chabrier,M. Pouyfaucon,A. Chatelin,Y. Bleyenheuft,J. Fluss,V. Gautheron,C. Newman,G. Sébire,P. Bogaert,C. Vuillerot,S. Brochard,M. Dinomais

Published 2020 in Annals of Physical and Rehabilitation Medicine

ABSTRACT

Cerebral palsy (CP), an umbrella term for a developmental motor disorder caused by early brain injury (EBI)/interference, remains debated. In this essay, we present a narrative, beginning with the original anatomical-clinical description of the so-called paralysie congéniale (congenial paralysis) by the French psychiatrist Jean-Baptiste Cazauvieilh. We then discuss how the concept has evolved over the last 2 centuries. We aim to illustrate these ideas with the biopsychosocial model of health, especially in light of the current neuroscientific and sociological knowledge of human development. We endeavour to integrate 3 connected but distinct entities: 1) the EBI as a seminal turning point of the individual's story, 2) the clinical findings we call CP, when motor impairment and activity limitation related to post-EBI (or other early non-progressive brain interference) appears, and 3) a post-EBI developmental condition that encompasses the overall consequences of an EBI. This framework should guide individual, familial and collective care discussions and research strategies beyond the scope of CP.

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