Cerebral Palsy History

Sir William Little

1860
Going back in history Cerebral palsy, then known as "Cerebral Paralysis", and it was first identified in 1860 by William Little, an English orthopaedic surgeon He was the first to describe cerebral palsy and associate the condition with difficult delivery at birth (Little 1861, 1862; Accardo 1989).

1887
In 1887, Sir William Osler popularized the term cerebral palsy. Drawing upon the previous work of Little, he first described central nervous system lesions and their relationship to clinical findings (Osler 1887).

Crouthers and Payne, in their book "The Natural History of Cerebral Palsy," and Eugene Bleck, in his classic monograph, "Orthopedic Management of Cerebral Palsy," provide important text material regarding diagnosis and management in cerebral palsy.

1897
Sigmund Freud (1856-1939), while better known for his contributions to the field of psychiatry, recognized the relationship between diplegia and premature birth and provided a classification of the condition in 1897 (Freud 1897).

Treatment paradigms regarding the management of cerebral palsy continue to evolve; however, it is now recognized that even severely involved patients can show improvement with appropriate intervention. The use of therapeutic modalities, oral and injectable pharmacologic agents, orthotics, and surgery have made a positive impact on the lives of children and adults with cerebral palsy. In the second half of the 20th century, the use of neuromuscular blocking agents such as phenol, alcohol and botulinum toxin have provided effective nonoperative methods to balance joint forces, reduce the effects of spasticity in selected muscles, and improve function and health-related quality of life.

In addition, techniques which decrease spasticity from a spinal cord level have been developed. The role of rhizotomy and intrathecal Baclofen are not completely delineated; however, both techniques are an important management strategy in selected children. The exact techniques and appropriate timing of surgical interventions that balance joint forces, stabilize body segment, and correct deformity continue to evolve.