These are different names related to congenital disorders (disorders present from birth) - cerebral palsy (CP), spasticity, epilepsy, fits, mental retardation, down's syndrome.  They are related to brain malfunction, and are normally found out only after a few months of birth ( except when costly tests are used).

Celebral palsy

Palsy means paralysis (temporary suspension or permanent loss of function, especially loss of sensation or voluntary motion). (Taber’s 18^th edn.p 1405).

CP or cerebral palsy is a name given to a group of symptoms, the most important being - impaired body movements. If due to any reason, blood does not reach a part of the brain for a few minutes, it causes death of neurons of a certain section of the brain. If death of neurons happens in the motor area of the cerebral cortex, then the brain will not be able to command or coordinate bodily movements. Such a child will be unable to turn, get up, sit or stand by himself without help. They often are totally immobile. Sometimes, the loss of function is so total that parents have to lift the child physically even to make it lie in another location.

It is felt that birth injury / hypoxic ischemic insults (= lack of oxygen, due to a surgical procedure or any complication during delivery), which block the blood supply to the brain, may cause CP, but this may not be so. (Taber’s 18^th ed.p 348). In such children, the CT scan of the brain will have the words :

"Ischemic changes in cerebral cortex/white matter of brain" etc.

This is often associated with premature babies due to hypoxia, but not always so.

Spasticity  

Spasticity is a term to indicate an abnormal stiffness of the limbs. This is due to lesions in upper motor neurons of the brain. It is Guruji’s remarkable discovery that increased alkalosis of the blood is one of the main factors for spasticity.

Fits

Fits simply means a sudden attack, paroxysm or convulsion. It consists of involuntary spasmodic movements in which muscles contract and relax alternately, over which the person has no control. The attack may even occur without any warning symptoms; and may last from a few seconds to several minutes. (Taber’s 18^th edn. p 440 ).

Fits are often associated with a disorder of the brain, known as epilepsy. However normal persons or children may get fits due to any of the following reasons:

• Low levels of sugar, calcium, salt (=sodium) in the blood.
• Increased blood levels of ammonia, chloride, potassium or alkali.

Epilepsy

Epilepsy is a disorder of the cerebrum which recurs at infrequent intervals. It is characterized by convulsions, along with episodes of alternate consciousness (= the person is sometimes aware of what is going on around him, and at other times, he does not know anything going on).

It is attributed to lesions in the the cerebral cortex, causing improper functioning of the motor neurons. In this disorder, several areas of the CNS become intensely excited by electrical activity, due to which several parts of the body start shaking violently and uncontrollably.

In several persons, a severe attack causes them to lose control over voluntary actions, as a result of which they may pass urine or stools during the attack, and later they may remember nothing.

In a number of children, this occurs after a bout of severe fever. When this happens too frequently, at first a CT scan is taken, which may show up some anomaly. Later an EEG is taken. If the EEG test report states "epileptiform changes in brai", then and only then the disease is termed as epilepsy.

Hippocampus and epileps

(Guyton 10^th ed. p 686).

Weak electrical stimuli can cause local epileptic seizures in the hippocampal areas. Probably one of the reasons for the hyper-excitability of the hippocampus is that it has only three nerve cell layers in some of its areas instead of the six layers found elsewhere.

Other symptoms of epilepsy include loss of consciousness, which may last from a few seconds to several minutes, which he may be unaware of, after waking up. Some lose control over the urinary and anal sphincters. Some may get frothing from the mouth.

Mental retardation

Mental retardation refers to the fact that the development of the mental faculties is not in keeping with his physical growth. Eg., a child may have the body of a ten year old, but may have the intellect and behaviour of a two year old. In such children, even basic activities such as turning to one side, sitting up, standing without support, talking, walking etc will take place at a much later age than other children. This is called as "delayed milestones". Though there are many reasons for this, the three main ones are CP, hypo-thyroidism, Down Syndrome.

Down Syndrome

This is a disorder which arises due to a chromosomal defect during conception. Normally every cell of a human being has 23 pairs of chromosomes (=46 chromosomes). But, due to some reasons, in some children, there are three numbers of chromosome number 21 (in place of two). Such a disorder is known as Down Syndrome, commonly called "Mongolism". There are several symptoms of this disorder, the most prominent being a face like Chinese, and moderate-to-severe mental retardation.

Relation among the different words

Fits, spasticity and mental retardation are symptoms, which can accompany any diseased state. But epilepsy, CP and Down Syndrome are different diseases in which several groups of symptoms are seen at the same time.

Patients of epilepsy may get fits and may later become unconscious, but every epileptic does not get fits and the same person may not get fits every time, neither does he become unconscious after every attack of fit. Taber’s 18^th edn.p 657: some but not all recurrent seizures are due to epilepsy.

Mental retardation indicates low mental intellect (IQ) and may accompany any other disease. In about 60% of cases CP is accompanied by mental retardation, and in about 50% of the cases, it is accompanied by epilepsy.

Again, not every child who is mentally retarded, has CP. Some children, who get fits, may also be mentally retarded, but every child who is mentally retarded does not get fits.

Spasticity is often found in children with CP, and sometimes may accompany epilepsy.

Several epileptic children are quite clever, but a few others may be mentally retarded. Most children who have CP and all children of Down Syndrome are mentally retarded, but it is not true that every child who is mentally retarded also has cerebral palsy (CP) or epilepsy.

Other reasons for fits in children

High fever, malaria, meningitis, any severe infection, rickets (calcium deficiency), insufficient nutrition, or if the mother had "toxemia of pregnancy" during pregnancy (severe viral / bacterial infection in the mother’s blood  during pregnancy), then it is possible that the child may get fits after birth.

When the fits accompany fever, it is called as "febrile convulsions". When a child gets fits even without an episode of fever, it is called afebrile convulsions.