Cerebral Palsy

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suspected etiology of cerebral palsy

Back 1

is believed to be lesions or abnormalities of the brain beginning in the early state of its development (based on 1992 definition by Mutch)

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cause of cerebral palsy movement abnormalities

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may be due to involvement of the cortex/deep white matter of the hemispheres, extrapyramidal motor system, or cerebellum – thus, the term “cerebral palsy” is a misnomer

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incidence of CP

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is seen in 1.5 to 2.5 per 1000 births

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cerebral palsy risk factors before pregnancy

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1.Maternal mental retardation, 2.Hyperthyroidism 3.Seizures even efore pregnancy 4.Two or more fetal deaths 5.A positive family history of CP; this may suggest specific chromosomal abnormalities 6.Metabolic abnormalities with an underlying genetic basis

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cerebral palsy risk factors during pregnancy

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1. Hypercoagulability – the most common cause of maternal death is thromboembolic disease 2. Obesity 3. Older age 4. C-section; overall, there has been an increase in the C-section rate in developed countries 5. Immobilization 6. History of previous thromboembolism 7. Estrogen use during pregnancy 8. Intrauterine exposure to infection or toxins 9. CNS malformations

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Cerebral palsy riskfactors at birth

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1 Breech (buttocks) or face coming out first rather than crown of head; 2.Placenta problems – bleeding, separating too quickly from the uterus 3.Umbilical cord problems 4Premature delivery; multiple births (twins, triplets, etc.)

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Types of CP; CP is classified according to the type of abnormal tone

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1.Hypotonic – low muscle tone 2.Spastic – increased resistance to passive movement 3 .Athetoid – slow writhing movements 4.Dystonic – persistent abnormal posture which increases with movement 5.Combination – abnormal tone with abnormal posture/movements

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Classification of CP by extremity involvement

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1.Monoplegia – only one extremity 2.Diplegia – two extremities, such as spastic diplegia which involves both legs 3.Hemiplegia – “half”-sided weakness, affecting arm and leg on one side of the body 4.Quadriplegia – all four limbs affected

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CP associated disabilities

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A. 1/3 of CP patients have epilepsy; in patients with hemiplegia, the incidence increases to 50% B. There is a higher chance of learning disabilities and problems with coordinated eye movements C. With quadriplegia, there is an increased chance of epilepsy and mental retardation