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13 Cards in this Set
- Front
- Back
What is cerebral palsy?
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Group of disorders in the development of motor control and posture occurring as a result of a non-progressive impairment of the developing CNS
Accompanied by disturbances of sensation, cognition, communication, perception and or seizure disorder Cerebral = refers to the cerebrum Palsy = refers to disorders of movement |
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What are syndromes of cerebral palsy?
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Occurs early in life, cerebral in nature, cause abnormal control of movement and posture during development
Non progressive, but no known cure |
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What are the causes of cerebral palsy?
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Caused by damage to the motor centers and/or their connections to the developing brain
Cases of CP typically occur during pregnancy, (85%) During childbirth (5%) Up to age 3 (10%) CNS infection - damage to white matter Hypoxia of the brain birth trauma during labour and delivery Stroke Asphyxia before birth multiple births 40-50 percent of children with CP are premature Asphyxia (caused by choking, near drowning, poison) Toxins, jaundice, lead poisoning, brain injury, shaken baby syndrome, hypoxia to brain, encephalitis, meningitis |
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The incidence of cerebral palsy?
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1 in 1000 newborns
1.33:1 males : females 10000 infants diagnosed/year in the United States |
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What is the diagnosis of cerebral palsy?
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History and physical examination
CT or MRI Diagnosis made shortly after birth, but typically postponed until child is 18-24 months Therefore see the functional status and progress of symptoms, developmental monitoring and screening Primitive reflexes tested in development can be evidence of neurologic deficit Example Moro Reflex (startle reflex) normally present in all infants up to 4 or 5 months Absence of reflex or persistence beyond 4-5 months can indicate severe neurological deficit |
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What are the four classifications of cerebral palsy?
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1. Spastic (50%) Corticospinal tract, motor cortical areas
2. Ataxic (10%) cerebellum 3. Dyskinetic (20%) basal ganglia 4. Mixed (20 percent) Spastic and one other All 4 are characterized by hyperreflexia, spasticity, involuntary movements, unsteady gait, balance disturbances |
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What is spastic cerebral palsy?
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Affects the corticospinal tract, motor areas
All types of spastic have hypertonia and or hyperreflexia Classified based on the distribution of motor disability A. Hemiplegic spastic type - 1 side affected B. Diplegic spastic type - All 4 extremities affected (lower limbs more affected) C. Quadriplegic spastic type - all 4 limbs significantly affected |
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What is spastic cerebral palsy, hemiplegic spastic type?
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1 side affected
most ambulatory of all forms seizures occur in 70 percent of cases cognitive abilities preserved |
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What is spastic cerebral palsy, diplegic type?
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All 4 limbs affected but little to no upper body spasticity
Strabismus (eyes do not align) gait disturbances many have preserved cognitive abilities |
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What is spastic cerebral palsy, quadriplegic type?
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All 4 limbs severely affected, equally, Most severe form, least likely to walk
Tremor and severe gait disturbances Severe mental retardation, epilepsy, dysarthria |
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What is ataxic cerebral palsy?
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Affects cerebellum
Dysmetria - difficulty in performing intentional movements Hypotonia, tremors difficulty with fine motor skills Impaired balance during walking Impaired coordination cerebellum also controls eye movements |
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What is dyskinetic cerebral palsy?
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Affects basal ganglia
Affects all 4 limbs, but upper limbs are more affected typically occurs after 2 years of age and can progress into adulthood Mixed muscle tone (hypotonia and hypertonia) Presence of involuntary movements (chorea, athetosis, dystonia) Slow, writhing movement Balance difficulties lesions are often localized to the putamen |
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What is the gross motor function classification system for cerebral palsy?
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Universal classification system
uses a five level system, gross motor function on basis of self initiated movement abilities higher number indicates a higher degree of severity Each level is determined by an age range and a set of activities the child can achieve on his or her own |