Weller Chapter 17 Cerebral Palsy

Front 1

What does APGAR stand for?

Back 1

Performed 1 and 5 min after birth; scores 1-10

A: Appearance (skin color)
P: Pulse
G: Grimace response (reflex irritability)
A: Activity (muscle tone)
R: Respiration

Front 2

How is a low APGAR score at 5 minutes (especially <3) associated with CP?

Back 2

Increased risk of CP,
Particularly in infants of normal birth weight

Front 3

Athetosis

Back 3

Slow, writhing, involuntary movements
Can affect any part of body
Repetitive, sinuous, and rhythmic
Athetoid CP involves extremities, mouth, tongue

Front 4

When is birth weight a risk factor for CP?

Back 4

Extremely low birth weight (<1,000 g or 2 lbs, 3 oz) is risk factor for CP

Very low birth weight is also a risk factor, but lower the risk

Front 5

Dystonia in CP

Back 5

Involuntary muscle contractions that cause repetitive and twisting movements, awkward and irregular postures

Dystonic CP affects trunk more than limbs

Front 6

Extrapyramidal motor system

Back 6

One of 2 motor systems of brain

Includes cerebellum, basal ganglia, brainstem

Makes adjustments to posture and coordinated movements

Front 7

Hypotonia

Back 7

Low muscle tone

Loose limbed, poor head control

Front 8

Intrauterine growth restriction

Back 8

Poor growth of baby during gestation

Weight <90th percentile for gestational age

Front 9

Intraventricular hemorrhage (IVH)

Back 9

Bleeding inside ventricular system of brain

Freq occurs in prematurity (30 wks or less)

Usually occurs in first few days of life

Front 10

Periventricular leukomalacia (PVL)

Back 10

White matter necrosis around ventricles that interrupts motor tracts

Result of interrupted blood flow to the area

Particularly common in preterm babies

Front 11

Prematurity

Back 11

Baby born >3 weeks before due date
Gestational age <37 weeks
More severe prematurity increases risk of CP

Front 12

Pyramidal system

Back 12

-One of 2 motor systems of brain
-Includes precentral motor cortex, spinal motor neurons, and corticospinal tract that connects the two
-Initiates and carries signals for voluntary muscle contractions that enable skilled movements
-Damage is associated with spastic CP

Front 13

Spasticity

Back 13

Abnormally increased muscle tone or stiffness

Front 14

Cerebral palsy

Back 14

Umbrella term of brain-based disorder characterized by motor impairments

A syndrome, not a disease

Nonprogressive (usually has prenatal cause)

Front 15

CP is the most common cause of childhood _________.

Back 15

physical disability

Front 16

Most CP involve damage to motor pathways originating in the ________.

Back 16

Cortex

Most common subtype of CP involves spasticity due to involvement of pyramidal motor system, which originates in cerebral gray matter or corticospinal tract

Front 17

All of the following are risk factors for CP, except ______.

a. maternal epilepsy
b. female sex of fetus
c. multiple-birth gestation
d. standing before 8 months

Back 17

female sex of fetus

Front 18

CP most often results from brain insult that occurs during which developmental stage?

Back 18

Prenatal

Front 19

For a child with CP, a favorable prognostic indicator is _______.

Back 19

Sitting by 24 months predicts future ambulation

Front 20

Pyramidal CP implies damage to brain pathways originating in the ________.

Back 20

Cerebral gray matter or corticospinal tract

Front 21

Spastic CP is considered a hallmark sign of ________.

Back 21

Pyramidal motor involvement

Front 22

Spastic diplegic CP is characterized by involvement of ________ and lesser/no involvement of ________.

(arms, legs)

Back 22

Involvement of legs

Lesser or no involvement of arms

Front 23

Spastic diplegic CP subtype is associated with...

Back 23

Premature birth

Periventricular leukomalacia or intraventricular hemorrhage

Front 24

Spastic quadriplegia is associated with...

Back 24

-prenatal factors involving diffuse brain damage
-weakness of trunk and head control
-cognitive impairments

Front 25

Extrapyramidal CP is associated with...

Back 25

abnormal involuntary movements

Front 26

CP is associated with intellectual disability in ______% of people with the disorder

Back 26

50%

Spastic quadriplegia has highest risk of ID

Front 27

Does peripheral neuropathy occur more often in CP?

Back 27

No

CP is caused by brain-based pathology, not primary damage to peripheral nerves, muscles, or spinal cord

Front 28

Treatment options for CP do not include:
a) Botox injections
b) Antiparkinsonian drugs (dopamine agonists)
c) Hyperbaric oxygen therapy
d) Intrathecal baclofen

Back 28

C