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M Gambino Cerebral Palsy
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M Gambino Cerebral Palsy

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  • 1. CEREBRAL PALSY AND ITS TREATMENTS Mindy Gambino ENG 333
  • 2. Overview BACKGROUND   TYPES, CAUSES AND SYMPTOMS  TREATMENTS
  • 3. CEREBRAL PALSY Non curable, non progressive disorder   Affects the ability to move  Affects posture and balance
  • 4. Types of Cerebral Palsy Spastic   Athetoid  Ataxic  Mixed
  • 5. SPASTIC CP Tense, contracted muscles   Most common ◦ Affects 70-80% of all CP patients Stiff, awkward movements   Difficulty shifting positions
  • 6. SPASTIC CP (Cont.) Three subtypes  1. Diplegia – affects one side 2. Hemiplegic – affects both arms/both legs 3. Quadriplegia – affects all limbs Spastic CP is caused by damage to  the motor cortex
  • 7. ATHETOID Uncontrolled motion in face, arms, and  trunk  Movements may increase with stress and dissipate during sleep  Interferes with coordinated movements  Caused by damage to the cerebellum
  • 8. ATAXIC CP Poor balance resulting in stumbles  and falls  Caused by damage to the cerebellum  10% of CP patients have this form
  • 9. MIXED CP Spastic, involuntary movements   Combinations of the previously mentioned types  Damage to both the motor cortex and cerebellum  25% of CP patients have this form
  • 10. CAUSES OF CP Developmental malformations   Neurological damage  Brain damage occurring before, during or after birth
  • 11. DEVELOPMENTAL MALFORMATIONS Failure of the brain to develop  correctly  Lower than normal number of brain cells  Fetal brain cells not migrating to correct areas
  • 12. NEUROLOGICAL DAMAGE Before , during or after birth 
  • 13. NEUROLOGICAL DAMAGE Three main causes before and during  birth ◦ RH incompatibility  Blood conflict between the mother and fetus ◦ Illness of the mother  Viral diseases  Poor nutrition  Diabetes  Alcohol or drugs
  • 14. NEUROLOGICAL DAMAGE (Cont.) Severe Lack of Oxygen  ◦ Premature Separation of the placenta from the uterine wall ◦ Breach birth ◦ Interference with circulation of the umbilical cord
  • 15. NEUROLOGICAL DAMAGE (Cont.) After Birth Causes of CP  Accidental Injury  Lead Poisoning  Illness ◦ Meningitis ◦ Encephalitis
  • 16. SYMPTOMS OF CP Usually noticeable before age three   Two main ◦ Physical ◦ Behavioral
  • 17. PHYSICAL SYMPTOMS OF CP Difficulty sucking   Poor muscle control  Poor coordination  Muscle spasms and seizures  Developmental delays in: ◦ Crawling ◦ Sitting ◦ Walking
  • 18. BEHAVIORAL SYMPTOMS OF CP Unusual tenseness   Irritability  Lack of concentration  Emotional Problems  Sometimes Down Syndrome
  • 19. TREATMENT FOR CP Orthopedic Surgery   Orthotics  Drug Therapies  Physical and Occupational Therapy
  • 20. ORTHOPEDIC SURGERY Corrects muscle and bone deformities  caused by spasms  Can be done at any age, usually from age four
  • 21. ORTHOPEDIC SURGERY (Cont.) Benefits  Significant improvement in walking  Improved range of motion  Decreased deformity
  • 22. ORTHOPEDIC SURGERY (Cont.) Drawbacks  Time consuming  25% chance of infection  Child may temporarily regress  Costly - $20,000 or more
  • 23. ORTHOTICS Known as braces   Reduces plasticity  Stretches tight muscles and holds them to prevent contracture  May improve walking
  • 24. DRUG THERAPIES Botox injections   Inthrethecal baclofen
  • 25. BOTOX INJECTIONS Injected into the spastic muscle   Quick procedure – 5 minutes  Used on a few muscle groups at a time  Lasts up to three months  Used for spastic diplegia or spastic quadraplegia
  • 26. INTHRATHECAL BACLOFEN Pump implanted in the abdomen to  distribute dose  Delivered into the spinal fluid  Refilled every three months  Decreases spasms and blocks abnormal nerve signals
  • 27. INTHRATHECAL BACLOFEN Increased muscle control   Dosage can be adjusted  5-10% risk of infection  Risk of spinal fluid leaks  High cost - $20-$25,000
  • 28. SELECTIVE DORSAL RHIZOTOMY Neurosurgical treatment   Nerves from brain to leg muscles are exposed in the spinal cord  30-50% of the top of each nerve is cut off  Permanent decrease in spasms  For children between four and eight
  • 29. SELECTIVE DORSAL RHIZOTOMY (Cont.) Risks  Could decrease feeling in legs  Extensive hospital say  4-6 weeks of inpatient rehabilitation  Expensive
  • 30. SPEECH THERAPY Non invasive   Special devices such as a computer with a voice synthesizer
  • 31. OCCUPATIONAL THERAPY Develops skills such as:  ◦ Feeding ◦ Brushing teeth ◦ Dressing Improves day to day living   Boosts self-esteem
  • 32. PHYSICAL THERAPY Used in conjunction with other  treatments  Prevents muscle weakening (atrophy)  Helps prevent muscle contracture  Improves motor development

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