Cerebral Palsy
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Cerebral Palsy

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Cerebral Palsy Cerebral Palsy Presentation Transcript

  • CEREBRAL PALSY Presentation prepared by: Jawen Caguioa EDSP 202
  • Historical Background
    • WILLIAM LITTLE
      • 19 TH CENTURY
        • Senior physician at the London Hospital
        • Founder of the Royal Orthopedic Hospital
      • 1853
      • 1862 (Obstetrical Society of London)
        • Paper entitled “The Influence of Abnormal Parturition, Difficult Labor, Premature Birth and Asphyxia in Relation to Deformities”
  • Little’s Disease
    • Approx 200 cases studied
    • Outline of characteristics and traits
    • Causes
    • Fundamental approach to treatment and mgt
  • In the US in Early 1940’s :
    • Cerebral Palsy
  • Definition (history of)
    • PERLSTEIN (1949)
      • CP is a condition characterized by paralysis, weakness, incoordination or any other aberration of motor function due to pathology of the motor centers of the brain.
    • DENHOFF (1951)
      • CP is a condition in which interferences with the control of the motor system arise as a result of lesions occurring from birth trauma.
    • SWARTZ (1951)
      • CP is an aggregate of handicaps: emotional, neuromuscular, sensory caused by damage or absent brain structures.
    • CROTHERS and PAINE (1959)
      • A term which covers individuals who are handicapped by motor disorders which are due to non-progressive abnormalities of the brain.
  • CEREBRAL PALSY
    • A disorder in the movement and posture caused by an injury to the immature brain.
        • Movement
            • Posture
            • Immature brain
  •  
  • Causes/Etiology
    • Prenatal causes (before birth)
      • Maternal characteristics
    • Perinatal causes (at the time of birth to 1mo)
    • Postnatal causes (in the first 5 mos of life)
  • Prenatal causes
    • Hemorrhage/bleeding
    • Infections
    • Environmental factors
  • Maternal Characteristics
    • Age
    • Difficulty in conceiving or holding a baby to term
    • Multiple births
    • History of fetal deaths/miscarriages
    • Cigarette smoking >30 sticks per day
    • Maternal alcoholism and drug addiction
    • Social status; mother with MR
    • Mother’s medical condition
  • Perinatal Causes
    • High or low BP
    • Umbilical cord coil
    • Breech delivery
    • Oversedation of drugs
    • Trauma i.e. forceps or vacuum delivery
    • *** complications of birth
  • Postnatal Causes
    • Trauma, head injury
    • Infections
    • Lack of oxygen
    • Stroke in the young
    • Tumor, cyst
  • Types of CP
    • ** CP depends on the
    • 1. extent of the brain damage
    • 2. which part of the brain is damaged
  • Types of CP
    • Spastic CP
      • stiffness
    • Flaccid SP
      • floppy
    • Athetoid CP
      • Fluctuating tone
    • Ataxic CP
      • Unsteady; incoordinated
    • Mixed CP
      • Most common is spastic athetoid
  • Classification of CP
    • Topographical Classification (based on the location of the motor disability)
      • 1. quadriplegia
      • 2. diplegia
      • 3. paraplegia
      • 4. triplegia
      • 5. hemiplegia
      • 6. hemiplegia
      • 7. monoplegia
      • 8. double hemiplegia
  • Perlstein 1949, 1952
    • Degree of Severity
      • 1. Mild CP
      • 2. Moderate CP
      • 3. Severe CP
  • 5 CLINICAL SIGNS OF CP
    • 1. Abnormal tone
    • 2. abnormal posture
    • 3. presence of primitive reflexes
    • 4. delays in motor skills
    • 5. difficulty in executing movement
  • Associated Clinical Conditions
    • Mental retardation
    • Seizures
    • HI, VI
    • Sensory integration problems
    • Feeding problems
    • Behavioral/emotional difficulties
  • Diagnostic Procedures
    • MRI
    • CT Scan
    • EEG
    • Laboratory and radiologic work up
    • Physical evaluation
    • Interview
    • Assessment tools i.e. Peabody Development Motor Skills, Bruininx
  • Treatment strategies and interventions
    • Physical, occupational, speech therapy
    • Special education
    • Feeding management
    • Orthosis
    • Surgery
    • Pharmacologic i.e botox injection, anti spasticity drugs
    • Family and patient counseling program
    • Vocational and functional training program
    • Others: acupuncture, hyperbaric thx, thera suit
  • prognosis
    • “ A disabled child has the right to enjoy a full and decent life, in conditions which ensure dignity, promote self-reliance and facilitate the child’s active participation in the community.”
    • - UN Convention on the Rights of
    • the Child. 1989.