2. • In 1860s, known as
"Cerebral Paralysis” or
William “Little’s Disease”
John Little
• After an English surgeon
(1810-1894)
wrote the 1st medical
descriptions
3. CEREBRAL PALSY (CP)
• Cerebral“- Latin Cerebrum;
– Affected part of brain
• “Palsy " -Gr. para- beyond,
lysis – loosening
– Lack of muscle control
4. CEREBRAL
PALSY
• A motor function disorder
– caused by permanent, non-progressive brain lesion
– present at birth or shortly thereafter. (Mosby, 2006)
• Non-curable, life-long condition
• Damage doesn’t worsen
• May be congenital or acquired
5. CEREBRAL PALSY
A Heterogenous Group
of Movement Disorders
– An umbrella term
– Not a single diagnosis
8. An insult or injury to the brain
– Fixed, static lesion(s)
– In single or multiple
areas of the motor
centers of the brain
– Early in CNS dev’t
9. CAUSES
• Development Malformations
– The brain fails to develop correctly.
• Neurological damage
– Can occur before, during or after delivery
– Rh incompatibility, illness, severe lack of oxygen
* Unknown in many instances
10. CHIEF CAUSE
Severe deprivation of oxygen or
blood flow to the brain
– Hypoxic-ischemic
encephalopathy
or intrapartal
asphyxia
17. Types of Spastic CP
According to affected limbs:
* plegia or paresis - meaning paralyzed or weak:
• Paraplegia
• Diplegia
• Hemiplegia
• Quadriplegia
• Monoplegia –one limb (extremely rare)
• Triplegia –three limbs (extremely rare)
18. DEGREE OF SEVERITY
1. Mild CP- 20% of cases
• Moderate CP- 50%
- require self help for assisting their
impaired ambulation capacity.
• Severe CP- 30%;
-totally incapacited and bedridden
and they always need care from others.
29. DIAGNOSIS
• Physical evaluation, Interview
• MRI, CT Scan EEG
• Laboratory and radiologic work up
• Assessment tools
– i.e. Peabody Development Motor Skills,
Denver Test II
32. a. History Taking
–Include all that may predispose
an infant to brain damage or CP
•Risk factors
•Psychosocial factors
•Family adaptation
33. b. Child’s Health
History
• Often admitted to hospitals for corrective
surgeries and other complications.
– Respiratory status
– Motor function
– Presence of fever
– Feeding and weight loss
– Any changes in physical state
– Medical regimen
35. CRITERIA
P osturing / Poor muscle control and strength
O ropharyngeal problems
O
S trabismus/ Squint
S
T one (hyper-, hypotonia)
T
E volutional maldevelopment
E eflexes (e.g. increaseddeep tendon)
R
R *Abnormalities 4/6 strongly point to CP
37. - No treatment to cure cerebral palsy.
- Brain damage cannot be corrected.
• Crucial for children with CP:
–Early Identification;
–Multidisciplinary Care; and
–Support
38. I. Nonphysical Therapy
“The earlier we start,
the more improvement can be made”
-Health worker
39. • General management
- Proper nutrition and personal care
B. Pharmacologic
Botox, Intrathecal, Baclofen
- control muscle spasms and seizures,
Glycopyrrolate -control drooling
Pamidronate -may help with osteoporosis.
40. C. Surgery
-To loosen joints,
-Relieve muscle tightness,
- Straightening of different twists or
unusual curvatures of leg muscles
- Improve the ability to sit, stand, and
walk.
42. D. Physical Aids
• Orthosis, braces and splints
• Positioning devices
• Walkers, special scooters, wheelchairs
E. Special Education
F. Rehabilitation Services- Speech and
occupational therapies
G. Family Services -Professional
support
43. H. Other Treatment
- Therapeutic electrical stimulation,
- Acupuncture,
- Hyperbaric therapy
- Massage Therapy might help
44. II. Physical Therapy
'The ultimate long-term goal is realistic independence. To
get there we have to have some short-term goals.
Those being a working communication system, education to his potential,
computer skills and, above all, friends'.
- Parent of boy with CP
45. A.Sitting
- Vertical head control and
control of head and trunk.
B. Standing and walking
- Establish an equal distribution of
weight on each foot, train to use steps
or inclines
48. NURSING RESPONSIBILITIES
C. Functioning as a member of the
health team
D. Providing counseling and education
for the parents and promote optimal
family functioning
C. Promoting physical and
psychological health
49. D. Assisting with feeding management
and toilet training
E. Assisting with rehabilitation therapies
(physical, occupational and speech)
F. Providing counseling for educational
and vocational pursuits
G. Preventing child abuse
H. Providing care during hospitalization
50. I. Prevent physical injury
C. Prevent physical deformity
K. Promote a positive self-image
