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congenital abnormal in children .pptx
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Cerebral palsy is one of the most complex of the
common permanent disabling conditions.
Cerebral - of the brain, Palsy: lack of muscle control
• Cerebral palsy is a disorder that affect movement and
muscle coordination that is caused by damage to the
brain, usually before or during birth.
• CP is a life long condition but early intervention and
therapy can help improve out comes.
IntroductiontoCerebralPalsy
What is Cerebral Palsy?
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TYPESOFCEREBRALPALSY
• Spastic Cerebral Palsy : Tightness
in the limbs involved.
• Dyskinetic or Athetiod Cerebral
Palsy : Involvement of Excessive
Involuntary movements.
• Ataxic : Involvement of the
cerebellum (smaller brain).
• Mixed Cerebral Palsy
: Involvement of different parts of
the brain.
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Based on Clinical Presentation:
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Causes
• Brain damage before, during or after birth.
• Lack of oxygen to the brain (asphyxia)
• Infections during pregnancy such as ( rubella).
• Nutritional deficiencies. Nutritional deficiencies that may affect
brain growth during prenatal period could cause cerebral palsy.
• Prematurity.
• Trauma to the brain such as (head injury).
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Diagnosis
• Typically diagnosed in infancy or early childhood.
• Perform physical exam and motor skills
• Brain imaging tests such as MRI scan.
• Early diagnosis and intervention is key for better out
comes
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Treatment
• There is no cure for CP, but treatment can improve
quality of life.
• Physical therapy can help improve muscle control and
coordination.
• Occupational therapy can help with daily living skills.
• In severe cases, surgery may be necessary.
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Nursing Care of Cerebral Palsy in Children
• The first step in providing nursing care for a cerebral
palsy child is to assess their condition and diagnose
the type and severity of their symptoms.
• Nurses must also monitor the child's vital signs, assess
their nutritional status, Neurologic examination and
screen for potential complications such as seizures,
respiratory infections, and musculoskeletal
deformities.
• They may also educate the child and their family about
the importance of nutrition, hydration, and medication
adherence to reduce the risk of complications and
improve overall health outcomes.
• The primary goal of nursing care is to help the child
achieve optimal physical, emotional, and social
development.
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Introduction
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The human brain is a complex organ that
control all the functions of the body.
Any abnormalities in the brain can lead to
neurological disorders in children.
Neurological abnormalities can effect a child's
physical, cognitive and emotional development.
Its important for nurses to understand the
different types of neurological abnormalities
and provide appropriate care.
SOME OF THE MOST COMMON TYPES ARE:
Cerebral palsy, Epilepsy, Autism, muscular
Dystrophy, and Stroke.
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Epilepsy
• Epilepsy is a brain condition that causes a child to
have seizures.
• It is one of the most common disorders of the
nervous system. It affects children and adults of all
races and ethnic backgrounds.
• The brain consists of nerve cells that communicate
with each other through electrical activity.
• A seizure occurs when one or more parts of the brain
has a burst of abnormal electrical signals that
interrupt normal brain signals.
• Epileptic seizures are not usually dangerous.
However, a person is at risk of being harmed if they
are in a dangerous environment when a seizure
occurs, for instance if they are in a swimming pool or
driving.
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Whatcausesepilepsy?
Focal onset seizures
• Focal onset seizures happen when the seizure activity
begins on one side of the brain. In a focal onset seizure, your
child may just stare into space and be unresponsive. If there
is convulsing, it may only affect one side of the body.
• Focal onset seizures with reduced awareness may be
referred to by doctors as complex partial or focal dys-
cognitive seizures.
Generalized
• Generalized onset seizures
Generalized onset seizures happen when the seizure activity
begins on both sides of the brain at once. The child's awareness
and movements are always affected. There are different types
of generalized onset seizures, including:
• tonic- clonic seizures
• absence seizures
• myoclonic seizures
• atonic seizures
• tonic seizures
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For most children with epilepsy, the cause is unknown. Epilepsy sometimes runs in families, which indicates that
genetics play a part. Sometimes children develop epilepsy after a severe head injury, stroke or brain infection.
Epilepsy can also be a result of a brain malformation or benign (non-cancerous) tumor, which may be present from
birth.
Types
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ThirdType
Infantile spasms
• Infantile spasms are a special type of seizure with
both focal and generalized features.
• These often begin between three and six months of
age, and appear as brief stiffening movements lasting
one to two seconds each.
• An epileptic spasm is a specific type of seizure seen in
an epilepsy syndrome of infancy and childhood often
called West Syndrome.
• These are more commonly called infantile spasms (IS)
because they are seen most often in the first year of
life, typically between ages 4 and 8 months.
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DiagnosisandtreatmentofEpilepsy:
Diagnosis
• Electroencephalogram (EEG).
This is the most common test used to diagnose
epilepsy.
Treatment
Include:
• medicines called anti-epileptic drugs (AEDs)
• surgery to remove a small part of the brain that's
causing the seizures.
• a procedure to put a small electrical device inside the
body that can help control seizures.
• a special diet (ketogenic diet) that can help control
seizures.
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Nursingcare
The nursing care plan includes interventions to improve mobility:
• Provide emotional support
• Strengthen family support
• Prevent injury, monitoring seizures activity
• administering medications as prescribed
• prevent complications
• promote self-care
• enhance communication skills and
• providing education.
In addition, nurses may need to implement safety measures to
prevent injury during seizures and work closely with other
healthcare providers to ensure comprehensive care for the child
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Autism
Autism Spectrum disordered (ASD)
• Autism spectrum disorder is a
developmental disability caused by
differences in the brain and that effects
social interaction, communication, and
behavior.
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Causes
Exactly what causes autism remains
unknown.
There is a common cause at the
• genetic,
• cognitive
• and neural levels for the social and
non-social components of ASDs
symptoms.
Some signs of autism can appear
during infancy, such as:
• limited eye contact.
• lack of gesturing or pointing.
• Prefers of alone time.
• no response to hearing their
name.
• muted emotion in facial
expression.
• lack or loss of language.
• Behavioral management therapy.
• Cognitive behavior therapy.
• Early intervention.
• Educational and school-based
therapies.
• Joint attention therapy.
• Medication treatment.
• Nutritional therapy.
• Occupational therapy.
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Signandsymptoms Treatment
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Nursingcare
• Tailoring care based on sensory sensitivity and the
patient's ability to communicate
• The most significant role of a nurse in autism
is education.
• speech therapy to improve communication skills
• physical therapy to improve movement and balance
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Musculardystrophy
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• Muscular dystrophy is a group of diseases that cause
progressive weakness and loss of muscle mass.
• Many types of muscular dystrophy are diagnosed in
childhood, but there are several types that can
appear during adolescence and adulthood
Muscular dystrophy cannot be prevented.
There is no specific treatment or cure for the disease.
Care of those with muscular dystrophy is mainly focused
on preventing and treating its complications, and
improving the quality of life of affected children.
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Majortypes
What to know about types of muscular dystrophy…
Duchenne DMD
• The most common type
• Begins between ages 2 and 3
• Affects lower limbs first
• Impacts heart and respiratory
muscles later on
Becker
• Appears between ages 5 and 15
• Has slower progression than DMD
• Affects hips and pelvic area first
• Causes muscle weakness in the
heart for most
Limb-girdle
• Over 30 forms
• Starts pin either adult hood or
childhood
• Creates muscles weakness and
atrophy in hips and shoulders
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Causes
Most cases of MD are caused by gene mutations (changes in the DNA sequence) that affect muscle proteins.
Complications
• Trouble walking. Some people
with muscular dystrophy
eventually need to use a
wheelchair.
• Trouble using arms. ...
• Shortening of muscles or tendons
around joints (contractures). ...
• Breathing problems. ...
• Curved spine (scoliosis). ...
• Heart problems. ...
• Swallowing problems.
• Signs and symptoms, which
typically appear in early
childhood, might include:
• Muscle weakness usually begins
between the ages of 2 and 3
• Difficulty rising from a lying or
sitting position.
• Children face difficulty in walking
or running
• Walking on the toes.
• Large calf muscles.
• Muscle pain and stiffness.
• Mental retardation
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Nursingcare
• Help patient independent living for as long as possible
• Prevent respiratory infections
• Monitor skin
• Ensure good nutrition
• Assess mobility
• Self care
• Provide emotional support
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Stroke
Definition
Stroke also know as cerebrovascular accident (CVA) is
any functional or structural abnormality of the brain
caused by pathological condition of the cerebral vessels
of the entire cerebrovascular system . either bleeding
(hemorrhagic stroke) or lack of oxygen (ischemic
stroke).
• Strokes can occur at any point in a persons life.
• Strokes in childhood, including the newborn period,
are being increasingly recognized today.
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The main types of stroke (in children and adults) are:
• Ischemic stroke: is the most common type of
childhood stroke. This occurs when a blood clot forms
and becomes stuck in an artery to the brain. A bout
80% all strokes are ischemic stroke
• Hemorrhagic stroke: is far less common in children. It
occurs when a blood vessel in the brain ruptures. A
bout 20% all strokes are hemorrhagic stroke.
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Typesofstroke
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SignandSymptoms
Stroke signs and symptoms in children include:
• Slurred speech or Difficult talking
• Neck pain or stiffness
• Weakness or numbness
• Trouble balance or walking
• Seizure
• Vision problem such as double vision or loss of vision
• Sudden loss of consciousness
• Sudden loss of movement or weakness of face, arm
or legs.
• Sudden onset of severe headache
• vomiting
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causes
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The causes of many cases of stroke are
unknown.
But in some cases , cerebrovascular
anomalies : conditions that are characterized
by malformed blood vessels – can cause
stroke symptoms in a child.
Fundamental causes:
• Genetic causes: sickle cell, clotting
disorders and other disorders.
• Environmental causes: infection,
medication, trauma and dissection.
• Congenital causes: arteriovenous
malformation and other cerebrovascular
anomalies.
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ComplicationsandTreatmentofstroke
Complications
• The most common problem is loss of movement on
one side of the body
Difficulties with
• walking,
• seeing,
• speaking
• or reading.
• May cause a seizure disorder
Treatment
Treatment may be a combination of the following:
• Medical therapy: aspirin or other blood thinners
(anticoagulants) and special vitamins.
• Children with sickle cell disease and stroke may be
treated with hydroxyurea, transfusion therapy or
both.
• Tissue plasminogen activator (TPA) is the only stroke
drug that actually breaks up a blood clot
• Pain control
• Bed rest
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