Cerebral palsy is a motor disorder caused by problems during brain development or injury to the developing brain. It causes lifelong movement and posture problems. The main types are spastic, which causes stiffness, athetoid which causes involuntary movements, and ataxic which affects balance and coordination. Symptoms vary depending on the type and severity but can include difficulty walking, sitting, controlling movements, and communicating. Treatment focuses on physical, occupational, and speech therapy as well as braces, medications, and sometimes surgery to treat complications and improve mobility. Nursing care involves assessing for symptoms, ensuring nutrition, assisting with treatments, and supporting parents.

1. Cerebral Palsy
Presented By:
Mrs. PrecillaB. Thoppil
Associate Professor

2. History
In 1860s, known as “Cerebral
Paralysis” or “little’s Disease” after
an English Surgeon wrote the 1st
medical descriptions. (William
John Little)

3. Definition
• Cerebral palsy is a motor disorder,
the condition involves disturbing
sensation, perception,
communication, cognition and
behavior, secondary must
musculoskeletal problems and
epilepsy.

4. Causes
• Problems from being born too early (premature birth)
• Not getting enough blood, oxygen or other nutrients before or during
birth.
• A serious head injury
• A serious infection that can affect the brain, such as meningitis
• Some problems passed from parent to child (genetic conditions) that
affect brain development

5. Classification
1. Spastic cerebral palsy
It causes stiffness and movement difficulties.
In this type, muscle stiffness is mainly in the legs, with the arms less affected or
not affected at all. People with spastic diplegia might have difficulty walking
because tight hip and leg muscles cause their legs to pull together, turn inward
and cross at the knees (also known as asscissoring)

7. 2. Athenoid Cerebral Palsy
Leads to involuntary and uncontrolled movements. Problems with
controlling the movement of their hands, arms, feet and legs, making it
difficult to sit and walk.
The movements are uncontrollable and can be slow and writhing or rapid
and jerky. Sometime the face and tongue are affected and the person has a
hard time sucking, swallowing and talking.
A person with dyskinetic CP has muscle tone that can change (varying from
too tight to too loose) not only from day to day, but even during a single day.

9. 3. Ataxic cerebral palsy
• It causes a disturbed sense of balance and depth perception.
Problems with balance and coordination. They might be unsteady
when they walk. They might have a hard time with quick
movements or movements that need a lot of control, like writing.
They might have a hardtime controlling their hands or arms when
they reach for something.

11. Clinical Manifestations
1. In a baby less than 6 months of age
His head lags when pick him up while he’s lying on his back
He feels stiff
He feels floppy
When held cradled in the arms, he seems to over extend his back and neck,
constantly acting as if he is pushing away
When pick him up, his legs get stiff and they cross or scissor

12. In a baby older than 6 months of age
• They doesn’t roll over in either direction
• They cannot bring their hands together
• They have difficulty bringing their hands to mouth
• They reaches out with only hand while keeping the other fisted

13. In a baby older than 10 months of age
• They crawls in a lopsided manner, pushing off with one hand and leg
while dragging the opposite hand and leg
• They scoot around on their buttocks or hops on their knees, but does
not crawl on all fours.

14. Diagnostic Evaluation
• History Taking
• Physical examination
• Neurologic assessment
• MRI
• ULTRASOUND
• CT SCAN
• EEG
• EMG and NERVE CONDUCTION STUDIES – to test the electrical activity of muscles ad to measures the conducting
function of nerves.
• Additional test: Vision impairment, hearing impairment, speech delays or impairment, intellectual disabilities,
other developmental delays, movement disorders.

15. Management
• Braces
• Physical therapy, occupational therapy, speech therapy
• Language therapy
• Recreation therapy – this therapy can help improve their motor
skills, speech and emotional well being.

16. Medications
• Anticholinergic – uncontrolled body movements
• Anticonvulsant –seizure medications
• Antidepressants – depression medications
• Antistatic – muscle relaxers
• Anti – inflammatory – pain management
• Stool softeners

17. Surgery Management
Surgery used to correct problems with bones and joints, by lengthening any muscles and
tendons that are short and causing problems.
1. Orthopedic Surgery
It may be required to correct contracture is spastic deformities, to provide stability for
an uncontrolled joint, to address bone mal alignment, and to provide balanced muscle
power.

18. 2. Selective Dorsal Rhizotomy
• It is a surgical procedure that can help children with particularly severe
muscle stiffness in their legs to improve their walking. The operation
involves cutting some of the nerves in the spinal column, which can help
relieve leg stiffness

19. 3. Gastrostomy
•Surgery may performed to improve feedings, correct
gastroesophageal reflux disease and correct
associated dental problems.

22. Nursing responsibility
• Assessment of infants for abnormal muscle tones, inability to achieve
milestones and persistence of neonatal reflexes
• Encourage parents to define their concerns, acknowledge the concerns as
genuine, and ask the parents what approach.
• Ensure as adequate nutritional and caloric intake
• Monitor the body weight
• Assistance and advice parents to administration medication through
gastrostomy tube to prevent clotting.