orthopedics.Cerebral palsy.(dr.baxtyar rasul)
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Cerebral palsy is a group of disorders resulting from non-progressive brain damage early in development. It has an incidence of 2 per 1000 live births. Common causal factors include prematurity, perinatal anoxia, kernicterus, post-natal brain infection, and post-natal injury. Symptoms may include delayed development of motor skills, stiff movements, difficulty sucking or swallowing, and spasticity. Treatment options include medications to control seizures and hyperactivity, physiotherapy, splinting, botulinum toxin injections to reduce muscle tone, and surgery to correct deformities.
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post polio residual paralysis
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Avascular necrosis of femoral head
Avascular necrosis (AVN) of the femoral head is a pathologic process that results from interruption of blood supply to the bone. AVN of the hip is poorly understood, but this process is the final common pathway of traumatic or nontraumatic factors that compromise the already precarious circulation of the femoral head. Femoral head ischemia results in the death of marrow and osteocytes and usually results in the collapse of the necrotic segment
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The document provides information on anterior cruciate ligament (ACL) injuries, including:
1. The ACL originates from the femur and inserts into the tibia, resisting anterior tibial translation and medial rotation. ACL injuries most commonly result from rapid changes in direction during sports.
2. Physical examination of ACL injuries involves tests like the Lachman test and anterior drawer test to assess knee stability. MRI is also used for diagnosis.
3. Treatment involves RICE initially, followed by either nonsurgical rehabilitation with bracing or surgical reconstruction using grafts like the patellar tendon. Reconstruction aims to restore stability and function to prevent further knee damage.
Peripheral nerve injuries
Peripheral nerve injuries can occur through various mechanisms and be classified in different ways. The median, radial, and ulnar nerves are commonly injured in the upper limb. Examination of specific muscles innervated by each nerve helps to localize the level and severity of injury. Precise history taking and clinical assessment including motor, sensory and trophic changes are needed to diagnose peripheral nerve lesions.
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hip osteoarthritis is most disabling condition and surgery is a consequence of the same. but if this condition can assess on time so it can be manageable with conservative treatment and decrease the prevalence of AVN. further life of an individual become better.
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Shoulder impingement syndrome occurs when the tendons of the rotator cuff muscles become irritated and inflamed as they pass through the subacromial space under the coraco-acromial arch. It results in pain, weakness, and loss of movement, especially in an arc between 45-160 degrees of shoulder abduction and elevation. Causes include repeated overhead arm use, trauma, poor posture, and degenerative changes. Clinical features are pain at rest or with movement, and limited range of motion. Diagnosis involves x-rays and MRI, while special tests like Neer's and Hawkins' tests reproduce shoulder pain. Treatment consists of rest, anti-inflammatories, physical therapy including stretching,
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- Pes planus is characterized by a low or absent medial longitudinal arch. It can be flexible or rigid.
- Causes include ligament laxity, obesity, muscle weakness, bony abnormalities, and tarsal coalitions.
- Treatment focuses on orthotics, stretches, braces, and surgery if conservative options fail. Surgical procedures include tendon lengthening, osteotomies, and fusions.
perthes disease
This document provides an overview of Legg Calve Perthes disease, including its definition, demographics, risk factors, pathogenesis, clinical features, investigations, classifications, management, and surgical procedures. Some key points:
- It is avascular necrosis of the femoral head in children, most common in ages 4-8 years. Positive family history and low birth weight are risk factors.
- Clinical features include hip/thigh pain aggravated by movement. Imaging shows stages from avascular necrosis to fragmentation to regeneration/healing.
- Conservative management includes bracing for young/mild cases. Surgical containment is used for more severe/older cases to encourage spherical remodeling.
- Procedures
Pott’s fracture
ANKLE FRACTURES
Pott’s fracture
A Pott’s fracture is a type of ankle fracture that is characterized by a break in one or more bony prominences on the sides of the ankle known as the malleoli.
Also known as Broken Ankle, Ankle Fracture and malleolar fracture.
Pott’s fracture often occurs in combination with other injuries such as a sprained ankle or other fractures of the foot, ankle or lower leg.
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This document discusses principles of tendon transfers for restoring lost movement. It outlines key principles such as having supple joints before transfer, using a donor tendon with adequate excursion and strength, adhering to principles of synergy and straight line of pull. The timing of transfers depends on the likelihood of nerve recovery but can be done early to aid recovery. Contraindications include a lack of suitable donor muscles or transfers for joints with stiffness. Classification systems like Sunderland and Seddon are used to describe nerve injuries requiring tendon transfers.
Arthrodesis
Arthrodesis refers to the surgical fusion of a joint. It is indicated for pain and instability in the joint. With improvements in joint replacement surgery, arthrodesis is now less commonly performed. It permanently relieves pain by fusing the bones and eliminating joint movement, at the cost of stiffness. The optimal positions for fusing different joints are described. Common complications include malposition and nonunion.
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Tuberculosis of the hip is caused by Mycobacterium tuberculosis infection. It typically affects people aged 20-30 years old. The infection spreads hematogenously from a primary focus and causes destruction of bone and joints over several years. Clinical features include limping, decreased range of motion, and deformities in advanced cases. Imaging shows osteopenia, joint space narrowing, and bone erosion. Treatment involves chemotherapy for at least 6-9 months along with local measures like joint aspiration and traction. Surgery may be needed for debridement, arthrodesis, or arthroplasty in advanced cases.
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Shoulder Dislocations
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Rotator cuff injuries
This document discusses the anatomy, biomechanics, causes, symptoms, diagnosis, and treatment of rotator cuff tears. It begins by introducing the rotator cuff muscles and their function in stabilizing the shoulder joint. Common causes of tears include impingement, trauma, aging, and ischemia. Symptoms include shoulder pain that is worsened with overhead activities. Diagnosis involves physical exam maneuvers like the Neer's and Hawkins tests as well as imaging like x-rays, ultrasound, CT, or MRI. Treatment ranges from rest, physical therapy, and injections for mild cases to surgical repair for larger or chronic tears if conservative measures fail.
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The document discusses various types of orthotic devices and their purposes, including arm slings to prevent shoulder subluxation, arm troughs to support painful shoulders, wrist and hand splints to reduce stress on joints and decrease pain from conditions like rheumatoid arthritis, and finger splints to immobilize injuries. It also covers devices to restore mobility like elbow hinges and hand gauntlets, and devices that substitute for or modify muscle tone like wrist-hand orthoses.
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Orthosis are devices used to support weak joints and correct deformities. They work by applying three point pressure and distributing weight across a wide surface area. Common orthosis include ankle foot orthosis (AFO) which support the ankle and foot, knee ankle foot orthosis (KAFO) which stabilize the knee and lower leg, and hip knee ankle foot orthosis (HKAFO) which provide support from the hip to the foot. Orthosis are made of plastic or metal and their design depends on the joints needing support and the individual's condition.
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The document discusses extrapyramidal disorders and basal ganglia disorders. It provides information on:
- The extrapyramidal system and basal ganglia, which are involved in motor control and other functions.
- Movement disorders are divided into hyperkinetic disorders involving excessive movements (chorea, dystonia) and hypokinetic disorders with diminished movement (akinesia, bradykinesia, rigidity).
- Lesions in the basal ganglia can cause specific movement disorders like athetosis, dystonia, bradykinesia, rigidity, tremor, and others.
- Parkinson's disease is discussed as a primary hypokinetic disorder caused by degeneration of dopaminergic
Duchene muscular dystrophy
muscle degeneration and weakness. It is one of nine types of muscular dystrophy.(most common and sever clinical symptoms)
Cerebral Palsy
The term ‘cerebral palsy’ includes a group of disorders that result from permanent non-progressive brain damage during early development and are characterized by abnormalities of movement and posture.
Cerebral Palsy Orthopedic Manifestations and Treamtnes
Cerebral palsy (CP) is a group of disorders caused by non-progressive brain damage early in development. It is characterized by abnormal movement and posture. The main types are spastic, dyskinetic, ataxic and mixed. CP is diagnosed based on symptoms, medical history and examination. Management includes therapies to improve mobility, surgical correction of deformities, medications to reduce spasticity, orthotics and assistive devices. The goals are maximizing function and independence.
Cerebral palsy
Cerebral palsy is a group of non-progressive motor conditions that cause physical disability, primarily in body movement. It is caused by damage to the developing brain that can occur during pregnancy, childbirth, or shortly after birth. The main types of cerebral palsy are spastic, ataxic, athetoid/dyskinetic, and hypotonic. Symptoms vary but can include abnormal muscle tone and reflexes, joint and bone deformities, involuntary movements, impaired gait, and balance problems. Secondary conditions such as seizures, intellectual disabilities, and speech/language disorders are also common. There is no cure for cerebral palsy, but treatment focuses on managing symptoms, preventing complications, and
Low back-pain-review
The document summarizes key points about low back pain (LBP):
- LBP is extremely common, with lifetime prevalence rates from 50-80% and point prevalence rates of 15-30%
- LBP can be classified as acute (<4 weeks), subacute (4 weeks to 3 months) or chronic (>3 months)
- Causes of LBP include mechanical (80-90%), neurogenic (5-15%), and other non-mechanical causes
- Features in history and examination can help distinguish neuropathic from mechanical LBP and identify red flags requiring further evaluation
Ayurvedic management of disc prolapse
The document discusses Ayurvedic management of disc prolapse. It begins by describing the causes as repetitive mechanical activities, obesity, poor posture, injury, and genetics. Symptoms include severe back pain radiating to the lower limbs. Diagnosis involves physical exam and imaging tests. Conventional treatments include bed rest, anti-inflammatories, physical therapy, and injections. Ayurvedic management focuses on detoxification, strengthening tissues, proper nutrition and herbs, yoga, and therapies like oil massages. The goal is to reduce pain and inflammation, strengthen tissues, and prevent further deterioration.
Ayurvedic management of disc prolapse
The document discusses Ayurvedic management of disc prolapse. It begins by describing the causes as repetitive mechanical activities, obesity, poor posture, injury, and genetics. Symptoms include severe back pain radiating to the lower limbs. Diagnosis involves physical exam and imaging tests. Conventional treatments include bed rest, anti-inflammatories, physical therapy, and injections. Ayurvedic management focuses on detoxification, strengthening tissues, proper nutrition and herbs, yoga, and therapies like oil massages. The goal is to reduce pain and inflammation, strengthen tissues, and prevent further deterioration.
CEREBRAL PALSY
This document provides an overview of cerebral palsy, including:
- Cerebral palsy is caused by non-progressive damage to the developing brain that causes motor impairments. Common types include spastic diplegia, hemiplegia, and quadriplegia.
- Insults can occur prenatally, perinatally, or postnatally from factors like genetic disorders, infections, or trauma.
- Treatment is multidisciplinary and may include medications, physical therapy, bracing, and surgery to address secondary deformities like contractures. Surgical procedures are aimed at improving function, mobility, and care.
Orthopedic disorders in children
the presentation contains club foot, juvenile rheumatoid arthhritis, hip dysplacement, fractures,osteomyelitis, kyphosis, scoliosis, lordosis, syndectyly, polydectyly etc
Osteochondroses
Osteochondrosis is a defect in bone growth that causes avascular necrosis. It commonly affects the epiphyses of joints in children and adolescents. Some specific types discussed include Legg-Calve-Perthes disease of the hip, Kohler's disease of the navicular bone, and Freiberg's infraction of the metatarsal heads. The document outlines the causes, presentations, classifications, imaging findings, and treatment options for various forms of osteochondrosis.
Physical-Disability.pptx
This document discusses students with physical disabilities, health impairments, and severe disabilities. It provides vignettes of individuals who overcame disabilities, including Apolinario Mabini, Arturo Acosta Borjal, Stephen Hawking, and Christopher Reeve. It then describes types of physical disabilities such as cerebral palsy, neural tube defects, seizure disorders, traumatic brain injury, and degenerative diseases. It also lists various health impairments and concludes by mentioning different assistive technologies that can help students with disabilities.
Periarthritis shoulder & painful arc
This document discusses periarthritis of the shoulder, also known as frozen shoulder. It begins by defining the condition as an inflammatory disorder of the shoulder joint and surrounding soft tissues. It then describes the three stages of frozen shoulder according to Cyriax: stage 1 involves pain with movement, stage 2 includes increased stiffness, and stage 3 is the recovery stage with gradual return of movement. The document outlines causes such as injury, prolonged immobility, diabetes, and thyroid disorders. Signs, symptoms, diagnosis, and management are explained, including medications, cortisone injections, physical therapy, and possibly surgery if conservative treatment fails.
Duchenne muscular dystrophy
Duchenne Muscular Dystrophy is a genetic disorder characterized by progressive muscle weakness due to a lack of the protein dystrophin. It is caused by mutations on the X chromosome and mainly affects boys. Symptoms begin in early childhood with difficulty walking and climbing stairs. As the disorder progresses, children become wheelchair-bound in their early teens and are at risk of cardiac and respiratory complications leading to an early death usually in the 20s. Management focuses on physical therapy, bracing, steroid treatment, and respiratory support to improve quality of life.
Approach to limping child 2
This document discusses the approach to evaluating a limping child. It begins by outlining the main causes of a limp as being pain, weakness, or structural abnormalities. Different abnormal gaits are then described that may provide clues to the underlying etiology, such as an antalgic gait indicating pain in one limb. A differential diagnosis is presented divided by painless versus painful limps and by age. The approach is then outlined as obtaining a thorough history, performing a full examination, ordering appropriate investigations, and determining the proper management.
Habilitation Perspective in the management of Cerebral Palsy.pptx
Institute for Child Development (ICD) is a private company registered under section 25 of company registration act, 1956. ICD is the brain child of Dr. Mansoor Alam, a pediatric developmental specialist who has treated more than 50,000 children with special needs during the last 25 years. ICD is a premier organization which provides the best treatment to children with complex health issues, developmental delay, neurodevelopmental disorders and childhood onset disabilities. ICD’s facility is available to children from birth to 21 years of age. Adult with disabilities are specially supported in case of need. ICD is the only organization in India which practices integrated approach of treatment, named as Multimodal treatment / Combination Therapy for children with developmental disorders. Combination Therapy combines the best available treatments into one treatment plan to get the best result. Researches have proved that combination therapy is better than isolated therapy. In fact, pediatric developmental disorders cannot be treated in isolation. It requires a team of professionals with varied specialization.
Presently ICD has its model centre named as “PediaMed” in Malviya Nagar (South Delhi), New Delhi. The model centre has capacity to treat 100 children in daily basis.
ICD is going to have its branches in the following places
North Delhi
West Delhi
East Delhi
Noida ( UP)
Ghaziabad (UP)
Faridabad (Haryana)
Gurugram /Gurgaon (Haryana)
Bahadurgarh (Haryana)
ICD is open to collaborate with other organizations with similar interests in rest of India
Similar to orthopedics.Cerebral palsy.(dr.baxtyar rasul) (20)
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Development
This document discusses child development from birth through adolescence. It covers the major areas of development - gross motor, fine motor, language, social/emotional - and provides typical milestones for various age groups like sitting up alone by 6 months and walking by 12-15 months. The document also mentions tools for assessing development like the Denver Developmental Screening Test and discusses prolonged development during school age and the biological, psychological, and social changes of adolescence.
Electrocardiographymain
This document discusses the vectorial approach to electrocardiography (ECG) interpretation. It explains that the vectorial approach views the standard ECG as representing three-dimensional vector forces over time, whereas a standard ECG shows only magnitude. By combining data from different ECG leads, one can derive information about the direction of forces. It also discusses how to interpret information about the frontal plane from limb leads and the horizontal plane from precordial leads, including the orientation and meaning of waves in each lead. Finally, it notes that ECGs differ between infants/children and adults due to anatomical differences, with infants typically showing right ventricular dominance.
Immunization2
The document discusses several vaccines including BCG, DTP, polio, Hib, MMR, rotavirus, varicella, hepatitis A, and pneumococcal. It provides information on the nature of the vaccines, indications for use, efficacy, administration schedule and route, storage requirements, adverse reactions and contraindications. Specific details are given for dosage, intervals between doses, age for administration and booster schedules for many of the vaccines.
Gyne,obst slides
The document contains medical terminology related to gynecology and obstetrics procedures, diagnoses, and conditions. Terms include descriptions of stages of labor, perineal injuries, reproductive anatomy, cysts, cancers, pregnancies, fertility treatments, versions, syndromes, and more. The document provides a list of brief medical terms and descriptions related to women's health and childbirth.
Catch up vaccine
1) The document provides immunization recommendations for children and teens from birth through 18 years of age. It outlines the recommended vaccines, dosing schedules, catch-up schedules, and contraindications.
2) Key recommended vaccines include hepatitis B, DTaP, polio, influenza, varicella, MMR, and Hib. The schedules provide the ages for routine administration, number of doses, minimum intervals between doses, and other guidance.
3) The document also lists contraindications and precautions for each vaccine, such as previous allergic reactions, immunosuppression, or moderate to severe acute illness. It aims to help healthcare providers appropriately immunize children and teens on time.
Assessment examination1
The document outlines an assessment examination for OBGYN consisting of 7 rooms evaluating various skills. Room 1 involves taking a history from a pregnant patient with vaginal bleeding and abdominal pain. Room 2 examines skills and findings from examining a patient after a normal vaginal delivery. Room 3 involves multiple choice questions about uterine sounds, speculums, oxytocin, curettes, and hysterosalpingograms. Room 4 presents an emergency preeclampsia case to diagnose, manage, and plan a delivery for. Room 5 involves analyzing a partogram to diagnose failure to progress labor and determine management. Room 6 presents an emergency ectopic pregnancy case to diagnose and manage. Room 7 involves identifying indications for various clinical presentations and procedures from
Assessment examination
The document outlines an assessment examination for pediatrics consisting of 11 rooms. In each room, students will demonstrate skills in history taking, physical examinations including respiratory, abdominal, and cardiovascular, interpret various tests and x-rays, diagnose conditions like iron-deficiency anemia, immune thrombocytopenic purpura, diaphragmatic hernia and recurrent aphthous ulcers. Students will also assess developmental age, recommend catch-up vaccinations, and identify clinical tools like pulse oximetry, intravenous fluids, and nebulizers along with their uses.
Medications
This document summarizes information on several drugs used to treat gynecological conditions. It describes the components, mechanisms of action, usages, dosages and side effects of drugs like Mirena (intrauterine device), Yasmin (oral contraceptive), Primolut (progesterone), Depo Provera (contraceptive injection), and drugs used for fertility treatments, menstrual disorders, pre-eclampsia and postpartum hemorrhage.
Hysterosalpingography
This document provides information on hysterosalpingography (HSG) procedures, including equipment used, indications, contraindications, timing, normal findings, and various abnormal findings. It lists conditions that can be evaluated with HSG such as infertility, congenital uterine anomalies, recurrent miscarriage, abnormal bleeding, and uterine masses. Potential risks including pain, bleeding, infection, and allergic reaction are noted. Images demonstrate normal uterine anatomy and various uterine anomalies detectable on HSG.
بسم الله الرحمن الرحيمAph
This document summarizes antepartum hemorrhage (APH), defined as bleeding in the third trimester between 24 weeks of pregnancy until delivery. Placenta previa, where the placenta covers all or part of the cervical os, is a major cause of APH, accounting for 30% of cases. Ultrasound is used to diagnose and grade placenta previa. Management depends on gestational age and bleeding severity, and may involve bed rest, blood transfusions, or caesarean section which is usually required for complete placenta previa. Complications of placenta previa include preterm birth, malpresentation, postpartum hemorrhage, and in rare cases
Ectopic pregnancy
This document provides information on ectopic pregnancy, including:
1. Ectopic pregnancy occurs when a fertilized egg implants outside the uterus, most commonly in the fallopian tubes.
2. Risk factors include STIs, IUD use, infertility history, smoking, and assisted reproduction.
3. Symptoms can include abdominal/pelvic pain, vaginal bleeding, and in severe cases, hypovolemic shock from rupture. Diagnosis involves ultrasound and beta-hCG levels.
4. Treatment options are expectant management, surgery (laparoscopy or laparotomy), or medical management with methotrexate depending on factors like size and symptoms. The goal is to preserve
Gestational trophoblastic disease 2
This document defines gestational trophoblastic disease and describes the pathological classification and genetic features of complete and partial hydatidiform moles. It also discusses the clinical presentation, diagnosis, treatment, and follow up of molar pregnancies. The main treatment is surgical evacuation, followed by careful monitoring of hCG levels to detect persistent trophoblastic tissue which may develop into invasive mole or choriocarcinoma in about 10% of cases. Close follow up for years after evacuation is important to identify and treat malignant cases early through chemotherapy.
Disfunctional uterine bleeding.gynaecology
Menstrual disorders are common reasons for women to see their doctor. They include menorrhagia (excessive bleeding), dysmenorrhea (painful periods), and amenorrhea/oligomenorrhea (absent or infrequent periods). Menorrhagia is defined as blood loss over 80ml and affects around 5% of women annually. It can be caused by pelvic issues, systemic diseases, or dysfunctional uterine bleeding. Treatment involves addressing the underlying cause, using medications like NSAIDs or hormonal drugs, or pursuing surgical options like endometrial ablation or hysterectomy if medications fail. A thorough history, examination, and testing are required to diagnose the cause and properly manage menorrhagia.
anaestheisa
Oxygen therapy is indicated for patients with low blood oxygen levels and is commonly provided after surgery. Supplemental oxygen can be administered through a nasal cannula, which provides oxygen through prongs in the nose and is comfortable for patients. The amount of oxygen received depends on factors like flow rate and breathing. A flow of 6L/min provides about 44% inhaled oxygen. Different types of face masks provide varying oxygen concentrations depending on their design and flow rates, such as whether they include reservoirs or valves. Air-entrainment masks use the Venturi effect to mix oxygen and room air for stable oxygen levels.
meidicine. first seizure.(dr.muhamad tahir)
This document discusses the management of a first seizure. It defines seizures and classifies them as generalized or partial. Common causes of first seizures include idiopathic, infections, tumors, and strokes. Management involves documenting the seizure history, examining the patient, checking glucose and other basic labs, observing the patient, and providing advice about seizure precautions and follow up. Recurrence is common within 6 months, especially for symptomatic causes or those with abnormal EEGs or family history of epilepsy.
medicine.Poisoningbyspecificdrugs.(dr.shaikhani)
1. Paracetamol toxicity results from formation of a reactive metabolite that binds to cellular proteins, causing cell death and hepatic or renal failure. Acetylcysteine replenishes glutathione stores and is highly effective if given within 8 hours of overdose.
2. Salicylate poisoning causes respiratory alkalosis, metabolic acidosis, and organ damage. Treatment involves correcting dehydration and acidosis with sodium bicarbonate. Hemodialysis is effective for removing salicylates from the body.
3. Tricyclic antidepressant overdose can cause arrhythmias, hypotension, and seizures due to sodium channel blockade. Treatment involves sodium bicarbonate to correct
medicine.Coma managment.(dr.muhamad tahir)
1. The document discusses various levels of impaired consciousness ranging from confusion to coma and defines them. It also describes the anatomy of the reticular activating system and two patterns of coma - diffuse cerebral injury or focal brainstem injury.
2. Specific causes of diffuse cerebral injury or focal brainstem injury that can lead to coma are provided. Evaluation of a comatose patient involves assessing level of consciousness, brainstem reflexes, and determining if focal neurological signs are present.
3. Management may involve giving thiamine, dextrose, naloxone and flumazenil in cases of diffuse injury without a known cause. For focal injuries, neuroimaging is important to identify structural
medicine.CRF2.(dr.kawa)
Chronic renal failure refers to the irreversible deterioration of renal function over years. It initially presents as biochemical abnormalities and eventually leads to uraemic symptoms as the excretory, metabolic and endocrine functions of the kidneys fail. Common causes include diabetes, hypertension, and glomerulonephritis. Management involves identifying and treating the underlying disease, slowing progression, managing complications, and renal replacement therapy for end-stage disease.
medicine.Age and aging lecture 1.(dr.aso)
This document discusses geriatric medicine and the aging population. It notes that the elderly population is growing significantly both in developed and developing countries. Physiological changes that occur with aging can impact multiple body systems and lead to atypical disease presentation and an increased risk of adverse drug reactions. A comprehensive geriatric assessment considers medical, psychological, functional, social and environmental factors when evaluating elderly patients.
medicine.Vasculitis 2.(dr.kawa)
Polymyalgia rheumatica (PMR) is a clinical syndrome characterized by muscle pain and stiffness affecting the neck, shoulders, and hips that is associated with an increased erythrocyte sedimentation rate. It predominantly affects those over age 50 and women are more commonly affected than men. Treatment involves corticosteroids which provide rapid relief of symptoms for most patients. Tapering of steroids over 12-18 months is usually needed.
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orthopedics.Cerebral palsy.(dr.baxtyar rasul)
- 2. Group of disorders which result from non-progressive brain damage during early development
- 3. Incidence : 2/ 1000 lives
- 4. Causal factors: 1- Prematurity 2- Perinatal anoxia 3- Kernicterus 4- Post-natal brain infection 5- Post-natal injury
- 5. Early Diagnosis 1- perinatal difficulty 2- Stiff Baby
- 6. 3- Dribbling at the mouth
- 7. 2- Difficulty in sucking and swallowing
- 8. 5- Developmental milestones delayed ( Normally holds head up at 3 months Sits up at 6 months Walking at 12 months
- 9. Later Diagnosis 3 typs: Spastic Paresis(% 60) Spasticity Weakness Brisk reflexes Babiniski sign (+ve) Normal sensation ± Fits ± Impaired intelligence
- 11. Appear as (1) Hemiplegia( One side of body) (2) Diplegia ( Both lower limbs) (3) Total body paresis( Usually low IQ) (4) Isolated asymmetrical paresis
- 12. Athetosis Continous , involuntary writhing movements
- 13. Ataxia Muscular incoordination during voluntary movements
- 14. Characteristic deformities Elbow flexion Wrist flxion Fingers flexion Hip adduction( scissor posture) Knee flexion Ankle equinus
- 15. Treatment
- 16. Medication: Fits and Hyperactivity
- 17. Physiotherapy: 1st year of life
- 18. Splintage: (1) To counteract spastic deformitie (2) Hold position after surgery
- 19. Botulinum A toxine: to decrease muscle tone
- 20. Surgery: (1) Spastic postures which cannot be controlled by conservative Measures. (2) Fixed deformities (3) Secondary complications ( Bone deformity, Hip dislocation, Joint instability)
- 21. Principles and Guidelines of Treatment (1) Hemiplegia = Good response to conservative or surgical treatment Will be able to walk unaided. Diplegia = More difficult but will be able to walke Total body involvement: Poor prognosis for walking (2) Surgery at 6 years age( Unless fixed deformity threatening)
- 22. (3) Surgical options: (a) Tight muscles are released OR Their tendons lengthened
- 23. (b) Nerve transaction when severe spasticity
- 24. (c) Correction of fixed deformities by: (1) Osteotomy (2) Joint fusion (3) Arthroplasty