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CEREBRAL
PALSY
BY - Dolly Chauhan Rajput
-dcrt
CEREBRAL PALSY (CP)
• Cerebral“- Latin Cerebrum;
–Affected part of brain
• “Palsy " -Gr. para- beyond,
lysis – loosening
–Lack of muscle control
-dcrt
CEREBRAL PALSY (CP)
Definition:
• Cp is a group of permanent disorder of the
movement and posture. It is defined as an
umbrella term covering a group of non-
progressive, but often changing motor
impairment syndrome secondary to
leisons/anomalies of the brain arising in the
early stages of development.
-dcrt
CEREBRAL
PALSY
• It may stated as Static Encephalopathy in which, primary
lesion or pattern of injury is static but clinical presentation
may change with the time due to growth and neural
plasticity.
• 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 -dcrt
CP Affects
Muscle
Strength
Movements
Balance
Coordination
Posture
-dcrt
CAUSES
OF CEREBRAL PALSY
-dcrt
Neurology Chapter of IAP
CAUSES
• Variety of perinatal, prenatal, and postnatal
factors contribute to CP.
• Commonly thought to be due to birth asphyxia;
now known to be due to existing prenatal brain
abnormalities.
• Premature delivery is the single most important
determinant of CP.
• In 24% of cases, no cause is found.
-dcrt
Neurology Chapter of IAP
CAUSES
• Time (% of cases)
• Prenatal (44%)
– First trimester
– Second trimester
• Causes
• Teratogens,
chromosomal
abnormalities, genetic
syndromes, brain
malformations
• Intrauterine infections,
problems in
fetal/placental
functioning
• Rh incompatibility
-dcrt
Neurology Chapter of IAP -dcrt
CAUSES
• Time (% of cases)
• Labor and delivery
(19%)
• Perinatal (8%)
• Postnatal
• Childhood (5%)
• Not obvious (24%)
• Causes
• Preeclampsia, complications of
labor and delivery
• Sepsis/CNS infection, asphyxia,
prematurity, seizures
• Respiratory distress
• Jaundice, infections
• Meningitis, traumatic brain injury,
toxins
-dcrt
TYPES
OF CEREBRAL PALSY
-dcrt
1. On the basis of
Severity of Muscle Tone
1. Mild CP- 20% of cases
- child will move out without assistance, ADL’s
not affected.
2. Moderate CP- 50%
- require self help for assisting their impaired
ambulation capacity, Able to manage ADL’s
3. Severe CP- 30%;
-totally dependent and bedridden and they
always need care from others. -dcrt
2. On the basis of Topographical
Distribution
According to affected limbs:
* plegia or paresis - meaning paralyzed or weak:
• Monoplegia = one limb (extremely rare)
• Diplegia = two limbs
• Triplegia = three limbs (extremely rare)
• Quadriplegia = four limbs
• Hemiplegia = half side
• Paraplegia = (Only lower limbs involved)
-dcrt
Neurology Chapter of IAP -dcrt
3. On the basis of physiological
involvement
• Based on the
- extent of the damage
- area of brain damage
• Each type involves the way
a person moves
-dcrt
4. Main Types
1. Spastic CP- hypertonicity with poor posture
control
2. Athetoid CP- abnormal involuntary
movement/slow worm like writhing
3. Ataxic CP- wide-based gait
4. Mixed CP- combination of spasticity and
athetosis -dcrt
Neurology Chapter of IAP
Ataxic CP
-dcrt
Signs and
Symptoms
OF CEREBRAL PALSY
-dcrt
a.
b.
c.
d.
e.
f.
g.
h.
-dcrt
Early Signs
• Stiff or floppy posture
• feeding difficulties
• Poor head control
• Excessive lethargy or
irritability/ High pitched cry
Infancy (0-3 Months)
-dcrt
CHILD with CP
-dcrt
Behavioral Symptoms
• Poor ability to concentrate,
• Irritability
-dcrt
-dcrt
ASSOCIATED
PROBLEMS
OF CEREBRAL PALSY
-dcrt
• Hearing and visual
problems
• Sensory integration
problems
• Failure-to-thrive, Feeding
problems
• Behavioral/emotional
difficulties,
• Communication
disorders
• Bladder and bowel
control problems,
digestive problems
(gastroesophageal reflux)
• Skeletal deformities,
dental problems
• Intellectual Disabilities
and learning disabilities
• Seizures/ epilepsy
-dcrt
Treatment
OF CEREBRAL PALSY
-dcrt
- No treatment to cure cerebral palsy.
- Brain damage cannot be corrected.
• Crucial for children with CP:
–Early Identification;
–Multidisciplinary Care; and
–Support
-dcrt
“The earlier we start,
the more improvement can be made”
-Health worker
I. Non-Physical Therapy
-dcrt
A. 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.
-dcrt
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.
-dcrt
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
-dcrt
'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
II. Physical Therapy
-dcrt
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
-dcrt
C. Prone Development
D. Supine Development
o Head control on supine and positions
-dcrt
THANK
YOU -dcrt

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Cerebral Palsy basics short notes _ -dcrt _

  • 1. CEREBRAL PALSY BY - Dolly Chauhan Rajput -dcrt
  • 2. CEREBRAL PALSY (CP) • Cerebral“- Latin Cerebrum; –Affected part of brain • “Palsy " -Gr. para- beyond, lysis – loosening –Lack of muscle control -dcrt
  • 3. CEREBRAL PALSY (CP) Definition: • Cp is a group of permanent disorder of the movement and posture. It is defined as an umbrella term covering a group of non- progressive, but often changing motor impairment syndrome secondary to leisons/anomalies of the brain arising in the early stages of development. -dcrt
  • 4. CEREBRAL PALSY • It may stated as Static Encephalopathy in which, primary lesion or pattern of injury is static but clinical presentation may change with the time due to growth and neural plasticity. • 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 -dcrt
  • 7. Neurology Chapter of IAP CAUSES • Variety of perinatal, prenatal, and postnatal factors contribute to CP. • Commonly thought to be due to birth asphyxia; now known to be due to existing prenatal brain abnormalities. • Premature delivery is the single most important determinant of CP. • In 24% of cases, no cause is found. -dcrt
  • 8. Neurology Chapter of IAP CAUSES • Time (% of cases) • Prenatal (44%) – First trimester – Second trimester • Causes • Teratogens, chromosomal abnormalities, genetic syndromes, brain malformations • Intrauterine infections, problems in fetal/placental functioning • Rh incompatibility -dcrt
  • 10. CAUSES • Time (% of cases) • Labor and delivery (19%) • Perinatal (8%) • Postnatal • Childhood (5%) • Not obvious (24%) • Causes • Preeclampsia, complications of labor and delivery • Sepsis/CNS infection, asphyxia, prematurity, seizures • Respiratory distress • Jaundice, infections • Meningitis, traumatic brain injury, toxins -dcrt
  • 12. 1. On the basis of Severity of Muscle Tone 1. Mild CP- 20% of cases - child will move out without assistance, ADL’s not affected. 2. Moderate CP- 50% - require self help for assisting their impaired ambulation capacity, Able to manage ADL’s 3. Severe CP- 30%; -totally dependent and bedridden and they always need care from others. -dcrt
  • 13. 2. On the basis of Topographical Distribution According to affected limbs: * plegia or paresis - meaning paralyzed or weak: • Monoplegia = one limb (extremely rare) • Diplegia = two limbs • Triplegia = three limbs (extremely rare) • Quadriplegia = four limbs • Hemiplegia = half side • Paraplegia = (Only lower limbs involved) -dcrt
  • 14. Neurology Chapter of IAP -dcrt
  • 15. 3. On the basis of physiological involvement • Based on the - extent of the damage - area of brain damage • Each type involves the way a person moves -dcrt
  • 16. 4. Main Types 1. Spastic CP- hypertonicity with poor posture control 2. Athetoid CP- abnormal involuntary movement/slow worm like writhing 3. Ataxic CP- wide-based gait 4. Mixed CP- combination of spasticity and athetosis -dcrt
  • 17. Neurology Chapter of IAP Ataxic CP -dcrt
  • 20. Early Signs • Stiff or floppy posture • feeding difficulties • Poor head control • Excessive lethargy or irritability/ High pitched cry Infancy (0-3 Months) -dcrt
  • 22. Behavioral Symptoms • Poor ability to concentrate, • Irritability -dcrt
  • 23. -dcrt
  • 25. • Hearing and visual problems • Sensory integration problems • Failure-to-thrive, Feeding problems • Behavioral/emotional difficulties, • Communication disorders • Bladder and bowel control problems, digestive problems (gastroesophageal reflux) • Skeletal deformities, dental problems • Intellectual Disabilities and learning disabilities • Seizures/ epilepsy -dcrt
  • 27. - No treatment to cure cerebral palsy. - Brain damage cannot be corrected. • Crucial for children with CP: –Early Identification; –Multidisciplinary Care; and –Support -dcrt
  • 28. “The earlier we start, the more improvement can be made” -Health worker I. Non-Physical Therapy -dcrt
  • 29. A. 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. -dcrt
  • 30. 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. -dcrt
  • 31. 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 -dcrt
  • 32. '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 II. Physical Therapy -dcrt
  • 33. 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 -dcrt
  • 34. C. Prone Development D. Supine Development o Head control on supine and positions -dcrt