Today's lecture discussed cerebral palsy. It covered the definition, causes, types, clinical features and management of cerebral palsy. Specifically, it defined cerebral palsy as a non-progressive motor dysfunction caused by brain damage. The main causes were identified as genetic factors, complications during birth, infections and trauma. The types and clinical features of spastic, ataxic, athetoid and mixed cerebral palsy were explained. Management involves physical, occupational and speech therapy as well as surgery. Nursing management focuses on mobility, development, protection and education.

1. GODAVARI COLLEGE OF NURSING
PRACTICE TEACHING ON
CEREBRAL PALSY
SUBMITTED TO SUBMITTED BY
MRS VISHAKHA MAM MISS SWATI SANGOLE
ASS. PROFESSOR MSC FIRST YEAR
G.C.O.N JALGAON G.C.O.N JALGAON
SUBMITTED ON:

2. SUBJECT : NURSING EDUCATION
TOPIC : CEREBRAL PALSY
METHOD OF TEACHING : LECTURE CUM DISCUSSION
DATE AND TIME : 27/1/2017 TIME: 12PM
DURATION : 45 MIN
NUMBERS OF LEARNERS: 20
TYPE OF COURSE : M. Sc. NURSING
EDUCATIONAL LEVEL : 1ST YEAR
A.V. AIDS : CHART, BLACK BOARD, PPT, LEAFLET, ROLLER BOARD
VENUE : GODAVARI COLLEGE OF NURSING

3. GENERAL OBJECTIVES:
At the end of the class the students will be able to gain knowledge regarding cerebral
palsy and will be able to apply this knowledge while practicing nursing profession.
SPECIFIC OBJECTIVE:
By the end the students learn about:
 define the club foot
 enlist the incidence and etiology of the club foot
 enumerate the clinical features of the club foot
 list the type of club foot
 explain the diagnosis of the club foot
 described the management of the club foot
 explain the nursing management

4. TIME SPECIFIC
OBJECTIVE
CONTENT TEACHING
LEARNING
ACTIVITY
A.V.AIDS EVALUATION
2min
3min
4min
The student
should explain
the introduction
of the cerebral
palsy
The student
should define the
definition of the
cerebral palsy
The student
should enlist the
incidence and
etiology of
cerebral palsy
INTRODUCTION
Cerebral palsy is a group of non-progressive disorder resulting from
malfunction of the motor centres and pathway of brain. It is a non-
curable and nonfatal condition due to damage of growing brain before
or during birth.
DEFINITION
Cerebral palsy is a chronic non-progressive motor dysfunction caused
by damage to the motor areas of brain.
INCIDENCE AND ETIOLOGY
In 2007, the incidence of cerebral palsy was estimated
to be 2.12-2.45 per 1000 live birth.
a. Prenatal factors
 Genetic or chromosomalanomalies
 Brain malformation
 Exposure to teratogens
 Multiple features
 Intrauterine infection
 Placental problems causing insufficient nutrition
and oxygen delivery to the fetus
Lecture cum
discussion
Explain
listening
Roller
board
poster
The student will
be understand
define the
Cerebral palsy
student will be
understand the
incidence and
etiology of the
cerebral palsy

5. TIME SPECIFIC
OBJECTIVE
CONTENT TEACHING
LEARNING
ACTIVITY
A.V.AIDS EVALUATION
5min
The student
should enlist the
classification of
cerebral palsy
b. Birth factors
 Pre eclampsia
 Complicated labour and delivery
 Birth injury caused by direct head trauma
c. Perinatal factor
 Kernicterus
 Central nervous system infection
d. Childhood factors
 Head trauma
 Meningitis
 Toxic infection like lead poisoning
 Shaken baby syndrome
CLASSIFICATION
Cerebral palsy is divided into four major classes
according to different impairment and areas of brain that
are damaged.
1. Spastic cerebral palsy
80% of all cases.
a. Spastic Hemiplegia
 Injury to the left side of the brain will cause right
side bodydeficit and vice versa
Lecture cum
discussion
poster
student will be
understand the
classification of
cerebral palsy

6. TIME SPECIFIC
OBJECTIVE
CONTENT TEACHING
LEARNING
ACTIVITY
A.V.AIDS EVALUATION
 These patient are most ambulatory of all forms of
spastic cerebral palsy
 The affected person have equinus on the affected
side and are prescribed ankle-foot orthoses to
prevent equinus.
b. Spastic Diplegia
 In this type, lower extremities are affected with
little or no upper bodyspasticity.
 This is the common form, seen in 70-80% cases
 These patient have a ‘scissors gait’
 These patient may also have near-sightedness or
strabismus
c. Spastic Monoplegia
 One limb is affected
d. Spastic Triplegia
 Three limbs are affected
e. Spastic Quadriplegia
 All four limbs are affected
 These patient are unable to walk

7. TIME SPECIFIC
OBJECTIVE
CONTENT TEACHING
LEARNING
ACTIVITY
A.V.AIDS EVALUATION
2. Ataxic cerebral palsy
 Caused by damage to cerebellum
 Occurs in about 10% of cases
 Wide based gait
 Motor skill like writing, typing or using scissors might
be affected
 Hypotonia and tremors are present
3. Athetoid
 Athetoid cerebral palsy involves mixed muscle tone
both hypotonia are present along with constant
involuntary writing motions
 10% patient have this type of cerebral palsy
 Patients have trouble holding themselves in upright
steady position for sitting or walking
4. Mixed type
 Symptoms of more than one form exist in these
patients.

8. TIME SPECIFIC
OBJECTIVE
CONTENT TEACHING
LEARNING
ACTIVITY
A.V.AIDS EVALUATION
4min The student
should explain
the clinical
feature of cerebral
palsy
CLINICAL FEATURES
 Abnormal muscle tone and reflexes
 There can be joint and bone deformities and
contractures
 The classical symptoms are spasticity, spasms, other
involuntary movements, problem with balance.
 Pain is associated with tight and shortened muscle,
abnormal posture, stiff joints.
 Skeletal abnormalities and angular deformities.
 Overall language delay is associated with problems of
mental retardation, hearing impairment.
 Speech and language disorder
 Seizures, epilepsy, apraxia, dysarthria or other
communication disorder
 Birth defects, such as spinal curvature, a small
jawbone or a small head sometimes occur along with
cerebral palsy
 Irregular posture
Lecture cum
discussion
PPT The student will
be understand
the clinical
feature of
cerebral palsy

9. TIME SPECIFIC
OBJECTIVE
CONTENT TEACHING
LEARNING
ACTIVITY
A.V.AIDS EVALUATION
CLASSIFICATION ACCORDING TO SEVERITY
Mild cerebral palsy: (20%)
Patient are ambulatory, fine movements are impaired only
Moderate cerebral palsy: (50%)
These children achieve ambulation by self-help. These is
impaired gross motor, fine motor, and speech development.
Severe cerebral palsy: (30%)
The children present with multiple defect and unable to
perform usual activities of daily living.

10. TIME SPECIFIC
OBJECTIVE
CONTENT TEACHING
LEARNING
ACTIVITY
A.V.AIDS EVALUATION
3min
8min
The student
should enumerate
the cerebral palsy
The student
should describe
the cerebral palsy
DIAGNOSTIC EVALUATION
Patient history
Physical examination
CT scan
MRI
EEG
Psychometric test
Examination on blood and urine
MANAGEMENT
1. Physicaltherapy
Physiotherapy programs are designed to improve gait and
voluntary movement, together with stretching programs to
limits contractures.
2. Occupationaltherapy
It help the children and adult maximize their functioning,
adapt to their limitation and live as independently as
possible. Occupational therapy
Enables individuals with cerebral palsy to participate in
activities of daily living are meaningful to them.
Asking
questions
Taking notes
Chart
PPT
The student will
be understand
the clinical
feature of
cerebral palsy
The student will
be understand
the management
of cerebral palsy

11. TIME SPECIFIC
OBJECTIVE
CONTENT TEACHING
LEARNING
ACTIVITY
A.V.AIDS EVALUATION
3. Speechtherapy
It help to control the muscles of the mouth and jaw, and
help improve communication. Speech therapy often starts
before a child begins schooland continues throughout the
schoolyear.
4. Biofeedback
It is alternative therapy in which people with cerebral
palsy learn to control their affected muscles
5. Massagetherapy
It is designed to help relax tense muscles, strengthen
muscles, and keep joints flexible.
6. Drug therapy
Botulinum Toxins An injection are given into muscle that
are spastic or sometime dystonic, the aim being to reduce the
muscle hypertonus that can be painful.
Most often lower extremities muscles are injected and
reinjection is needed every 4-6 months.

12. TIME SPECIFIC
OBJECTIVE
CONTENT TEACHING
LEARNING
ACTIVITY
A.V.AIDS EVALUATION
4min
7. Surgery and orthoses
Loosening of tight muscles and releasing fixed joints,
most often performed on the hips, knees, hamstrings and
ankles.
Straightening abnormal twist of the leg bone i.e. femur
and tibia.
Cutting nerves of the limbs most affected by spasms. This
procedure, called rhizotomy reduce spasmand allow
more flexibility and control of the affected limbs and
joints
PROGNOSIS
Cerebral palsy is not a progressive disorder, but the
symptoms can become more severe over time due to
subdural damage. A personwith the disorder may
improve somewhat during childhood if he or she receives
extensive care from specialists, but bones and
musculature become more established, orthopaedic
surgery may be required.

13. TIME SPECIFIC
OBJECTIVE
CONTENT TEACHING
LEARNING
ACTIVITY
A.V.AIDS EVALUATION
3min
6min
The student
should explain
the prevention of
cerebral palsy
The student
should explain
the nursing
management of
the cerebral palsy
PREVENTION
Antenatal care: prevention of maternal infection, fetal
problems and perinatal hazard
Prevention of birth injury, perianal asphyxia.
Early diagnosis and prompt initiation of appropriate
management of etiological factors along with the condition,
reduce the incidence of neurological, psychological and
emotional handicapped of the child.
NURSING MANAGEMENT
Nursing assessment should include the detection of ability
to perform activities of daily living, developmental
milestones, neurological reflexes, feeding behaviour,
nutritional status, bladder, and bowel habits, problem related
to vision, hearing and language, associated health hazards or
congenital anomalies, present problem, parent child
interactions, treatment compliance etc. nursing diagnosis
should be formulated accordingly to plan and to provide
nursing interventions.
Lecture cum
discussion
Explanation
Taking notes
Black
board
PPT
The student will
be understand
the prevention of
cerebral palsy
The student will
be understand
the nursing
management of
the cerebral
palsy

14. TIME SPECIFIC
OBJECTIVE
CONTENT TEACHING
LEARNING
ACTIVITY
A.V.AIDS EVALUATION
Nursing intervention
Increasing mobility and minimizing deformity
Maximizing growth and development
Protect the child
Health education

15. TIME SPECIFIC
OBJECTIVE
CONTENT TEACHING
LEARNING
ACTIVITY
A.V.AIDS EVALUATION
CONCLUSION
Cerebral palsy (CP) isa group of permanent movementdisorders that
appearin earlychildhood.Signsandsymptomsvaryamongpeople.Often,
symptomsinclude poorcoordination, stiff muscles,weakmuscles,and
tremors.There maybe problemswith sensation,vision,hearing,swallowing,
and speaking.Oftenbabieswithcerebral palsydonotroll over,sit,crawl,or
walkas earlyas otherchildrenof theirage.Difficultywiththe abilityto think
or reasonand seizures eachoccursinabout one thirdof people withCP.
While the symptomsmaygetmore noticeable overthe firstfewyearsof life,
the underlyingproblemsdonotworsenovertime
SUMMARY
Today we have discussed the topic cerebral palsy. In that we see the
introduction definition, causes , incidence, types, diagnostic evaluation,
management and nursing management

16. TIME SPECIFIC
OBJECTIVE
CONTENT TEACHING
LEARNING
ACTIVITY
A.V.AIDS EVALUATION
REFERRANCE
  "Cerebral Palsy: Overview". National Institutes of Health.
September 5, 2014. Retrieved 4 March 2015.
  "CEREBRAL PALSY, SPASTIC QUADRIPLEGIC, 1; CPSQ1".
Online Mendelian Inheritance in Man. November 13, 2012. Retrieved
4 March 2015.
  "How many people are affected?". National Institutes of Health.
September 5, 2014. Retrieved 4 March 2015.
  Oskoui, M; Coutinho, F; Dykeman, J; Jetté, N; Pringsheim, T
(Jun 2013). "An update on the prevalence of cerebral palsy: a
systematic review and meta-analysis.". Developmental Medicine &
Child Neurology. 55 (6): 509–19. doi:10.1111/dmcn.12080.
PMID 23346889.
  Panteliadis, C; Panteliadis, P; Vassilyadi, F (Apr 2013).
"Hallmarks in the history of cerebral palsy: from antiquity to mid-20th
century.". Brain & Development. 35 (4): 285–92.
doi:10.1016/j.braindev.2012.05.003. PMID 22658818.
 "What is cerebral palsy?". The Cerebral Palsied Association of the
Philippines Inc.