Cerebral palsy is a group of disorders that affect movement and posture, caused by non-progressive damage to the developing brain before or after birth. It is diagnosed when brain damage occurs prenatally from conception to labor onset, perinatally from 28 weeks gestation to 7 days after birth, or postnatally in the first 2 years of life. The prevalence is 1-5 per 1000 live births globally and 2-2.5 per 1000 in Western countries. Etiology includes prematurity, low birth weight, infections, trauma, and complications during pregnancy, labor, or delivery. Early identification is based on risk factors and developmental delays. Diagnosis usually occurs between ages 2-5 years through

1. HANDLING OF CHILDREN WITH
CEREBRAL PALSY
Vinay Kumar
MPT/CNDT
Physiotherapist
SVNIRTAR

3.  Group of disorders of the development of
posture and movement, causing limitations in
activities, attributed to non-progressive
disturbances in the developing fetal or infant
brain. Often, the disorder is associated with
sensory, behavioral, perception
communicational and cognitive impairments

4. • We only talk about cerebral palsy if the brain damage
arises during one of the following periods:
• Prenatal period: Conception to the onset of labor
• Perinatal period: 28 weeks intrauterine to 7
days postnatal
• Postnatal period : First two (and some say five) years
of life
• After the age of 5 we speak of stroke or traumatic
brain injury.

5. • The prevalence varies between 1-5/1000
babies in different countries.
• The incidence is 2-2,5/1000 live births in
Western Countries.
• Some affected children do not survive.

6. INDIA
• Incidence of cerebral palsy is about
• 2-4 per thousand live birth .
• Incidence of cerebral palsy in India has
remained constant over the last 20 years.
• India About 25 Lakh of person are suffering
with cerebral palsy.
• Incidence are 15 time higher in low birth wt
baby(<1.5 kg)

7. Etiology
 Improved medical care have decreased the
incidence of CP among some children,
medical advances have also resulted in the
survival of children who previously would
have died at a young age.
 The type of cerebral palsy has also changed.
 In the 60’s around 20% of children with CP
had athetoid/dyskinetic cerebral palsy. Today
only 5 or 10% have this type and 80-90% have
spastic CP.

8.  This decrease is mainly due to advances in
the treatment of hyperbilirubinamia.
 The increase of spastic cerebral palsy is
because of higher survival rates for (very
small premature) babies.

9. etiology
 Prenatal
 Prematurity (gestational age less than 36
weeks)
 Low birth weight (less than 2500 g), which
could be due to poor nutritional status of the
mother
 Maternal epilepsy

10. Hyperthyroidism

11. Herpes simplex virus

12.  Infections (TORCH =toxoplasmosis, rubella,
cytomegalovirus, Severe toxemia.
 Drug abuse

13.  Trauma
 Multiple pregnancies
 Placental insufficiency

14.  Perinatal
 Prolonged and difficult labor
 Vaginal bleeding at the time of admission for
labor
 Bradycardia
 Hypoxia

15.  Postnatal (0-2 years)
 Central Nervous System infection
(encephalitis, meningitis)
 Hypoxia
 Seizures
 Neonatal hyperbilirubinemia
 Head trauma

16.  There is no way to predict which children’s
brain will be damaged by one of these factors,
or to what the extent of the damage will be.
None of these factors always results in brain
damage; and even when brain damage
occurs, the damage does not always result in
CP.
 E.g.: Some children may have an isolated
hearing loss from their meningitis, others will
have severe intellectual disability, and some
will have CP (either alone, or with these other
problems, too

17. Associated problem

18. types

19. Early identification
 Cerebral palsy can be identified at very early
stage by an awareness of risk factors, regular
developmental screening of all high risk
babies, thorough neurological examination ,
delayed developmental milestone

21.  History of:-
 • Premature birth, Difficult delivery, Asphyxia, Septicemia ,
Jaundice
 • Delayed motor mile stones like poor head control,
inability to sit and stand
 • Asymmetry in functional use of extremities.
 • Difficulty in feeding and drooping of saliva
 • Abnormally increase or decrease in tone.
 • Involuntary movement.
 Associated problems like mental retardation & speech
problem, hearing loss, squint and seizure

22. what parents may recognize
 The primary indicators parents will notice are
developmental delay and impaired muscle tone.
 Developmental delay occurs when a child does
not develop specific skills within the predicted
time period.
 If parents worry about the development of their
child: take them seriously, because usually they
are right!

23. Medical history
 Doctors want to know about the child’s prenatal
history,
 as well as any complications during pregnancy,
labor and delivery
 Eliminating other possibilities is a crucial factor
in diagnosis of cerebral palsy. Both parents’
medical histories are important to this process.
By reviewing medical history of parents, doctors
can look for possible genetic,(down,spinal
atrophy)progressive, or degenerative(Cerebral
atrophy,wilson) nervous system disorders

24.  Common tests by neurologists or
neuroradiologists, may include neuroimaging,
such as
 computed tomography scan (CT Scan), and
magnetic resonance imaging scans (MRIs).
 Other specialists can be brought in to test
hearing, vision, and perception, as well as
cognitive, behavioral, and physical
development

25. Diagnosis of CP
 Diagnosing cerebral palsy takes time, and is
usually not made until the brain is fully
developed when the child is two to five years old.
Exceptions exist, usually in severe cases, when
the child may be diagnosed soon after birth.
 For example the average age of diagnosis for a
child with spastic diplegia, a very common form
of cerebral palsy, is 18 months.
 There is no definitive test that confirms or rules
out cerebral palsy

26. Carrying the child

33. feeding

34. Feeding with bottle

35. Spoon and feeding

38. HELPING CONTROL MOUTH
FUNCTION

39. Spoon feeding

41. 4 to 6 month

42. After 4 to 6 month

43. Chewing

44. Drinking

45. Self-feeding

46. Physiotherapy

47. Exercises

48. Occupational therapy

49. Orthotic Management

50. Sitting and standing frame

51. Botulinum toxininjection

52. Surgery

53. Mobility aids

54. Thank you