Definition A nonprogressive nonhereditary disorder of movements and posture occurring in a maturing brain Main features include Impairment of motor and posture function Nonprogressive and nonhereditary ID: 935199
Download Presentation The PPT/PDF document "Cerebral Palsy Gbadero D. A." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Cerebral Palsy
Gbadero D. A.
Slide2Definition
A non-progressive, non-hereditary disorder of movements and posture occurring in a maturing brain. Main features include
Impairment of motor and posture function
Non-progressive and nonhereditary
Present since birth or early childhood
Major symptoms are muscle rigidity, dyskinesia and
hyperreflexia
Slide3Epidemiology
G
lobal pediatric health challenge
Incidence 1.5-5
per 1000 live births
Slide4Aetiology
Hypoxic-
ischaemic
encephalopathy
Neonatal sepsis/meningitis
ABE/kernicterus
Neonatal metabolic disorders
Neonatal seizures
Head injury
Intracranial hemorrhage
Preterm birth
Infantile cerebral malaria, meningitis/encephalitis and head trauma
Slide5Classifications
Topographic
classification based on
area of predominant
limbal
motor
deficits
Spastic types:
Spastic
quad,
S
pastic
triplegia
,
S
pastic
paraplegia,
S
pastic
diplegia
Spastic
monoplegia
Slide6Other types
Choreo-athetotic
dyskinetic
types
Ataxic
Hypotonic types
Slide7Spastic CP
75% of cases have spasticity
May be associated with other forms
Common subtypes
Spastic quadriplegia most common form: all four limbs are
spatic
Spastic
diplegia
: Lower limbs more involved than arms
Hemiplegia – One side involved primarily
Paraplegia – Lower limbs only involved.
Monoplegia
- One limb involved
Triplegia
– Three limbs involved
Slide8Hypotonic CP
Persistent
hypotonia
and variable degrees of muscle weakness occur in about 10% cases
Slide9Dyskinetic types
Athe
totic
– Involuntary slow convoluted writhing movements of the fingers hands and toes associated with CP
Choreiform
Choreo-athetotic
Extrapyramidal involvements
Often associated with rigidity,
quadriplegia
or
diplegia
Ataxic types
CP with impaired balance or coordination
Comprises about 1-2%
May occur in combination with other types
Slide10Associated problems
Seizures affect 60% of children with CP
Mental retardation Present mostly in children with spastic quad. Overall incidence of 10%
Sensory and speech deficits
Impairment of speech vision and hearing is particularly more common in children with
kernicteric
CP.
M
ental retardation is often marginal
Slide11Clinical features
Delayed milestones
Contractures following prolonged hypertonia and poor motion
Microcephaly especially frontally very common present in about 25%
Spasticity
Dyskinesis
Atonia
/
hypotonia
Slide12Laboratory Investigations
EEG
Blood group
G6PD status
Investigation of
Lesch
Nyhan
syndrome – amino
aciduria
Slide13Diagnosis
Based on history and
p
hysical findings
Differential diagnosis
Mental retardation
Seizure disorder
Brain damage
Slide14Treatment
Anticonvulsant therapy for seizures
Special
education to address associated mental retardation
Orthopedic surgery for release of contractures
Physiotherapy to improve movement or prevent contractures
Psychological therapy for parents and patients
Slide15Prevention
Quality obstetrics services; ANC and active management of
labour
Quality neonatal care
Appropriate and prompt Phototherapy
EBT where necessary