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developmental disabilties > cerebral palsey > Flashcards

cerebral palsey Flashcards

1
Q

what is Cerebral Palsy (CP)

A

A heterogeneous group of motor disorders
A syndrome of motor impairment
Results from brain abnormalities early in life
Non-progressive
Often accompanied by disturbances of sensation, perception, cognition, communication, and behaviour, epilepsy, and secondary musculoskeletal problems

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2
Q

Five Main Features of CP

A
  1. Onset before, during, or after birth (usually before 5 years)
  2. Damage to the brain, or an abnormality of the developing brain
  3. Motor difficulties that are secondary to brain damage or abnormal development
  4. Decreased control of movements with poor motor co-ordination, balance, or abnormal movements
  5. A condition that is non-progressive, but permanent
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3
Q

Early Signs of CP

A

Hypotonia/floppy baby syndrome or hypertonia
Failure to thrive syndrome- babies not gaining weight
Delayed motor milestones or abnormalities in movements

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4
Q

Identification of CP

A

Pediatricians conduct physical and neurological examination
May use an CT scan or MRI of the brain
Diagnosis often not made until 2 years old- usually diagnosed by age 4
Prevalence of 2.5 of 1000 children

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5
Q

what is the cause of CP?

A

Combination of genetic vulnerability and environmental stressors

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6
Q

what are the risk factors associated with CP?

A

Risk factors
Prenatal
Perinatal
Postnatal (10-25%)

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7
Q

Prenatal Risk Factors

A 
Congenital malformations of the brain
Congenital infections
Exposure to teratogens
Twin/multiple births
Prematurity/low birth weight
Inflammation of the placenta or amniotic fluidamniotic fluid
Stroke
Toxemia (maternal high blood pressure)
Severe jaundice
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8
Q

Perinatal Risk Factors

A

Premature separation of the placenta from the uterus
Neonatal encephalopathy (birth asphyxia)
Hypoxic ischemic injury- lack of oxygen causes damage to brain and spinal cord (13%)
Not as common as originally thought
Cord prolapse
Brain hemorrhage or stroke
Use of forceps and squeezing the skull

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9
Q

Postnatal Risk Factors

A

Asphyxia (secondary to choking or near drowning)
Head injury/shaken baby syndrome
Brain infections (e.g. meningitis)
Strokes

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10
Q

Spastic CP

A

Scissor gait
Most common form of CP (70-80%)
spasticity
hypertonicity

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11
Q

Spasticity

A

extra stiffness in the muscles associated with increased reflexes

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12
Q

Hypertonicity

A

muscles are stiff and permanently contracted in a state of continual high muscle tone”

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13
Q

bilateral

A

limbs on both sides of the body are involved

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14
Q

Spastic diplegia

A

both legs

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15
Q

Spastic quadriplegia

A

ll four limbs

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16
Q

Unilateral

A

limbs on one side of the body are involved

AKA spastic hemiplegia

17
Q

Dyskinetic CP

A

Uncontrolled, slow, writhing movements

10-20% of people with CP

18
Q

Dystonic

A

fluctuation in tone and stiffness of movements

Might get stuck in abnormal postures

19
Q

Choreoathetotic

A

hyperkinetic/increased activity involuntary movements

20
Q

Ataxic CP

A

Poor balance and decreased muscle co-ordination
Difficulty with depth perception, fine motor coordination, and sudden movements
Wide based gait
Rare- 5-10% of people with CP

21
Q

Impact of CP on Movement

A

Difficulty controlling and planning motor movements
Wide variability in movement function
Most individuals with hemiplegia and diplegia are able to walk
Individuals with quadriplegia or dyskinetic CP usually need a wheelchair

22
Q

Contracture

A

shortened muscles/tendons, resulting in muscles being rigidly fixed in abnormal positions

23
Q

Level I

A

walks without restrictions; limitations in more advanced motor skills

24
Q

Level II

A

walks without assistive devices; limitations walking outdoors and in the community

25
Q

Level III

A

walks with assistive mobility devices; limitations walking outdoors and in the community

26
Q

Level IV

A

self-mobility with limitations; children are transported or use power mobility outdoors and in the community

27
Q

Level V

A

self-mobility is extremely limited even with the use of assistive technology

28
Q

Impact of CP on Learning

A

Not always associated with intellectual disability
Can have average intelligence (1/3)
However, learning disabilities are common
At a greater risk for developmental disability
30-60% of individuals with CP also have a DD
Cognitive deficits due to lack of exploration of the environment

29
Q

Impact of CP on Speech and Language

A

Some difficulty with articulation

Some may be unable to speak because of motor problems (more likely in dyskinetic CP)

30
Q

Medical Problems Associated with CP

A 
Seizures (20-30%)
Visual impairment or strabismus (25%) 
Hearing or speech impairment (50%)
Feeding and swallowing difficulties
Aspiration pneumonia
Poor nutrition and growth
Incontinence
Orthopedic complications
Drooling
31
Q

treatment of CP

A

Surgery
E.g. lengthening tendons to increase flexibility
Physiotherapy
Stretching for flexibility
Work on muscle strength and movements
Orthotist
Special equipment such as walkers and wheelchairs
Use of braces
Occupational Therapists
Improving hand control and fine motor function
Equipment and home renovations to promote independence
Speech and Language Pathologists
Improve articulation and language development
Augmentative communication systems
Other
Vocational training
Special education
Recreation and leisure

32
Q

Botox and CP

A

Boulinum toxin injections
Causes temporary paralysis of the muscle and decreases muscle tone
Can improve range of motion, function of opposing muscles, and relieve muscle spasms

33
Q

Prevention of CP

A

Magnesium sulphate
Given to pregnant women at risk of having a preterm baby
May reduce the amount and severity of CP
Cooling beds
Newborns suspected of having CP go in a cooling bed for 72 hours after birth
May reduce the severity of CP
Vaccination of mothers
Prevents potential for infections such as rubella and meningitis

developmental disabilties (14 decks)

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