Cerebral Palsy Flashcards
What is cerebral palsy
-Chronic disorders of posture + movement
-Due to non-progressive (+permanent) CNS lesions sustained before 2 years old
-Results in:
Delayed motor development
Evolving CNS signs
Learning disabilities
Epilepsy
Survival of cerebral
- 20yrs if quadriplegic
- Much longer if less affected
Signs of cerebral palsy
- Weakness
- Paralysis
- Delayed milestones
- Seizures
- Language/speech problems
4 types of cerebral palsy
- Spastic
- Dyskinetic
- Ataxic
- Mixed
What kind of lesion does spasticity suggest
Pyramidal lesion
What kind of lesion do dystonias (uncoordinated, involuntary movements + postures) suggest
Basal ganglia lesion
Describe spastic hemiplegia in relation to CP
- Arm>leg
- Early development of hand preference (<12mth)
- Delay in walking
- Increased deep reflexes in affected limb
Describe spastic diplegia
- Both legs affected worse than arms
- Child looks normal until picked up
- Legs “scissor” (hip flexion, adduction + IR with knee extension + plantar flexion)
Describe spastic quadriplegia
- Most severe form
- Associated with seizures + reduced IQ
- Swallowing difficulties (may lead to aspiration pneumonia)
Describe dyskinetic CP
- Unwanted actions
- Poor movement flow/posture control
- Spasticity
- Hypotonia
- Dysarthria
- Hearing reduced
Describe ataxic CP
- Uncommon
- May be hypo or hypertonia
Rx of spasticity in CP
- Baclofen
- Diazepam
- Botulinum Toxin
Basic symptoms for CP
- Spasticity
- Lack of voluntary
- Weakness
- Poor coordination
- Sensory impairment (hearing)
4 orthopaedics priorities in CP
- Spine
- Hip
- Feet
- Torsional lower limb problems
3 investigations for CP
- Gait analysis
- Radiographs
- MRI
5 prerequisites for normal gait
- Stability in stance
- Clearance of swing
- Preposition of foot
- Adequate step length
- Energy conservation
4 ways of analysing gait in CP
- By observation
- By video
- By 3D instrumented analysis
- +/- EMG, energy expenditure
Define cadence, step + stride length and velocity
- Cadence = Steps/minute
- Step length = RIC to LIC
- Stride length = RIC to RIC
- Velocity = Distance/time
RIC = right initial contact
What is kinematics
Study of how the body moves through space
Common spinal problem in CP
Scoliosis
Does the severity of CP and scoliosis relate to each other
- Yes
- Severity of scoliosis parallels neurological involvement
Reason for surgical Rx of scoliosis in CP
- Maintain seating
- Maintain resp. function
- To avoid rib/pelvic impingement
What does GMF stand for
Gross Motor Function
How is GMF graded
GMFCS (gross motor function classification system)
- Level 1 = Walks without limitations
- Level 2 = Walks with limitations
- Level 3 = Walks using hand-held mobility device
- Level 4 = Self mobility with limitations, may use powered mobility
- Level 5 = Transported in a manual wheelchair
