Cerebral Palsy Flashcards
1
Q
Cerebral Palsy complications to discuss in long case
A
Spasticity / contractures Dystonia Sialorrhoea Oromotor dysfunction Aspiration Feeds support Hip dysplasia/ subluxation Scoliosis Pressure areas ID / developmental delay Pain Poor sleep Low bone mineral density Continence Mobility
2
Q
CP: Aspiration
A
Assess risk:
- Coughing/gagging while feeding
- Recurrent chest infections
- Cyanosis with feeds
- Pooling saliva
Observe a feed CXR/CT VFSS - tell risk of aspiration not diagnostic Barium swallow Oesphageal ph monitoring GORD
Treat: Upright positioning Thicken feeds Trial NJT/PEG/PEJ Fundoplication PPI Consider pro-motility agent e.g. domperidone Venting PEG post feed Continuous or more frequent smaller feeds
3
Q
CP: Communication
A
Hearing and vision assessment
- Hearing aid
- Glasses
Gestures Key word sign Picture sequences Sounds board Computer Speech therapy
4
Q
CP: Hip dislocation + Scoliosis
A
HIP DISLOCATION "Migration percentage" Manage: - Treat spasticity - Postural - Adductor release
SCOLIOSIS "Cobb angle" - Causes: chest deformity/restrictive lung disease, pain, pressure sores Manage: - Wheelchair side supports - Physio - Brace - Surgery
5
Q
CP: Spasticity (abnormal muscle tone
A
Manage:
- Physio, stretching exercises
- Hydrotherapy
- Orthoses/AFO
- Medications: Botox, Baclofen, Diazepam
- Surgical: selective dorsal rhizotomy (sectioning of sensory nerve root)
6
Q
Spasticity vs dystonia
A
Spasticity = increased muscle tone e.g. weakness, increased tone Dystonia = excessive muscle activity e.g twisting, contraction, cramp
