Cerebral Palsy

Question 1

What is the definition of Cerebral Palsy?

Answer 1

Difficulty in controlling body movements and posture due to a non progressive disorder of the areas of the developing brain.

Question 2

What is the epidemiology of Cerebral Palsy?

Answer 2

0.2-0.25% of the population.
No differences in sex.

Question 3

What is the aetiology of Cerebral Palsy?

Answer 3

Prematurity.
Due to permanent brain damage in areas controlling movement.
In the pre, peri and early postnatal period.
Caused by infection, cerebral bleeds, hypoxia, injury.

Question 4

What are the different movement types of Cerebral Palsy? x8

Answer 4

1. Spastic - stiff, slow muscles, strong muscle tone
2. Athetoid - writhing, slow movement
3. Ataxic - poor balance and coordination
4. Mixed e.g. severe spasticity with athetosis
5. Paresis - weakness
6. Plegia - paralysis
7. ATNR: Asymmetrical Tonic Neck Reflex
8. Fluctuating muscle tone

Question 5

How is Cerebral Palsy categorised?

Answer 5

Severity: mild, moderate, severe
Movement type according to the site of brain damage.

Question 6

Which bit of the brain is affected by Spastic Cerebral Palsy?

Answer 6

Motor cortex and pyramidal system.

Question 7

What bit of the brain is affected by Athetoid?

Answer 7

Extra-pyramidal system.

Question 8

What bit of the brain is affected by Ataxic?

Answer 8

Cerebellum.

Question 9

What are the different locations on the body Cerebral Palsy can affect?

Answer 9

1. Hemiplegia (one side)
2. Quadriplegia (all four limbs)
3. Diplegia (legs)

Question 10

What is ATNR?

Answer 10

Asymmetrical Tonic Neck Reflex
Neck turns away from the direction in which you’re grabbing something

Question 11

How can muscle tone fluctuate with Cerebral Palsy? x3

Answer 11

1. Increase vs decreased
2. Stiff vs floppy
3. Hyper vs hypotonicity

Question 12

What are comorbidities associated with Cerebral Palsy? x5

Answer 12

1. 35% intellectually typical range
2. 65% LD (mild-severe) (LP greater in Spastic CP)
3. 46% Epileptic
4. 25-30% hearing impaired, mostly sensorineural (due to a pathology of the cochlea, auditory nerve, or central nervous system)
5. 28% visually impaired - Nystagmus, short sightedness (Myopia)

Question 13

What is Nystagmus?

Answer 13

Rhythmical, repetitive and involuntary movement of the eyes

Question 14

How can speech be impacted by Cerebral Palsy?

Answer 14

Dysarthria
Articulation disorders
Fluency disorders
Voice disorders

Question 15

How can language be impacted by Cerebral Palsy?

Answer 15

Expressive disorders - can affect sentence production

Question 16

How can pragmatics be impacted by Cerebral Palsy?

Answer 16

Difficulty elaborating in narrative and conversational contexts.

Question 17

What assessments can be used for people with Cerebral Palsy?

Answer 17

Expressive language e.g. Derbyshire
Speech sound assessments e.g. CLEAR, STAP
Oro-motor e.g. DEAP

Question 18

What interventions can be used for people with Cerebral Palsy?

Answer 18

AAC e.g. Makaton
Articulation therapy
Eating and drinking management