Cerebral Palsy

Question 1

What is damaged in Spastic CP?

Answer 1

UMN, motor cortex damage; increased tone

• Especially Anti-Gravity Muscles

Question 2

What is damaged in Athetoid CP?

Answer 2

Damage to the Basal Ganglia; slow writhing movements

Question 3

Risk factors for CP: Prenatal

Answer 3

• Rh incompatibility
• Maternal Malnutrition
• Infection
• Diabetes

Question 4

Hypo or Hyperthyroidism associated with Prenatal CP?

Answer 4

Hypothyroidism

Question 5

Risk Factors for CP: Perinatal

Answer 5

• Multiple Births
• Premature Births
• Low Birth Weight
• Asphyxia

Question 6

Risk Factors: Postnatal

Answer 6

• CVA
• Head Trauma
• Infection
• Brain Tumor

Question 7

What is Monoplegia?

Answer 7

One involved extremity

Question 8

What is Hemiplegia?

Answer 8

Unilateral involvement of the upper and lower extremities

Question 9

What is Quadriplegia?

Answer 9

Involvement of ALL extremities

Question 10

General Characteristics of CP?

Answer 10

• Motor Delays
• Abnormal Muscle Tone and Motor Control
• Abnormal Reflexes
• Poor postural control
• Impaired intellect, vision, hearing

Question 11

Common Comorbidities

Answer 11

• Seizures
• Vision and Hearing Impairments
• Hydrocephalus

Question 12

PT Management

Answer 12

• Neurodevelopmental Treatment
• Sensory integration techniques
• Tone Normalization
• Milestones

Question 13

Surgical Management

Answer 13

• Hip Correction
• Dorsal Rhizotomy
• Scoliosis Correction

Question 14

Is CP progressive?

Answer 14

No, CP is non-progressive

Question 15

How is this similar to Arthrogryposis?

Answer 15

Occurs in utero, also considered to be non-progressive.

Question 16

What is typically maintained in Arthrogryposis?

Answer 16

Typically have normal intelligence

Question 17

What is Diplegia?

Answer 17

Bilateral LE involvement

Question 18

What type of gait can be seen in Spastic CP?

Answer 18

Crouched Gait; walking with hip flexion, IR and knee flexion

Also

Scissoring gait

Question 19

Tone Characteristics of Ataxic CP?

Answer 19

Low postural tone; floppy

Question 20

How can WC position be changed to decrease Extensor Tone?

Answer 20

WC or Seat tilted posteriorly

Question 21

If a patient with an intrathecal baclofen pump has signs of overdose or withdrawal what is the most appropriate action?

Answer 21

CALL EMS

Question 22

What is an Intrathecal Baclofen Pump used for?

Answer 22

Control spasticity below the level of the segment

Question 23

What is Dorsal Rhizotomy?

Answer 23

Severing overstimulated dorsal sensory nerve rootlets to decrease spasticity and improve motor control.

Question 24

Muscles that need work on being lengthened?

Answer 24

• Achilles Tendons
• Hamstrings
• Iliopsoas
• Hip Adductors

(Triple Threat Stretch)

Question 25

Pros and Cons: Baclofen (Lirosol)

Answer 25

Pros: Decrease **_spasticity and Spasms_** Cons: Decrease **_Strength, postural control_**

Question 26

Pros: Diazepam (Valium)

Answer 26

Pros: Improved **_Motor Control_**

Question 27

Cons: Dantrolene Sodium (Dantrium)

Answer 27

Side Effects: Drowsiness, _Hypotonia, Weakness_ - Increased Fall Risk

Question 28

Patients with CP are at risk for the development of what type of skeletal deformities?

Answer 28

- _High risk for hip dysplasia_ - Scoliosis

Question 29

Athetoid CP presentation:

Answer 29

- Poor Stability - **Intention Tremor** - _Fluctuating Tone_

Question 30

What is damaged in ataxic CP?

Answer 30

Cerebellum