Cerebral Palsy

Question 1

1 Risk factor of Cerebral Palsy

Answer 1

PREMATURE

Question 2

TORCH Risk Factors

Answer 2

• Toxoplasmosis
• Other (Syphilis, Zika, Varicella/Zoster)
• Rubella
• CMV
• HSV

Question 3

MUST KNOW THESE TERMS
* Monoplegia –
* Hemiplegia –
* Paraplegia –
* (MC) Diplegia –
* Quadriplegia –
* Double Hemiplegia –
* Total body –

Answer 3

• Monoplegia – 1 extremity involved (MC LE)
• Hemiplegia – both extrem on same side (arms>legs)
• Paraplegia – both legs
• (MC) Diplegia – Legs more affected than arms
• Quadriplegia – all 4 limbs equally involved
• Double Hemiplegia – all 4 limbs involved
• Total body – all 4 limbs severely involved and NO head/neck control

Question 4

Which level of paralysis is MC in Cerebral Palsy?

Answer 4

Diplegia (legs worse than arms)

Question 5

Which type of Cerebal Palsy is MC?

Spastic? Dyskinetic? Ataxic?

Answer 5

Spastic CP

Question 6

_____ is the MCC of death in those with CP

Answer 6

Aspiration Pneumonia

Question 7

Tx for Spastic CP

Answer 7

• PT/OT
• Baclofen (Gablofen) - Muscle Relaxer
• Benzos
• Botox Inject q3-8mo

Question 8

Tx for Dyskinetic CP

Answer 8

• Dopamine Agonists (Carbidopa/Levodopa)
• Anticholinergics/Antihistamines (Trihexyphenidyl)
• Benzos -> Clonazepam

Question 9

1 Early sign for CP

Answer 9

**Delayed Milestones **
- Not sitting by 8mo
- Not walking by 18mo
- Hand fn asymmetry before 1yo

Question 10

____ Classification System is used to classify CP

Answer 10

Gross Motor Function Classification System (GMFCS)

can you sit? ADLs? Simple tasks?

Question 11

Describe the 3 preterm ET for CP
- Periventricular Leukomalacia (PVL)
- Intraventricular Hemorrhage
- Bronchopulmonary Dysplasia

Answer 11

• Periventricular Leukomalacia (PVL) -> decr blood flow to immature brain + immature lungs = poor oxygenation of white matter
• Intraventricular Hemorrhage -> small capillaries around ventricles rupture -> Hydrocephalus
• Bronchopulmonary Dysplasia -> immature lungs -> incr risk for pulm infx (like aspiration pneumonia)

Question 12

Spastic CP has predominantly ___ motor neuron findings

upper or lower?

Answer 12

UPPER

Question 13

Strongest independent predictors for CP risk

Answer 13

• 5 min APGAR Score (LOW = CP risk)
• Maternal intrauterine Infx
• Maternal drug use

Question 14

Which congenital abnormalities are MC in those with CP

Answer 14

Microcephaly
Congenital Hydrocephalus