Cerebral Palsy Flashcards

1
Q

What does the term ‘palsy’ refer to?

A

Muscle weakness or paralysis

Includes conditions like Bell’s palsy, shaking palsy (Parkinson’s), and bulbar palsy.

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2
Q

What is the most common movement disorder in children?

A

Cerebral palsy

Affects about 1 in 500 births.

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3
Q

What are the types of cerebral palsy?

A
  • Spastic cerebral palsy (70-80%)
  • Dyskinetic cerebral palsy (10-20%)
  • Ataxic cerebral palsy (5-10%)
  • Hypotonic (3%)
  • Mixed
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4
Q

What percentage of cerebral palsy cases are congenital?

A

90%

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5
Q

List some risk factors for cerebral palsy.

A
  • Oxygen deprivation during birth
  • Pre-term birth
  • Genetics (minor factor)
  • Twin births
  • Low socioeconomic status (poor maternal nutrition)
  • Low birth weight
  • Maternal infection
  • Perinatal stroke (in the baby) = brain bleed/ o2 deprivation during birth
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6
Q

Which part of the brain is primarily injured in spastic cerebral palsy?

A

White matter from the Motor cortex (upper motor neurons)

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7
Q

What is Spastic CP characterised by?

A
  • Hypertonia (stiffness)
  • Problems swallowing, speaking
  • Vision problems
  • Diplegia characteristic = “scissoring gait”
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8
Q

What are the types of hypertonia in spastic cerebral palsy based on limb involvement?

A
  • Diplegia - mainly legs affected
  • Hemiplegia – one side of the body
  • Quadriplegia – all four limbs
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9
Q

What part of the brain is injured in Dyskinetic CP?

A

Damage to basal ganglia (so problems in controlling movement)

Brain regions involved in regulating motor function and inhibiting unwanted movements

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10
Q

What defines ataxic cerebral palsy?

A

Damage to the cerebellum causing problems with coordination and balance (drunk-like movements)

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11
Q

What are some common issues faced by individuals with cerebral palsy?

A
  • Intellectual disability (in 20% of people, this is severe)
  • Seizures
  • Bone and joint problems - e.g. arthritis due to abnormal gait, fragile bones due to low exercise and curvature of spine
  • Chronic pain - linked to bone/joint problems, GI tract issues (chronic constipation) and contractures (locking of joint)
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12
Q

True or False: Intellectual disability is caused by cerebral palsy.

A

False

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13
Q

What types of therapies are involved in the treatment of cerebral palsy?

A
  • Physiotherapy
  • Speech and language therapy
  • Assistive technologies/ mobility aids
  • Muscle relaxants eg. Diazepam, baclofen, Botox
  • Surgery - Musculoskeletal (repair damaged joints or lengthening of tendons to correct scoliosis) or Selective dorsal rhizotomy (lesion motor pathways coming out of spine)
  • Pain relief medication
  • Anticonvulsant medication
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14
Q

What genetic neurodevelopmental disorder is characterized by a deletion of 27 genes on chromosome 7?

A

Williams syndrome

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15
Q

What are the key features of Angelman syndrome?

A
  • Characteristic appearance = small head, skin in corner of eyes
  • Seizures
  • Ataxia
  • Learning difficulties
  • Uncontrolled laughter
  • Affects brain regions = hippocampus (cognitive deficits - learning and memory), Cortex & cerebellum (motor deficits)
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16
Q

Which brain regions are affected in Angelman syndrome?

A
  • Hippocampus
  • Cortex
  • Cerebellum
17
Q

Fill in the blank: Williams syndrome is associated with difficulties in _______.

A

[motor tasks and visual-spatial tasks]

18
Q

What are common cognitive characteristics in Prader-Willi syndrome?

A
  • Mild cognitive deficits
  • Poor spoken language but better reading and comprehension
  • Good at visual organization
  • Insatiable appetite (obesity and diabetes risk)
19
Q

What type of movement is characterized by hyperkinetic symptoms in dyskinetic cerebral palsy?

A

Chorea

20
Q

What is the role of physiotherapy in treating cerebral palsy?

A

To improve strength and range of movement, preventing contractures

21
Q

What is underdeveloped in individuals with Prader-Willi syndrome?

A
  • Regions of basal ganglia
  • Amygdala
  • Hippocampus
  • Hypothalamus
  • Cerebellum
22
Q

What is white matter in the brain?

A

Axons and myelin sheath

23
Q

What part of the brain is primarily injured during Diskinetic CP?

A

The basal ganglia

24
Q

What occurs during perinatal brain injury?

A

Differentiation of oligodendrocyte precursor cell (OPC) into mature oligodendrocyte is not possible

SO myelinating oligodendrocyte is not formed and normal myelination cannot occur

This results in hypomyelination = cognitive, sensory, motor deficits —> cerebral palsy

25
Q

What is Dyskinetic CP characterised by?

A
  • Athetosis = slow writhing movements
  • Chorea = hyperkinetic movements (“dance like” involuntary and irregular movements)
  • Dystonia = repetitive and twisted movements/ abnormal postures (can be very painful)
26
Q

How can CP be prevented?

A
  • Prevent traumatic birth/ hypoxia during birth
  • By hypothermia treatment (lessens hypoxia)
27
Q

What genetic neurodevelopmental disorder is characterized by a deletion of UBE3A gene on maternal chromosome 15?

A

Angelman syndrome

Paternal copy is usually imprinted so if deletion occurs in maternal copy of gene, the individual is missing both copies of the gene

28
Q

What genetic neurodevelopmental disorder is characterized by a deletion of a cluster of genes on paternal chromosome 15?

A

Prader-Willi syndrome

maternal gene is typically imprinted so if the genes get deleted on the paternal copy, the individual is missing both copies of the gene

29
Q

What are the key features of Williams syndrome?

A
  • Characteristic appearance = chubby face, flattened nasal bridge, long filtrum (bit between nose and lips)
  • Abnormalities in frontal cortex & cerebellum = difficulties in motor tasks
  • Abnormalities in parietal cortex = difficulties in visual-spatial tasks
  • “cocktail party personalities” = highly verbal relative to cognitive abilities
  • Exaggerated fear response = differences in size and response of amygdala (structure in brain)
30
Q

What is the characteristic appearance of someone with Prader-Willi syndrome?

A
  • Small hands and feet
  • Excess body fat
  • Prominent nose bridge
  • Downturned, thin lips