Cerebral Palsy Flashcards
What is the definition of Cerebral Palsy?
Disorders of the development of movement and posture, causing activity limitation, attributed to non-progressive disturbances that occurred in the developing foetal or infant motor brain.
What is the prevalence of Cerebral Palsy per 1000 live births?
1.5 – 3 per 1000 live births.
What factors are inversely associated with CP prevalence?
Gestational age and birthweight.
What is the prevalence of CP for infants weighing less than 1000 grams?
90 per 1000.
What is the prevalence of CP for infants weighing more than 2500 grams?
1.5 per 1000.
What are the main risk factors for developing Cerebral Palsy?
Prematurity and low birth weight.
What percentage of children who develop CP experienced major birth asphyxia?
Only 10%.
What is the upper age limit used for the definition of CP?
Arbitrary, but considered to be 5 years in most studies.
List some preconception risk factors for CP.
- History of stillbirths
- History of miscarriages
- Low socioeconomic status
- Assisted reproduction
- Abnormal genetic copy number variants
List some pregnancy risk factors for CP.
- Genetics
- Birth defects
- Multiples
- Males
- Maternal thyroid disease
- Preeclampsia
- Infection
- Intrauterine growth restriction
- Prematurity
- Substance abuse
What is the probability of one twin having CP if both are live births?
One in 56.
What is the probability of both twins having CP if both are live births?
One in 430.
What are some genetic factors associated with CP?
- Single gene Mendelian disorders (e.g., Hereditary Spastic Paraplegia)
- Genetic and metabolic disorders (e.g., dopa-responsive dystonia, GLUT-1 deficiency)
What is the primary basis for diagnosing Cerebral Palsy?
Clinical findings.
At what age is the diagnosis of CP generally more reliable?
After 2 years of age.
What are early signs of CP at 3-6 months?
- Head Lag
- Feels stiff or floppy
- Overextends back and neck when cradled
- Legs get stiff and cross/scissor when picked up
What are early signs of CP at more than 6 months?
- Doesn’t roll over
- Can’t bring hands together
- Difficulty in bringing hands to mouth
- Reaches with only one hand and fisting of the other
What is the significance of MRI in diagnosing CP?
MRI is recommended when CP is suspected, but 17% of children with CP have a normal MRI.
What is the characteristic pattern seen in CP associated with preterm birth?
Periventricular leukomalacia.
What type of injuries result in CP?
Destructive processes that injure healthy brain tissue.
What is the most common type of CP?
Spastic CP.
What are the features of spastic diplegia?
- Most common in preterm
- LL > UL
- Flexion, adduction, internal rotation of hip
- Contractures of hip flexors, hamstring muscles
What are the clinical features of dyskinetic CP?
- Injury to thalamus, basal ganglia
- Severe hypoxia
- Kernicterus
- Neurometabolic or neurogenetic disorders
What are common treatment strategies for spasticity?
- Pharmacological (e.g., Baclofen, Botulinum toxin)
- Non-pharmacological (e.g., Physiotherapy, Occupational therapy)
What is the purpose of therapeutic hypothermia in infants with HIE?
To prevent Cerebral Palsy.
What is the Gross Motor Function Classification System (GMFCS)?
A tool to categorize the gross motor skills of children and young people with cerebral palsy into different levels.
What is the Manual Ability Classification System (MACS)?
A tool to categorize the ability of children with cerebral palsy to handle objects in everyday activities.
What percentage of children with CP experience pain?
43%.
What percentage of children with CP have an intellectual disability?
1 in 2.
What are the treatment considerations for non-verbal children with CP?
Augment speech early.
What are the clinical findings and types of CP based on brain lesions?
- Spastic CP
- Dyskinetic CP
- Ataxic/Hypotonic CP
- Mixed CP
True or False: All children with CP have cognitive impairments.
False.
Fill in the blank: The motor defect in CP largely depends on the _______.
[location of the brain lesion].
What is the primary pharmacological treatment for dystonia?
Botulinum toxin IM injection
Botulinum toxin is often used for its muscle-relaxing effects in dystonia treatment.
Name two oral medications used to manage dystonia.
- Oral Valium
- Oral clonazepam
These medications are benzodiazepines that can help reduce muscle spasms.
What non-pharmacological treatments are available for dystonia?
- Physiotherapy
- Occupational therapy
- Orthotics
- Orthopaedic surgery
- Selective dorsal rhizotomy
These treatments focus on improving function and quality of life.
What is an antidystonic drug that has anticholinergic properties?
Trihexyphenidyl
This drug is used to reduce dystonia by adjusting neurotransmitter levels.
What is the overall survival rate of children with CP until the age of 20?
90%
This statistic indicates a significant survival rate for children with cerebral palsy (CP).
At what age do most adults with CP begin to show age-related changes and diseases?
Earlier than typical populations
This reflects the increased health challenges faced by individuals with CP.
What percentage of children with mild cognitive deficit survive until age 38?
95%
This statistic highlights the prognosis for children with less severe cognitive challenges.
What are the ‘F-words’ in child development for children with CP?
Focus on six key areas of child development
More details can be found at the CanChild website.
True or False: Most adults who have CP are under the age of 45.
False
Most adults with CP are actually over the age of 45.
What is the role of gabapentin in the treatment of dystonia?
It is used as an adjunctive treatment
Gabapentin is often used to help manage neuropathic pain and may assist in reducing dystonia symptoms.
What surgical intervention is mentioned for treating dystonia?
Deep brain stimulation
This invasive procedure is aimed at modulating brain activity to alleviate symptoms.
Fill in the blank: The overall survival rate for children with CP until age 20 is _______.
90%
This statistic underscores the improved lifespan for children with CP.
