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