cerebral palsy Flashcards
2 types of typical motor dev
- gross
2. fine
3 predictable patterns of motor development
- proximal to caudal
- cephalocaudal
- invol. reflexes to goal oriented behavior
2 general factors inpacting dev
- intrinsic - temp. health, genes
2. extrinsic - familiy, culture, exposures
what are 3 primitive reflexes
- moro - grab of dropped
- ATNR - fencer pose
- grasp
when should prim reflexes be gone by
3-8 months
what are 2 postural reflexes and when
- lateral propping - 6-9 mon
2. parachute - 8-9 mon
3 keys GM timelines
4 months - roll front to back
12 month - indep. steps
18 month - run and throw ball
4 key FM timelines
3 months - bat at objects and hold in midline
5 months - palmar grasp
12 months - pincer grasp
18 month - 3 block tower
3 key delayed milestone redflags
- no head control by 4 months
- not sitting by 9 mon
- not walking by 18 mon
2 early dev red flags
- early hand dom
2. rolling under 3 mon
4 other red flags
- persistence of prim reflexes
- hyper/hypo tonia
- delayed post. reactions
- persistence of hand fisting
5 features of CP
- disorder of movement or posture
- secondary to brain abnormality
- arises early in dev
- static - not degenerative
- causes activity limitiation
what is CP diagnosis based on
clinical assessment
3 major timeframes for CP risk
- prenatal
- perinatal
- postnatal
prenatal risk factors (6)
- maternal disorders
- multiple gestation
- intruterine infection
- congenital fetal abnormalities
- placental abnormalities
- too much/little gest growth
Perinatal risk factors (4)
- premature birth - up to 100 times
- iscemic stroke
- acute intrapartum hypoxic event
- neonatal encepholopathy
5 postnatal risk factors
- infection
- injuries
- stroke
- hyperbilirubinemia
- metabolic abnormalities
what is spasticity
velocity resistant hypertonicity
3 overall types of CP
- spastic
- dyskinetic
- ataxic
3 types of spastic
- diplegic
- quadrapelegic
- hemipelegic
2 types of dyskinetic
- hypokinetic
2. hyperkinetic
2 most common causes of hemiplegia
- MCA infarct
2. periventricular venous infarct
what is main risk factor for hemiplegia
perinatal ischemic stroke
what is MCA infarct clinical picture (4)
- hemiplegia
- motor arm>leg
- cog problems due to grey matter
- sizure and hemianopsia
what is neuropath of spastic quardriplegia
hits watershed area between MCA and ACA
what is clinical picture of spastic quardriplegia
- involvement of all four limbs -
- cog disability
- seizures, aspirations, failure to thrive,
- small head circumference
what is neuropath of spastic diplegia
periventricular leukomalacia - along white matter of ventricles
what runs in this region
water shed in early brain - contains leg fibers
what is clincial picture of spastic diplegia
- ambulatory, but with toe walking
- normal cognitive
- general good health