Cerebral Palsy

Question 1

What is cerebral palsy?

Answer 1

It is a group of disorders that affects the development of movement and posture

Question 2

When does the catalyst for cerebral palsy have to occur?

Answer 2

Before 2

Question 3

What are the three types of CP?

Answer 3

1. Spastic
2. Dyskinetic (extra pyramidal - involuntary)
3. Ataxic

Question 4

What is the most common type of CP?

Answer 4

Spastic

Question 5

What two things characterise spastic CP?

Answer 5

Resistance to passive movement

Increases with velocity

Question 6

What is the pathology behind spastic CP?

Answer 6

Damage to the motor cortex

Question 7

What types of spastic CP are there?

Answer 7

Hemiplegia

Quadriplegia

Diplegia

Question 8

What is extrapyramidal (dyskinetic) CP associated with?

Answer 8

Basal ganglia or pyramidal tract damage

Question 9

What are the three types of dyskinetic?

Answer 9

1. Dystonic - sustained contraction of agonist and antagonists with stronger muscles winning. eg hip flexionsion and knee extension
2. Chorea - Slow writhing
3. Athetoid - rapid sudden movements

Question 10

What is ataxic cerebral palsy?

Answer 10

Ataxia which is loss of smooth muscles movement which affects speech and walking.

Associated with cerebellar damage

Question 11

What are some prenatal causes of CP?

Answer 11

Rubella, chromosome abnormalities

Question 12

What are some perinatal causes of CP?

Answer 12

Asphyxia, haemorrhage

Question 13

What are some postnatal causes of CP?

Answer 13

CVA, infection, hyperbilirubinaemia

Question 14

Which one is hyperbilirubinaemia associated with?

Answer 14

Dyskenetic

Question 15

Which one is hypoxia associated with?

Answer 15

Dyskinetic

Question 16

How does it present?

Answer 16

At birth it may be obvious or they may miss developmental milestones such as not sitting aline at 6 months or walking alone at 1 year

Question 17

What would you see on examination?

Answer 17

Abnormal tone (dyskentic)

Ataxia (ataxic)

Hyperreflexia (spastic)

Question 18

How is CP coservatively managed?

Answer 18

Physio, education, walking aids

Question 19

What is the medical management for CP?

How do they work?

Answer 19

Baclofen - Gaba agonist (anti spasmodic)

Botulinum - ACH antagonist (blocks muscle contraction)

Question 20

What is the surgical management for CP?

Answer 20

Orthopedic correction

Cutting sensory fibres so less motor stimulation - causes very weak muscles