Cerebral Palsy Flashcards
What is cerebral palsy?
- Group of disorders of the development of movement and posture
What is cerebral palsy attributed to?
Non-progressive disturbances that occured in developing foetal or infant brain
What is the prevalence CP?
2 per 1,000 live born infants
During/post birth onset is 1 per 10,000 (5%)
How is CP classified?
Based on the predominant movement disorder and pattern of limb involvement
What are the 4 main types of CP?
- Spastic
- Dyskinetic
- Ataxic
- Mixed
What is spastic CP?
- The muscles are stiff and tight,
2. Making it difficult to move and reducing range of movement
What is dyskinetic CP?
- Muscles switch between stiffness and floppiness
2. Causes random, uncontrolled body movements
What is ataxic CP?
- Balance and co-ordination problems
2. Shaky or clumsy movements, sometimes tremors
What is mixed CP?
Mixture of symptoms from more than one type
Give 7 risk factors which may increase risk of CP
- Prematurity
- Twin gestation and twin-twin transfusion
- Small at birth, low birth weight
- Mother being 35+ years
- Placental insufficiency
- Intrauterine infections eg. TORCH, HIV
- Mother having unusually low or high blood pressure
Give examples of infections caught by the mother which may increase risk of CP (4)
Cytomegalovirus, rubella, chickenpox or toxoplasmosis
What is periventricular leukomalacia (PVL)?
Damage to white matter resulting in reduction of blood and O2 supply
What problems can cause CP during birth? (6)
- Asphyxiation - not getting enough O2 to brain
- Infection of the brain eg. meningitis
- A serious head injury
- Choking or nearly drowning
- Very low blood sugar level
- Stroke
What problems can cause CP before birth?
- Stroke in the baby
- Infection caught by mother
- Periventricular leukomalacia (PVL)
- Injury to unborn baby’s head
Summarise the diagnostic tests for CP (5)
- Examination and medical history
- Brain scans
- Electroencephalogram (EEC)
- Electromyogram (EMG)
- Blood tests
What brain scans are used in the diagnosis of CP?
- Cranial ultrasound
- MRI - brain or spine
- CT scan
When do symptoms of cerebral palsy become noticeable?
- Not usually obvious at birth/just after
2. Normally become noticeable during first 2-3 years of life
What are 7 movement and development problems associated with the symptoms of CP?
- Delays in reaching developmental milestones
- Seeming too floppy/stiff
- Weak arms or legs
- Fidgety, jerky or clumsy movements
- Muscle spasms
- Shaking hands (tremors
- Walking on tip-toes
What are 12 other symptoms associated with CP?
- Feeding, drooling and swallowing difficulties
- Constipation
- Communication
- Epilepsy
- Sleep
- Reflux
- Curved spine (scoliosis)
- Hips easily dislocate
- Bladder control
- Learning disability
- Reduced vision, squint, uncontrolled movements
- Hearing loss
What is the prognosis of CP? (5)
- 80-90% live into adult life
- May limit activities and independence
- Some may attend mainstream schools, others special
- Mental health difficulties
- Cause of death: respiratory infections, aspiration, status epilepticus and other infections
What are 2 predictors of outcomes in CP?
- Severity of cognitive impairment
(<20 - 50% survival to adulthood, >85 - 95%) - ‘Cause’
Summarise the treatment of CP (6)
- Currently no cure
- Physiotherapy
- Speech
- Occupational therapy
- Medication
- Surgery
How is physiotherapy used in the treatment of CP? (3)
- Encourage movement
- Increase strength
- Prevent muscles shortening
How is speech therapy used in the treatment of CP? (3)
- AAC
- Speech difficulties
- Swallowing techniques
Give examples of medications used in treatment of CP (5)
- Muscle stiffness eg. Diazepam, Baclofen
- Botolium toxin injections to relax certain muscles
- Sleeping eg. Melatonin
- Anti-seizure for epilepsy
- Laxatives for constipation
What is surgery used for in the treatment of CP (4)
- Restore movements if restricted by tight muscle/connective tissue
- Repair dislocated hips
- Correct curvature of spine
- Reduce stiffness in legs
