Cerebral Palsy + Cognitive Impairment Flashcards
Is cerebral palsy a diagnosis?
No
Definition of cerebral palsy?
Disorder of movement and posture:
Permanent, non-progressive
Due to defect/lesion in developing brain
Prevalence
0.2% of live births
Increases with low birth weight or premature births
Casues of cerebral palsy…
- Prenatal causes 70-80%
- congenital infections (TORCH)
toxoplasmosis, rubella, cutomegalovirus, herpes)
- vascular (stroke) in developing foetus - Perinatal 8-10%
= hypoxia (cord around the neck), hypoglycaemia, severe jaundice, prolonged seizures - Postnatal (10%)
Head injury, meningitis
Different typea of physical affects on body
- Spastic- increases tone (1-4 limbs)
- Dyskinetic (dystonic
- Hypotonic (decreased tone)
Types of cerebral palsy
4
- Monoplegia = 1 limb
- Hemiplegia = 1 side of the body (1 arm, 1 leg)
- Diplegia = symmetrical half (both legs or both arms)
- Quadriplegia = all 4 limbs
What is spasticity??
Velocity dependant resistance to movement
Affects 75%!!
Increased muscle tone, tendon reflexes
Affects mobility, ADL
What is Dyskinetic… Cerebral palsy
- Tone fluctuations in location and type = different muscle groups at different times
=fluctuates between hypertonia (increased tone) and hypotonia (low tone) - Abnormal involuntary movements
= rapid jerking movements (chorea)
= slow withering movements (athetosis)
Gross Motor Functional Classification System (GFMC)
5 LEVELS!
L1= AMBULATORY in all settings
L2= walks without aides, but has limits in community settings
L3= walks with aides
L4= mobility requires wheelchair
L5= dependant for mobility
What % of cerebral palsy has intellectual disabilities?
40 - 50 %
Associated conditions…
What % of cerebral palsy have epilepsy
Up to 50% children
Up to 20% adults
(General population = 1%)
What are other associated conditions with cerebral palsy?
- reflux
- dysphagia
- underweight/ overweight if immobile
- nutritional deficiencies (iron and folate)
-chronic lung disease (common cause of death)
> aspiration, chest infections
- genitourinary problems
> urinary incontinence, retention, infections - musculosketal
> spasticity, Osteoporosis (from longterm anticonvulsant therapy)
What is sialorrhoea?
Drooling
Due to low muscle tone with poor lip closure
How does ageing affect the existing conditions of a person with cerebral palsy?
Leads to
Deterioration of existing conditions
- Mobility deterioration
- Sensory impairments
- Dysphagia
Common medications used
7
- Anticonvulsants (may be multiple)
- PPIs
- Laxatives
- Anti spasmodics (baclofen, benzos)
- Prophylactic antibiotics (esp in winter)
- Nebulised meds (brochodilators, steroids)
- Analgesics (panadol, pregablin)
Do all patients with cerebral palsy have an intellectual disability?
No.
Usually have communication impairment but understand more than they can say.
What is AAC communication system?
For people with communication impairments:
Augmenting and alternative communication systems
Eg
Gestures, body language, signs, communication boards, speech generating apps
