Cerebral_Palsy_flashcards (1)
Key questions for Cerebral Palsy history?
Difficulty in speech or swallowing/feeding, Visual problems, Hearing problems, Motor features (unusual fidgety movements, asymmetry in movements, floppiness, rigidity, stiffness, late developmental milestones, feeding difficulties, toe walking), Abnormal facies, Focal neurological signs, Regression, FH of progressive neurological disorder, Antenatal factors (preterm, chorioamnionitis, maternal infection), Perinatal factors (LBW, chorioamnionitis, neonatal encephalopathy or sepsis, maternal infection), Postnatal factors (meningitis), Social history, ICE.
What are some differential diagnoses for Cerebral Palsy?
Muscular dystrophy, Metabolic disorders, Genetic syndromes, Neurodegenerative diseases, Structural brain anomalies, Hypoxic-ischemic encephalopathy, Infections like meningitis or encephalitis.
What are the key investigations for Cerebral Palsy?
Obs and examination (developmental and neuro – posture, tone, reflexes, handedness), Observation of child playing, Height and weight, CK to rule out muscular dystrophy if isolated muscle delay, May need MRI head.
What is the initial management plan for Cerebral Palsy?
Refer to child development centre for urgent assessment if in GP, Involve MDT – developmental paediatrician, specialist nurses, physiotherapy, OT, SLT, dieticians, psychologists if necessary (consider orthopaedic/orthotic input, social services, visual and hearing specialist services, teaching support/school support).
What are the long-term management strategies for Cerebral Palsy?
Regular follow-up with child development specialist doctors, Physiotherapy for movement and strength, Speech and language therapy for communication and swallowing, Occupational therapy for daily tasks, Education and school support, Monitoring for associated complications, Support for parents through charities like SCOPE.
What are the red flags for other neurological disorders in a child with suspected Cerebral Palsy?
Absence of risk factors, Family history of progressive neurological disorder, Loss of already attained cognitive or developmental abilities, Development of unexpected focal neurological signs, MRI findings suggestive of progressive neurological disorder, MRI findings not in keeping with CP.
What are the key points to cover when explaining Cerebral Palsy to parents?
Explanation of CP being a motor development condition due to brain damage, It is not progressive but lifelong without a cure, Possible associated health problems (heart, tummy, hearing, vision), Emphasis on multidisciplinary team support and interventions (physio, SALT, OT), Importance of early intervention and regular monitoring.
What is the role of the MDT in managing Cerebral Palsy?
Developmental paediatrician, Specialist nurses, Physiotherapy, Occupational therapy, Speech and language therapy, Dieticians, Psychologists, Orthopaedic/orthotic input, Social services, Visual and hearing specialist services, Teaching support/school support.
What are the common complications associated with Cerebral Palsy?
Difficulty in speech or swallowing, Visual and hearing problems, Motor issues (unusual movements, asymmetry, stiffness), Late developmental milestones, Feeding difficulties, Focal neurological signs, Regression.
What are the common risk factors for Cerebral Palsy?
Antenatal: Chorioamnionitis, maternal respiratory or GU infection, Perinatal: Preterm birth, LBW, neonatal encephalopathy, neonatal sepsis, maternal infection, Postnatal: Meningitis, head trauma prior to 3 years.
What are the possible early motor features of Cerebral Palsy?
Unusual fidgety movements or abnormality of movement (including asymmetry or paucity of movement), Abnormalities of tone (hypotonia, spasticity, dystonia), Abnormal motor developing (late head control, rolling, crawling), Feeding difficulties, Delayed motor milestones (not sitting by 8 months, not walking by 18 months, hand preference before 1 year).
What are some supportive treatments for specific issues in Cerebral Palsy?
Eating, Drinking and Swallowing – speech and language therapist assessment, Video fluoroscopy, Individualised plan for managing eating, drinking, swallowing, Saliva control – anticholinergics, botulinum toxin A injection, Pain management – simple analgesia, specialist pain MDT if needed, Sleep disturbance – sleep hygiene, melatonin, Visual impairment – ophthalmological assessment, Hearing impairment – baseline assessment, Learning disability and behavioural difficulties, Gastro-oesophageal reflux – specialist referral, Chronic constipation – laxatives, Epilepsy – anticonvulsants.
What should be considered in the dietary management of a child with Cerebral Palsy?
Assess dietary intake of calcium and vitamin D, Consider an active movement/weight bearing programme, Dietetic interventions, Monitoring for low bone mineral density and low-impact fractures.
What are some pharmacological treatments used in Cerebral Palsy?
Stiffness – baclofen, diazepam, Sleeping – melatonin, Constipation – laxatives, Drooling – anticholinergic, Other options: Dorsal rhizotomy, Intrathecal baclofen, Deep brain stimulation.
