Chapter 17 - Cerebral Palsy Flashcards
What motor impairments can be observed in cerebral palsy?
Posture
Balance
Muscle control
Movement
What is the most frequent neuro pathological finding in cerebral palsy?
White matter damage
What brain structures comprise the pyramidal motor system?
Precentral motor cortex
Corticospinal tract
Spinal motor neurons
What is the pyramidal motor system responsible for?
Initiating and carrying out signals that enable voluntary skilled movements
What subtype of CP results from damage to the pyramidal system?
Spastic CP
70-85% of cases of CP are of what subtype?
Spastic CP
What is the specific neuropathology often observed in spastic CP?
Periventricular leukomalacia
Intraventricular hemorrhage
What are the three subtypes of spastic CP that result from damage to the pyramidal motor system?
Spastic hemiplegic CP
Spastic diplegic CP
Spastic quadriplegic CP
What is cerebral palsy not?
A disease or etiology
What are the two CP subtypes that result from injury to the extrapyramidal system ?
Dyskinetic
Ataxic
What is the most frequent neuropathology observed in spastic hemiplegic CP?
Unilateral MCA stroke
What is the most severe subtype of CP?
Spastic quadriplegic CP
What is the most common neuropathology observed in spastic quadriplegic CP?
Anoxia or other generalized gray matter injury
What brain regions comprise the extrapyramidal motor system?
Cerebellum
Basal ganglia
Brain stem
What is the function of the extrapyramidal system?
Fine tune the movements of the pyramidal system by making adjustments to posture and coordination
What does damage to the extrapyramidal system cause?
Abnormal involuntary movements
What is dyskinetic CP characterized by?
Athetoid or dystonic movements
What is dyskinetic CP caused by?
An underlying hypoxic-ischemic injury
What is ataxic CP characterized by?
Lack of coordination during voluntary gross and fine motor movements
What are the signs of ataxic CP?
Poor balance
Unsteadiness
Wide-based gait
Shakiness during tasks that involve manual dexterity
What is the most typical presentation in CP?
Spasticity with athetoid movements
Which extremities are affected in the two subtypes of CP that result from damage to the extrapyramidal system?
All of them
Upper more than lower
Normal intellectual functioning is observed in which forms of CP?
Extrapyramidal
After what age is cerebral palsy an incorrect term to use?
3 years
What is the leading cause of physical disability in childhood?
CP
Can CP be diagnosed in utero?
No
What are signs of possible CP in infancy?
Persisting reflex patterns
Earlier than typical acquisition of milestones (standing earlier - hypertonia)
When is a definitive dx of CP usually made?
In second or third year of life
About what percentage of children outgrow the dx of mild CP?
50%
Severity of cognitive impairment is positively correlated with what?
Degree of motor impairment
Damage to what areas of the brain results in attentional difficulties?
Peri ventricular white matter and subcortical damage
What cognitive domain is affected more than any other in CP?
Visuospatial functions
What medication is used to reduce muscle contractions in CP?
Botox
What medication is used to reduce spasticity, hyper reflexes, and painful muscle spasms?
Baclofen
What medication is used to decrease abnormal muscle movements in CP?
Sinemet or Artane (DA agonists)
What medication is used to reduce spasticity, hyper reflexes, painful muscle spasms and reduce anxiety in CP?
Valium
What is the trade name for diazepam?
Valium
What is the term for slow and writhing involuntary movements that can affect any part of the body?
Athetosis
What is the term for involuntary muscle contractions that cause repetitive and twisting movements, as well as irregular postures?
Dystonia
What is the most frequent neuropathology observed in spastic diplegic CP?
White matter damage of prematurity
