Chapter 7 Cerebral Palsy

Question 1

What is the difficulty with the cerebral palsy diagnosis?

Answer 1

the diversity of symptoms from one patient to another

Question 2

definition of CP

Answer 2

applies to any injury of the CNS caused by congenital abnormalities, prenatal trauma or postnatal trauma such as TBI or meningitis up to the age of 2
affects body movement and muscle coordination (motor, cognitive, etc)

Question 3

types of CP

Answer 3

spastic, athetoid, ataxic

Question 4

spastic cp

Answer 4

tight muscles; rigidity (increase muscle tone); contractures develop

Question 5

what is spasticity

Answer 5

reflex arc is out of control-no inhibitory signal from upper motor neurons to lower motor neurons

Question 6

athetoid cp

Answer 6

motor control problem; non voluntary movements (uncoordinated)

Question 7

ataxic cp

Answer 7

pertaining to not moving; combo of both spastic and athetoid; disrupts motor function to be functional; might be able to walk, but won’t be functional

Question 8

prevalence of CP

Answer 8

2.5 TO 4.2 cases pf CP for every 1,000 births

Question 9

etiology - general (in utero and postnatally)

Answer 9

results from damage to infant brain
potentially resulting from: abuse to mother; hydrocephalus
in utero-hypoxia, brain abnormalities, congenital genetic defects, mechanical trauma, hypoglycemia
postnatally: anoxia, TBI, meningitis

Question 10

etiology-maternal

Answer 10

HTN; pelvic inflammatory disease; infections; herpes; exposure to toxic substances; mental retardation; seizures; thyroid abnormalities

Question 11

etiology-baby

Answer 11

born with low birth weight; infant jaundice (untreated); seizures; respiratory or circulatory problems; head injuries after birth; infections after birth

Question 12

signs and symptoms

Answer 12

vary widely
unilateral hemiparesis or hemiplegia to bilateral spastic diplegia or diparesis, spastic quadriplegia or quadriparesis; hypertonicity; hypotonicity; ataxia and non ataxia

Question 13

plegia

Answer 13

paralyzed

Question 14

paresis

Answer 14

impairment of 1 system

Question 15

hemiparesis

Answer 15

impairment that affects 1/2 body; right or left

Question 16

hemiplegia

Answer 16

1/2 body paralyzed; top or bottom

Question 17

diskinesia

Answer 17

malfunctioning movement

Question 18

seizures

Answer 18

can vary; absentee

Question 19

scoliosis

Answer 19

different lines of pulls from different working/spastic muscles

Question 20

abnormal skin sensation

Answer 20

no pain sensation

Question 21

additional signs and symptoms

Answer 21

diskinesia; mental retardation; seizures; developmental delay; scoliosis; kyphosis; vision, speech and hearing deficits; abnormal skin sensation; incontinence

Question 22

secondary signs and symptoms

Answer 22

depression; osteopenia; osteoporosis; fatigue; pain; weakness; arthritis; overuse syndromes

Question 23

osteopenia and osteoporosis

Answer 23

assume anyone in a wheelchair has this; wolfe’s law

Question 24

fatigue

Answer 24

neurological fatigue; neurotransmitters (synaptic fatigue-ACH) or can have ATP depletion; muscle works and then it doesn’t work; in pain because muscles can’t relax

Question 25

overuse syndromes

Answer 25

example:shoulders in muscle because of pushing wheelchair

Question 26

diagnosis confirmed by

Answer 26

CT scans; MRI; cranial ultrasound

Question 27

prognosis

Answer 27

variable dependent on severity; not progressive; many people lead functional lives; use of assistive devices help overcome limitations

Question 28

prevention of CP

Answer 28

mother-neonatal/prenatal care

baby- car seats, supervision when bathing; prevent trauma to brain

Question 29

medications or medical interventions for CP

Answer 29

anti-seizure; muscle relaxants; analgesics(pain mgmt); baclofen pump; botox injections; braces

Question 30

baclofen pump

Answer 30

pumps meds onto spinal cord to turn down spasticity

Question 31

botox injections

Answer 31

for spastic or hypertonicity; lasts about 3 months; add stretching and bracing

Question 32

surgical interventions for CP

Answer 32

muscle or tendon release; dorsal rhizotomy; orthopedic Sx

Question 33

dorsal rhizotomy

Answer 33

dorsal ganglion for reflex arc; can cut the ganglion to reduce spasticity at spinal cord level