Chapter 7 Cerebral Palsy Flashcards
What is the difficulty with the cerebral palsy diagnosis?
the diversity of symptoms from one patient to another
definition of CP
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)
types of CP
spastic, athetoid, ataxic
spastic cp
tight muscles; rigidity (increase muscle tone); contractures develop
what is spasticity
reflex arc is out of control-no inhibitory signal from upper motor neurons to lower motor neurons
athetoid cp
motor control problem; non voluntary movements (uncoordinated)
ataxic cp
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
prevalence of CP
2.5 TO 4.2 cases pf CP for every 1,000 births
etiology - general (in utero and postnatally)
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
etiology-maternal
HTN; pelvic inflammatory disease; infections; herpes; exposure to toxic substances; mental retardation; seizures; thyroid abnormalities
etiology-baby
born with low birth weight; infant jaundice (untreated); seizures; respiratory or circulatory problems; head injuries after birth; infections after birth
signs and symptoms
vary widely
unilateral hemiparesis or hemiplegia to bilateral spastic diplegia or diparesis, spastic quadriplegia or quadriparesis; hypertonicity; hypotonicity; ataxia and non ataxia
plegia
paralyzed
paresis
impairment of 1 system
hemiparesis
impairment that affects 1/2 body; right or left
hemiplegia
1/2 body paralyzed; top or bottom
diskinesia
malfunctioning movement
seizures
can vary; absentee
scoliosis
different lines of pulls from different working/spastic muscles
abnormal skin sensation
no pain sensation
additional signs and symptoms
diskinesia; mental retardation; seizures; developmental delay; scoliosis; kyphosis; vision, speech and hearing deficits; abnormal skin sensation; incontinence
secondary signs and symptoms
depression; osteopenia; osteoporosis; fatigue; pain; weakness; arthritis; overuse syndromes
osteopenia and osteoporosis
assume anyone in a wheelchair has this; wolfe’s law
fatigue
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
overuse syndromes
example:shoulders in muscle because of pushing wheelchair
diagnosis confirmed by
CT scans; MRI; cranial ultrasound
prognosis
variable dependent on severity; not progressive; many people lead functional lives; use of assistive devices help overcome limitations
prevention of CP
mother-neonatal/prenatal care
baby- car seats, supervision when bathing; prevent trauma to brain
medications or medical interventions for CP
anti-seizure; muscle relaxants; analgesics(pain mgmt); baclofen pump; botox injections; braces
baclofen pump
pumps meds onto spinal cord to turn down spasticity
botox injections
for spastic or hypertonicity; lasts about 3 months; add stretching and bracing
surgical interventions for CP
muscle or tendon release; dorsal rhizotomy; orthopedic Sx
dorsal rhizotomy
dorsal ganglion for reflex arc; can cut the ganglion to reduce spasticity at spinal cord level
