CP Flashcards
What is CP
Diverse group of non-progressive (and permanent) syndromes that affect the brain and cause motor or cognitive defects beginning in early infancy
500,000 cases in the US
CNS disorder
CP is a type of TBI
If the TBI happens before 24 months, it is called CP
Causes of CP
genetic or environmental
metabolic disease
hyperbilirubin
nutritional
toxemia
blood incompatibility
infection - rubella, cmv, meningitis
brain malformation
anesthesia
trauma during delivery
head injury
CVA
near drowning
lead poisoning
Strokes in early life
PVL (periventricular leukomalacia)
- damage to white matter (basically leaves holes)
- common in preemies before 32 weeks
Hypoxic or ischemic encephalopathy
- loss of O2 to the brain for any reason
- utero to 2 years
IVH - Intraventricular hemorrhage
- bleeding into the brain
- preemies
Congenital malformation of the brain
Acquired CP - one month to 2 years
Types of CP
Spastic
Dyskinetic/ Athetoid (extrapyramidal)
Ataxic (extrapyramidal)
Mixed
Spastic CP
Increased muscle tone
Prolonged primitive reflexes - walking, sitting, suck reflex
Rigidity of extremities
Contractures - a condition of shortening and hardening of muscles, tendons, or other tissue, often leading to deformity and rigidity of joints
65-75% of all cases
Dyskinetic/ Athetoid (extrapyramidal) CP
Extreme difficulty with fine motor and purposeful movement
- Dystonia: muscles contract involuntarily
Jerky, uncontrolled movement
Tone fluctuates
Injury to basal ganglia or extrapyramidal tracts
20-25%
Ataxic CP
Gait disturbances and instability
Nystagmus - a condition in which your eyes make rapid, repetitive, uncontrolled movements
Hypotonic at birth but develop stiffness of trunk in late infancy
5%
Like a less extreme version of athetoid
Types of plegia with CP
Monoplegia – one limb
Paraplegia – 2 extremities, usually both lower
Diplegia – 2 extremities, usually both upper limbs
hemiplegia – 2 limbs, usually leg and arm on same side (ipsilateral)
Quadriplegia – effects 4 limbs
Plegia – means effects not paralyze
Mixed CP
- 13% of all people with CP
- Seizures: 35-50%
- Cognitive delay: 50-75% and depends on which part of the brain is damaged
- Visual impairment: 50%
- Hearing, communication, respiratory, bowel and bladder, and orthopedic
- Cognitive and physical limitations do not necessarily run hand in hand.
- Executive functions: budgeting
Diagnosing CP
Diagnosis can be difficulty
- The earlier the better
- Suspected when:
*Birth issues
*Poor eaters (poor motor control of mouth)
*Sides don’t match
*Only using one side
*Difficulty separating legs for diaper change
Runs Mild to Severe
- Outcome: “almost normal” to severe
CP impact on function
Signs and symptoms of CP
Tone abnormalities-hyper or hypo or both
Reflex abnormalities
Atypical Posture or motor performance
Delayed Motor Development
Cognitive impairment
Ortho issues
Seizure disorders
Visual and Oral issues
Gastroesophageal Reflux
Medical and surgical management of CP
Symptom management
Alleviate the cause
Medication to decrease tone
Valium – systemic drug (muscle relaxer); it decreases the tone for everything
Baclofen (oral or pump) – most common; systemic drug (muscle relaxer); it decreases the tone for everything; may decrease some of their function
Botox (botulinum toxin A) – only lasts about 3 months
Orthotics/Splints/casting
AFO
CIMT-Constraint Induced Movement Therapy
CP impact on occupation
Feeding
- Often the first to show up
Dressing and other ADLS
Education
- Adaptations and IEPS (individualized education plan)
Sleep
Work
PLAY and Social Participation
