CP Flashcards

1
Q

What is CP

A

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

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2
Q

Causes of CP

A

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

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3
Q

Strokes in early life

A

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

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4
Q

Types of CP

A

Spastic
Dyskinetic/ Athetoid (extrapyramidal)
Ataxic (extrapyramidal)
Mixed

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5
Q

Spastic CP

A

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

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6
Q

Dyskinetic/ Athetoid (extrapyramidal) CP

A

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%

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7
Q

Ataxic CP

A

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

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8
Q

Types of plegia with CP

A

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

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9
Q

Mixed CP

A
  • 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
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10
Q

Diagnosing CP

A

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

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11
Q

CP impact on function

A
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12
Q

Signs and symptoms of CP

A

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

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13
Q

Medical and surgical management of CP

A

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

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14
Q

CP impact on occupation

A

Feeding
- Often the first to show up
Dressing and other ADLS
Education
- Adaptations and IEPS (individualized education plan)
Sleep
Work
PLAY and Social Participation

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