Developmental problems Flashcards
what is the most common cause of motor impairment in chiuldren
cerebral palsy
when do developmental delays usually become apparent
2 years old
what is cerebral palsy
a permanent disorder of movement / posture due to non progressive abnormality in developing brain
When should hand preference develop
AFTER 1 year old
if before > feature of underlying hemiplegi
What are causes of cerebral palsy
80% antenatal
10% HIE (prenatal/natal)
10% postnatal
what are antenatal causes of cerebral palsy
CV haemorrhage /iuschaemia
cortical migration disorder
structural maldevelopment
what are postnatal causes of cerebral palsy
meningitis
encephalitis
encephalopathy
what are the 4 types of cerebral palsy
Spastic 90%
Dyskinetic 6%
Ataxic 4%
Other
Where is the damage in spastic CP?
upper motor neurone pathway
what does spastic CP present with
spasticity (increased limb tone)
brisk tendon reflexes
Extensor plantar response
What are the three types of spastic CP
unilateral hemiplegia
bilateral quadriplegia
bilateral diplegia
explain unilateral hemiplegia in spastic CP
arm> leg
face is spared
tip toe walk
explain bilateral quadriplegia in f spastic CP
all four limbs affected
trunk may also be involved (opisthotonos, poor head control, low central tone)
Explain bilateral diplegia
all 4 limbs affected
legs > arms
abnormal walking
what is bilateral diplegia associated with
periventricular leukomalacia
what is dyskinetic cerebral palsy
dyskinetic = movements that are involuntary, uncontrolled, stereotyped, evidence
with:
- chorea
- athetosis
- dystonia
what is presentation of dyskinetic cerebral palsy
in infancy
floppiness, poor trunk control, delayed motor development
What is a common cause of dyskinetic cerebral palsy
kernicterus
What is a cause of ataxic CP
GENETIC
what is presentation of ataxic CP
early trunk / limb hypotonia, poor balance, delayed motor development
what is medical/surgical management for cerebral palsy
- Oral diazepam
- Oral/intrathecal baclofen
- Botulinum toxin
- SURGERY: dorsal rhizotomy
what is a dorsal rhizotomy
cut some of the nerve roots in the spinal cord to reduce spasticity
what is general management in CP?
MDT management, with
- paediatrician
- nurse
- physiotherapist
- occupational therapiust
- speech and language therapist
- dietician
- psychologist
SO: -
- Physio
- Speech therapy
- Occupation therapy
- Meds
How do you manage stiffness in CP
baclofen, diazepam
How do you manage sleeping in CP
melatonin
how do you manage drooling in CP
anticholinergic
how do you manage constipation in CP
laxative
