Final Lecture 11 Flashcards
a group of disorders of movement and posture causing disability
- Due to disturbances in fetal or infant brain
- condition is non-progressive
- disability may worsen
- the most common cause of motor disability in children
cerebral palsy
4 types of CP
Spastic
Athetoid
Ataxic
Mixed forms
Prevalence of CP
- 500,000-764,000 people in U.S.
- 3.3 per 1,000 8 year old children
Incidence of CP
1.5- 2.5 per 1,000 births
Total direct cost of CP
$2.2 billion per year
Average lifetime cost of CP
- $11.5 billion for people with CP born in 2000
- $921,000 per person
Pathophysiology of CP
- caused by injury:
- prenatal (75% of cases)
- during birth
- post-natal
- Impairment in voluntary motor control
- damage to different brain areas affect people in different ways
- symptoms vary between people
Risk factors of CP
- Premature births; low weight births
- smoking
- alcohol abuse
- poor management of maternal conditions (diabetes, infections, hypertension)
- multiple births
- prolonged hypoxia during births
(affects 70-80% of patients)
- hypertonia; spasticity; contractures; stiff muscles
- named by limbs affected
Spastic CP
(affects 10-20% of patients)
-uncontrolled and slow movements in hands, feet, arms, or legs and, in some cases, the muscles of the face and tongue, causing grimacing or drooling; increase with stress; speech problems
Athetoid CP
(affects 5-10% of patients)
-usually due to damage in cerebellum; hypotonia; tremor; motor control affected; balance problems; unstable and wide gait
Ataxia CP
Combinations of symptoms from other types (most commonly: spastic + athetoid)
Mixed Form CP
Spastic symptoms
- symptoms may affect one or both side
- tight & weak muscles
- abnormal gait
- paralysis
Other CP types symptoms
- abnormal movements (jerking, tremors, writhing)
- unsteady gaits
- loss of coordination
- floppy muscles
Percentage of 8 year old children with CP who walk independently
58.2%
Percentage of 8 year old children with CP who uses hand-held mobility device
11.3%
Percentage of 8 year old children with CP who have limited or no walking ability
30.6%
Additional Symptoms
- cognitive or learning disabilities
- speech problems
- hearing or vision problems
- seizures
- pain
- difficulty sucking or feeding in infants
- problems with chewing and swallowing in other children and adults
- vomiting or constipation
- increased drooling
- slower than normal growth
- breathing difficulties
- urinary incontinence
Associated Clinical Conditions
- components of the primary disabling condition
- not preventable
Secondary Clinical Conditions
Physical or psychosocial health problems resulting from the primary disabling condition
-preventable
Comorbid Clinical Conditions
health problems independent of primary conditions
- Bowel/Bladder problems
- cognitive impairment
- musculoskeletal problems
- oral motor dysfunction
- respiratory problems
- seizures/ epilepsy
- sensory impairments
- vision problems
Associated Conditions
- Cardiovascular conditions
- deconditioning
- fatigue
- mobility problems
- communication disorders
- depression
- obesity
- pain
- pressure sores
Secondary Conditions
Diagnosis of CP
- Physical Exam-maternal and infant medical history, motor skill testing, reflexes, muscle tone, spasticity, posture, ruling out other conditions
- EEG
- Hearing and vision testing
- imaging of the brain: CT, MRI
