Neuromuscular Conditions Flashcards
What is cerebral palsy?
A permanent and non-progressive motor disorder due to brain damage before birth or during the first 2 years of life.
What are the causes of cerebral palsy?
Placental insufficiency Toxaemia Smoking, alcohol, drugs Infection such as toxoplasmosis, rubella, CMV and herpes type II (TORCH) Prematurity (most common) Anoxic injuries Head trauma
What are dynamic contractures?
Increased muscle tone and hyperreflexia
No fixed deformity of joints
Deformity can be overcome
What are fixed muscle contractures?
Persistent spasticity and contracture
Shortened muscle tendon units
Deformity cannot be overcome
What are some general features of cerebral palsy?
Spasticity Lack of voluntary control Weakness Poor co-ordination Sensory impairment
What are some of the complications which can arise from cerebral palsy?
Motor Sensory (speech and hearing difficulties, visual defects) Cognitive problems (50%) Epilepsy Feeding difficulties, Behavioural problems
What investigations can be done when diagnosing cerebral palsy?
Gait analysis
Xrays
MRI
What are the prerequisites of normal gait?
Stability in stance Clearance in swing Preposition of foot Adequate step length Energy conservation
What should be included in the clinical assessment of hips?
Sitting, lying and prone if possible Hip ROM - pain Hamstring tightness Pelvic obliquity Spine in coronal and sagittal planes
What are the different levels of GMFCS hip assessment?
LEVEL I - Walks without Limitations
LEVEL II - Walks with Limitations
LEVEL III - Walks Using a Hand-Held Mobility Device
LEVEL IV - Self-Mobility with Limitations; May Use Powered Mobility
LEVEL V - Transported in a Manual Wheelchair
What medications can be used to manage spasticity?
Baclofen
Diazepam
Botulinum toxin
Surgery
What management options are available for hip deformity?
Soft tissue release (adductors, hamstrings) Bony realignment (Varus Derotation Osteotomy, Pelvic Osteotomy)
What is spina bifida?
Failure to close neural tube
What is the spectrum of spina bifida?
Occulta – benign Meningocele Myelomeningocele Encephalocele Anencephaly
What are the complications of myelomeningocele?
Hydrocephaly Chiari II malform Tethered cord Urinary tract problems Locomotor limitation Latex allergy (3/4) Learning disability (1/5)
