NeuroPathology - Lecture 13 - Cerebral Palsy

Question 1

What is cerebral palsy?

Answer 1

a non-progressive, permanent disorder of posture and movement

Question 2

What determines the type of cerebral palsy?

Answer 2

which part of the brain is affected; cerebral cortex, basal ganglia, cerebellum

Question 3

How does cerebral palsy present when the cerebral cortex is affected?

Answer 3

stiff muscles/spasticity

Question 4

How does cerebral palsy present when the basal ganglia is affected?

Answer 4

uncontrollable movements (dyskinesia)

Question 5

How does cerebral palsy present when the cerebellum is affected?

Answer 5

poor balance and coordination

Question 6

How does cerebral palsy present when multiple areas of the brain are affected?

Answer 6

mixed or a combination of two or more types of cerebral palsy

Question 7

Spastic Cerebral Palsy presents as…

Answer 7

stiff muscles in legs and/or arms on one or both sides of the body

Question 8

Dyskinetic Cerebral Palsy presents as…

Answer 8

slow, uncontrollable jerky movement, hyperactivity in face/tongue

Question 9

Ataxic Cerebral Palsy presents as…

Answer 9

balance and depth perception is off, poor coordination, unsteady gait, wide BOS, difficulty with precise movements

Question 10

Mixed Cerebral Palsy presents as…

Answer 10

Combination of other types of cerebral palsy

Question 11

What is the neuropathology of Cerebral Palsy?

Answer 11

damage to white matter of the brain, abnormal development of the brain, bleeding in the brain, lack of oxygen

Question 12

What is the incidence of Cerebral Palsy - Prenatal?

Answer 12

structural abnormality, neonatal stroke, severe infection

Question 13

What is the incidence of Cerebral Palsy - Perinatal?

Answer 13

low birth weight, peri-ventricular leukomalacia, intraventricular hemorrhage, hypoxic-ishcemic encephalopathy, untreated jaundice

Question 14

What is the incidence of Cerebral Palsy - Postnatal?

Answer 14

Injuries (shaken baby syndrome), trauma, infections, stroke

Question 15

What are common causes of Cerebral Palsy?

Answer 15

Periventricular Leukomalacia
Intraventricular Hemorrhage
Hypoxic-Ischemic Encephalopathy

Question 16

What is the pathogenesis for PVL?

Answer 16

infants are at higher risk of ischemia in PV areas, especially between 23- 32 weeks’ gestation

Question 17

What is the pathway of CSF in the ventricles?

Answer 17

Lateral ventricles –> foramen of monro –> third ventricle –> cerebral aqueduct –> fourth ventricle –> foramen of Luschka and foramen of Magendie

Question 18

What is the pathogenesis for IVH?

Answer 18

caused by disruption of fragile vascular network of germinal matrix and subsequent ventricular dilatation, between 8-28 weeks’ gestation

Question 19

What is the pathogenesis for HIE?

Answer 19

decreased perfusion resulting from systemic hypotension and poor autoregulation of cerebral blood flow

Question 20

What is Bilirubin Encephalopathy (Kernicterus)?

Answer 20

Acquired metabolic encephalopathy of neonatal period // unbound and conjugated circulating bilirubin crosses the blood brain barrier

Question 21

What are the clinical manifestations of Bilirubin Encephalopathy?

Answer 21

Changes in muscle tone // poor selective control of muscles // poor regulation of activity // decreased ability to learn unique movements // delayed postural response // inappropriate sequencing of movements