Paeds: neuro Flashcards
Cerebral Palsy
what is it
permanent neurological problems resulting from damage to the brain around the time of birth
Cerebral Palsy
antenatal causes
- maternal infections
- trauma during pregnancy
Cerebral Palsy
perinatal causes
- birth asphyxia
- pre-term birth
Cerebral Palsy
postnatal causes
- meningitis
- severe neonatal jaundice
- head injury
Cerebral Palsy
what is spastic CP (aka pyramidal CP)
damage to UMNs
hypertonia + reduced function
Cerebral Palsy
what is dyskinetic CP (aka athetoid CP and extrapyramidal CP)
damage to basal ganglia
hyper + hypotonia –> athetoid movements + oro-motor problems
Cerebral Palsy
what is Ataxic CP
damage to the cerebellum
problems with coordinated movement
Cerebral Palsy
what is Mixed CP
a mix of spastic, dyskinetic and/or ataxic features
Cerebral Palsy
what is monoplegia
one limb affected
Cerebral Palsy
what is Hemiplegia
one side of the body affected
Cerebral Palsy
what is Diplegia
four limbs are affects, but mostly the legs
Cerebral Palsy
what is Quadriplegia
four limbs are affected more severely, often with seizures, speech disturbance and other impairments
Cerebral Palsy
signs + sx
- Failure to meet milestones
- Increased or decreased tone, generally or in specific limbs
- Hand preference <18 m
- Problems with coordination, speech or walking
- Feeding or swallowing problems
- Learning difficulties
Cerebral Palsy
what does a hemiplegic/diplegic gait indicate
an UMN lesion
Cerebral Palsy
what does a Broad based gait / ataxic gait indicate
a cerebellar lesion
what does a High stepping gait indicate
foot drop or a LMN lesion
what does a Waddling gait indicate
pelvic muscle weakness due to myopathy
what does a Antalgic gait indicate
localised pain
Cerebral Palsy
describe a hemiplegic/diplegic gait
- leg extended
- plantar flexion of the feet + toes
- swings leg around
Cerebral Palsy
signs
- UMN signs: good muscle bulk, increased tone, brisk reflexes and slightly reduced power
- hemiplegic/diplegic gait
Cerebral Palsy
differential dx of an UMN lesion
acquired brain injury or a tumour.
Cerebral Palsy
Complications and associated conditions
- Learning disability
- Epilepsy
- Kyphoscoliosis
- Muscle contractures
- Hearing and visual impairment
- GOR
Cerebral Palsy
mnx
MDT:
- physio
- OT
- speech + language
- dietician
- ortho surgeon
- paedatrician
- social works
- charities
Cerebral Palsy
mnx of excessive drooling
Glycopyrronium bromide
Cerebral Palsy
mnx for muscle spasticity + contractures
Muscle relaxants (e.g. baclofen)
