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Cerebral Palsy

Cerebral palsy is a non-progressive disorder of movement and posture caused by abnormal brain development or damage, with various etiologies including prenatal, perinatal, and postnatal factors. It can be classified based on topographic distribution and types of motor disorders, with clinical manifestations such as poor head control and stiffness in limbs. Treatment includes non-operative therapies like physical and occupational therapy, pharmacological interventions, and surgical options to improve function and manage symptoms.

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Mohammed Uwaish
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0% found this document useful (0 votes)
11 views26 pages

Cerebral Palsy

Cerebral palsy is a non-progressive disorder of movement and posture caused by abnormal brain development or damage, with various etiologies including prenatal, perinatal, and postnatal factors. It can be classified based on topographic distribution and types of motor disorders, with clinical manifestations such as poor head control and stiffness in limbs. Treatment includes non-operative therapies like physical and occupational therapy, pharmacological interventions, and surgical options to improve function and manage symptoms.

Uploaded by

Mohammed Uwaish
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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CEREBRAL PALSY

PRESENTED BY
N.RAMANAA
3rd YEAR MBBS
OBJECTIVES
• Definition
• Etiology
• Classification
Topographic
Types of motor disorder
• Clinical manifestation
• Treatment
DEFINITION
• Cerebral palsy is a term used for a group of non progressive disorder
of movement and posture caused by abnormal development of
damage to motor control centres of the brain.
ETIOLOGY
PRENATAL
Gestational Maternal
• Diabetes / hypertension • Chromosome abnormalities
• Exposure to radiation / toxins • Genetic syndrome
• Infection(TORCH) • Rh incompatibility
• Seizure • Congenital malformation
PERINATAL

• Prematurity and associated problems


• Periventricular hemorrhage
• Sepsis
• Seizure
• Meconium aspiration
• Low birth weight
POSTNATAL
• Brain injury
• Meningitis
• Traumatic brain injury
• Infection
CLASSIFICATION
Topographic Distribution
• Hemiplegia
It is a commonest form of cerebral palsy. Usually appears as a
spastic palsy on one side of the body with upper extremity more affected
than lower.
• Monoplagia
Occasionally appeared in upper limb. True monoplegia is show
unusual that other diagnosis should be considered such as neonatal
brachial plexopathy.
• Diplegia
It involve both side of the body with lower limb most severely
affected.
Side to side involvement may be asymmetrical.
• Triplegia.
• Quadriplegia.
• Paraplegia.
TYPES OF MOTOR DISORDER
• Spasticity – It is common muscle movement disorder and associated
with damage to pyramidal system. It is characterized by velocity
dependent increased muscle tone & hyper reflexia.
Dyskinetic – It is characterized by recurring uncontrolled and
involuntary movement.
• Dystonia – characterized by hypokinesia (reduced activity) &
hypertonia (increased tone) resulting in stiff movement.
• Choreoathetotic – characterized by hyperkinesia (increased activity)
& hypotonia (decreased tone) resulting in uncoordinated writhing and
jerky movements.
• Ataxia – characterized by generalized hypotonia with loss of muscle
coordination during voluntary movements.
CLINICAL MANIFESTATION
Physical signs
Poor head control after 3 months of age.
 Stiff or rigid arms or legs.
Floppy or limb body posture.
Cannot set up without any support.
Leg scissoring.
EARLY SIGNS
• Stiff or floppy posture
• Excessive lethargy or irritability/ high pitched cry
• Forehead control
• Weak suckling
• Tongue thrust/ tonic bite
• Feeding difficulty
DIAGNOSTIC TEST
• Physical examination
• History taking
• MRI
• Neurological assessment
• Electroencephalogram-small electrodes are placed on scalp to
monitor brain activity
• Electromyogram-to assess the electrical activity of muscle and nerve
conduction studies to measure the conducting function of nerve
ELECTROENCEPHAL
OGRAM

ELECTROMYOGRAM
• Labarotary studies to detect the blood clotting and screen for genetic
or metabolic problem
• Additional test-vision impairment, hearing impairment, speech delay,
intellectual disability
TREATMENT
Non operative
1.Therapy can help a person with a cerebral palsy to enhance
functional abilities and therapy is chiefly symptomatic and preventive
AIMS OS THERAPY
1.To establish locomotion, communication and self help
2.To gain optimum appearance and integration of motor function
3.To correct associated defect as early and effectively
4.To promote educational oppurtunites adapted to individual
child needs
PHYSICAL THERAPY
• Physical therapy is directed towards good skeletal alignment for child
with spasticity, training, face involuntary movement and gait training.
• Physical therapy can help the childs strength, flexibility, balance,
motor development and mobility.
• Physical therapy uses orthotic devices, such as braces, casting and
splints to support and improved walking.
OCCUPATIONAL THERAPY
• It is to promote childs independent participation in daily activitis and
routines in the home, the school and the community.
• Adaptive equipment may include walkers, seating systems or electric
wheelchairs.
SPEECH AND LANGUAGE
THERAPY
• Speech- language pathologists can help improve the childs ability to
speak clearly or to communicate using sign language.

RECREATION THERAPY

• The therapy can help improve your childs motor skills, speech and
emotional well- being.
PHARMACOLOGY TREATMENT
The goal of drug therapy is to reduce the effects of cerebral palsy and
prevent complication:
 Analgesic drug to reduce intense pain or muscle spasm.
Botulinium toxin type A, used to reduce spasticity in targeted muscle of the
upper and lower extremities.
Inhaled nitrous/ oral midazolam used for sedation during botulinum toxin A
injection.
Dantrolene sodium, baclofen, and diazepam to improving muscle
coordination and to muscle relaxation.
Anticonvulsants drugs to relieve or stop seizures.
OPERATIVE TREATMENT
• Surgery used to correct problems with bones and joints by
lengthening any muscles and tendons that or to short and causing
problems.
• Orthopediac surgery may be required to correct contracture or spastic
deformities, to provide stability for an uncontrolled joint, to address
bone malignant and to provide balanced muscle power.
Selective dorsal rhizotomy
• It is surgical procedure that can help children with particularly severe
muscle stiffness in their legs to improve their walking.
• The operation involves cutting some of the nerves in the lower spinal
column which can help relieve leg stiffness
Gastrostomy
• Surgery may performed to improve feeding, correct gastro
oesophageal reflex disease and correct associated dental problems.
THANK YOU

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