Cerebral Palsy and Hypoxic-Ischaemic Encephalopathy Flashcards

1
Q

What is the definition of cerebral palsy?

A

Permanent neurological problems resulting from damage to the brain around the time of birth.

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2
Q

What proportion of cerebral palsy cases are due to problems during labour itself?

A

1 in 10

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3
Q

What are some antenatal causes of cerebral palsy?

A

Maternal infections
Trauma during pregnancy

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4
Q

What are some perinatal causes of cerebral palsy?

A

Birth asphyxia
Pre-term birth

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5
Q

What are some postnatal causes of cerebral palsy?

A

Meningitis
Severe neonatal jaundice
Head injury

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6
Q

What are some types of cerebral palsy?

A

Spastic
Dyskinetic
Ataxic
Mixed

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7
Q

What is spastic cerebral palsy?

A

Hypertonia and reduced function due to damage to upper motor neurones

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8
Q

What is dyskinetic cerebral palsy?

A

Problems controlling muscle tone, with hypertonia and hypotonia, causing athetoid movements and oro-motor problems
Due to damage to basal ganglia

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9
Q

What is ataxic cerebral palsy?

A

Problems with coordinated movement resulting from damage to the cerebellum

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10
Q

What is mixed cerebral palsy?

A

Mix of spastic, dyskinetic and/or ataxic features

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11
Q

What are the patterns of spastic cerebral palsy?

A
  • Monoplegia: one limb affected
  • Hemiplegia: one side of the body affected
  • Diplegia: four limbs are affected, but mostly the legs
  • Quadriplegia: four limbs are affected more severely, often with seizures, speech disturbance and other impairments
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12
Q

What are some clinical features of cerebral palsy?

A

Mobility problems (spasticity and orthopaedic)
Learning difficulties
Epilepsy
Visual/hearing impairment
Communication difficulties
Feeding difficulties
Sleep problems
Behavioural problems

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13
Q

What does a hemiplegic/diplegic gait indicate?

A

Upper motor neurone lesion

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14
Q

What does a broad based/ataxic gait indicate?

A

Cerebellar lesion

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15
Q

What does a high stepping gait indicate?

A

Foot drop or lower motor neurone lesion

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16
Q

What does a waddling gait indicate?

A

Pelvic muscle weakness due to myopathy

17
Q

What does an antalgic gait indicate?

A

Localised pain (limp)

18
Q

What is the management of cerebral palsy?

A

MDT approach
- Physiotherapy
- Occupational therapy
- SLT
- Dietician
- Orthopaedic surgeon
- Paediatricians
- Social workers
- Support groups

19
Q

What is the definition of hypoxic-ischaemic encephalopathy?

A

Multi-organ damage due to prolonged or severe tissue hypoxia during birth

20
Q

What are some clinical features of HIE?

A

Poor APGAR scores- active resuscitation required

21
Q

What are some caused of tissue hypoxia causing HIE?

A

Maternal shock
Intrapartum haemorrhage
Prolapsed cord
Nuchal cord (cord wrapped around neck of baby)

22
Q

What is the management of HIE?

A

Supportive care with neonatal resuscitation
Ongoing optimal ventilation
Circulatory support
Nutrition
Acid base balance
Treatment of seizures
Therapeutic hypothermia