Pediatric Neuro Pathologies

Question 1

Cerebral Palsy Etiology

Answer 1

can occur before/during birth 2nd to lack of O2/maternal infection/ drug or alcohol abuse/ placental abnormalities/ toxemia/ prolonged labor/ prematurity/ Rh incompatibility

may also be due to meningitis, CVA, seizures, or brain injury

Question 2

Cerebral Palsy Signs/Symptoms

Answer 2

mild-severe loss of control w/ profound mental retardation

All pts- abnormal muscle tone, imparied modulation of movement, presence of abnormal reflexes, impaired mobility

Question 3

Cerebral Palsy Primary Motor Patterns

Answer 3

Spastic: indicates lesion in cerebral motor cortex- upper motor neuron damage

Athetoid: indicates lesion involving basal ganglia (cerebellar and cerebellum pathways)

Question 4

Cerebral Palsy Distribution of Involvement

Answer 4

Monoplegia: one extremity

Diplegia: bilateral LE involvement (UE may still be affected)

Hemiplegia: unilateral involvement of UE and LE

Quadriplegia: involvement of entire body

Question 5

Cerebral Palsy Treatment

Answer 5

Ongoing family/caregiver education
Normalization of tone
Stretch/Strengthen
Reaching developmental milestones
Positioning
WB activities
Mobility Skills
Splinting/ assistive devices/ specialized seating may also be required
Surgical intervention may be required for orthopedic management/ reduction of spasticity

Question 6

Downs Syndrome Etiology

Answer 6

incomplete cell division of 21st pair of chromosomes (aka Trisomy 21)
risks= advanced maternal age

Question 7

Downs Syndrome Signs/Symptoms

Answer 7

Mental retardation, hyoptonia, joint hypermobility, flattened nasal bridge, narrow eyelids w/ epicanthal folds, small mouth, feeding impairments, flat feet, scoliosis, congenital heart disease, visual/hearing loss

Question 8

Downs Syndrome Treatment

Answer 8

Emphasize exercise/fitness, stability, maximized respiratory function, education for caregivers
Surgical intervention may be needed for cardiac abnormalities

Question 9

Duchenne Muscular Dystrophy Etiology

Answer 9

inheritance of X-linked recessive trait- results in absence of gene required to produce muscle proteins (dystrophin & nebulin) causing weak cell membranes, destroyed myofibrils, lost muscle contractility
Fat/connective tissue replace muscle, death occurs from cardiopulmonary failure before age 25

Question 10

Duchenne Muscular Dystrophy Signs/Symptoms

Answer 10

characteristics manifest between 2-5 yrs old
Progressive weakness, disinterest in running, falling, toe-walking, excessive lordosis, pseudohypertrophy of muscle groups

Question 11

Duchenne Muscular Dystrophy Treatment

Answer 11

focus on family/caregiver education, respiratory function, submaximal exercise, mobility skills, splinting, orthotics, adaptive equipment
Meds= immunosuppressants, steroids, surgery for orthopedic impairment

Question 12

Spina Bifida Occulta Etiology

Answer 12

impairment & non-fusion of spinous process of vertebrae, spinal cord & meninges remain intact- usually no associated disability

Question 13

Spina Bifida Meningocele Etiology

Answer 13

herniation of meninges and cerebrospinal fluid into a sac that protrudes through the vertebral defect- spinal cord remains in canal

Question 14

Spina Bifida Myelomeningocele Etiology

Answer 14

severe form characterized by herniation of meninges, cerebrospinal fluid and spinal cord extending through defect in vertebrae- cyst may/may not be covered by skin

Question 15

Spina Bifida Signs/Symptoms

Answer 15

motor loss below level of defect, sensory deficits, hydrocephalus, osteoporosis, clubfoot, scoliosis, latex allergy, bowel/bladder dysfunction, learning disabilities

Question 16

Spina Bifida Treatment

Answer 16

PT- ongoing, emphasizes family teaching, positioning, handling, ROM, therapeutic exercise
Ther ex: facilitate developmental milestones, skin care, strengthening, balance and mobility training, adaptive equipment, splinting, orthotic/wheelchair prescription