Cerebral Palsy Flashcards
(30 cards)
What is the definition of global developmental delay?
A child has a global developmental delay if they have significant delay in milestones in at least 2 or more areas
What are the main causes of profound disability?
- Chromosomal abnormalities - micro-duplications and deletions
- Cerebral palsy
- Inborn errors of metabolism
What is cerebral palsy attributed to mostly?
Poor muscle tone (spasticity or rigidity)
What are the antenatal causes of CP?
- Maternal infections
- Trauma during pregnancy
- Prematurity
- Low BW
- Multiple gestation
What are the perinatal causes of CP?
- Birth asphyxia
2. Pre-term birth
What are the post-natal causes of CP?
- Meningitis
- Severe neonatal jaundice
- Head injury/NAI
- Cardio-pulmonary arrest
How would you define the following type of CP; Spastic?
Hypertonic patient with reduced function resulting from damage to upper motor neurones (UMN).
How would you define the following type of CP; dyskinetic?
Problems controlling muscle tone, with both hyper- and hypotonia. This causes athetoid movements and oro-motor problems (speech and eating repercussions). This is due to damage to the basal ganglia.
How would you define the following type of CP; Ataxic?
Problems in co-ordinating movements resulting from damage to the cerebellum.
What are the 3 types of CP?
- Spastic CP (UMN)
- Dyskinetic CP (basal ganglia)
- Ataxic CP (cerebellum)
What are some of the potential signs and symptoms of CP (these will become more evident as the child develops)?
- Failure to meet milestones
- Hypotonia or Hypertonia - general or in specific limbs
- Hand preference before 18 months old (KEY EXAM Q)
- Problems with co-ordination, speech or walking
- Feeding or swallowing problems
- Learning difficulties
What are the key features of Autism Spectrum Disorders (ASD)?
- Difficulties in communication
- Difficulties in social interaction
- Inflexible thinking
What sort of pathology is associated with CP?
Non-progressive, permanent
What are the protective factors of obstetric care against CP?
- Magnesium Sulfate
- Antibiotics
- Corticosteroids
What percentage of patients with CP had an antenatal cause for developing CP?
70-80%
There is a U shaped distribution of patients with CP, therefore which ages are most affected by CP?
Very premature and post-term babies
What is the leading cause of CP in premature infants?
Periventricular Leukomalacia (PVL)
What is Periventricular Leukomalacia (PVL)?
A condition of underdeveloped white matter in the brain
What causes periventricular leukomalacia (PVL)?
There are 2 important mechanisms;
- Ischaemia/hypoxia
- Infection/inflammation
What are the 2 main causes of CP due to prematurity?
- Periventricular leukomalacia (PVL)
2. Intraventricular haemorrhage (IVH)
List the TORCHS infections.
T - Toxoplasmosis O - Other infections (varicella zoster, adenovirus, enterovirus) R - Rubella C - Cytomegalovirus (CMV) H - Herpes Simplex Virus (HSV) S - Syphilis
What are the common intrauterine infections that can cause CP?
- Chroioamnionitis
2. The TORCHS infections
Why are preterm babies more at risk of periventricular leukomalacia (PVL)?
As they have poor auto-regulation of the cerebral blood flow which usually protects the foetal brain from hypo-perfusion due to underdeveloped arteriolar smooth muscle and immature vasoregulatory mechanisms
What are Upper Motor Neurones (UMN)?
Neurones of the brain and spinal cord (CNS) that control movement of the muscles. This is one half of the somatic nervous system. The cell bodies of the UMN most originate int he cerebral cortex or the brainstem and must terminate within the brain stem or spinal cord.
