Cerebral Palsy

Question 1

define cerebral palsy

Answer 1

dec BF to an immature brain - < 2yo

d/t trauma, immature or fargile vessels

non-progressive lesion that causes developmental delays

Question 2

most common zone affected in CP

Answer 2

watershed zone next to lat ventricles

Question 3

most common childhood disability

Answer 3

CP

Question 4

most common prenatal factor of CP

Answer 4

prematurity

Question 5

4 stages of brain affectation

Answer 5

1. germinal matrix
2. IV c normal ventricles - normal head size
3. IV c dilatation - CP c hyrdocpehalus or macrocephalus
4. IV c parenchymal hemmorhage - 90% neuro sequelae and affectation of physical abilities

Question 6

5 basic subtypes of hypoxic-ischemic neuropathy

Answer 6

parasagittal cerebral injury

PVL

focal and multifocal ischemic brain necrosis

status marmoratus

selective neuronal necrosis

Question 7

discuss parasagittal cerebral injury

Answer 7

zone: B cortical zone

involved: proximal UE more than LE

type: spastic quadri

Question 8

discuss PVL

Answer 8

zone: B white matter

involved: LE more

type: spastic diplegia more than quadri

Question 9

discuss focal and multifocal ischemic brain necrosis

Answer 9

zone: L MCA more than R

involved: motor function of UE more

type: spastic hemi or diplegia c seizures

Question 10

status marmoratus

Answer 10

zone: basal ganglia

involved: rare in isolation

type: choreathetosis CP

Question 11

selective neuronal necrosis

Answer 11

MC variety of injury

usually CN 5 and 7

mental retardation and seizures

Question 12

prenatal factors of CP

Answer 12

prematurity - MC

Rh incompatibility

fetal anorexia

maternal infections

inherited diseases

drugs, alcohol, teratogens

ecclampsia

Question 13

perinatal factors of CP

Answer 13

asphyxia - MC; cord coil

birth injury

abnormal birth process - breech

neonatal distress

prolonged labor - dec BF

< 800g

Question 14

postnatal factors of CP

Answer 14

head trauma - MC

vascular accident

infections

tumors

battering

Question 15

discuss Rh incompatibility

Answer 15

causes jaundice and affects BG

athetoid CP

Question 16

compare TBI and CP

Answer 16

TBI: mature brain - > 2yo

CP: immature brain - < 2yo

Question 17

topographic classification of CP

Answer 17

monoplegia

triplegia

hemiplegia

quadriplegia or tetraplegia

diplegia

double hemiplegia

Question 18

monoplegia

Answer 18

one of 4 limbs

Question 19

triplegia

Answer 19

2 UE and 1 LE plus trunk

Question 20

hemiplegia

Answer 20

1 side of body - UE and LE

Question 21

quadri or tetraplegia

Answer 21

all 4s equally affected

Question 22

diplegia

Answer 22

all 4s but LE more - scissoring gait

high chance of amb c AD

Question 23

double hemiplegia

Answer 23

all 4s but UE more

Question 24

types of CP based on neurologic

Answer 24

spastic - pyramidal affectation

dyskinetic - extrapyramidal affectation; BG; athetoid CP

mixed - spastic and dyskinetic; spastic choreaathetoid

Question 25

most common types of CP seen

Answer 25

hemiplegia diplegia quadriplegia

Question 26

compare athetoid, dystonic and ataxic

Answer 26

athetoid - limbs dystonic - abnormal trunk posturing ataxic - balance prob c wide BOS

Question 27

bet hemiplegic, diplegic and quadri which has better prog for walking

Answer 27

hemi and diplegic

Question 28

discuss spastic diplegia

Answer 28

aka little's disease UMN findings in legs more than arms can have cognitive impairment or not focal or local seizures (+) hx of prematurity and PVL MC in premature hypotonia or floppy infant followed by spasticity

Question 29

discuss spastic athetoid

Answer 29

hyperbiliburin ecepalopathy and affects BG - dyskinetic athetosis and triad of kernicterus

Question 30

what is the triad of kernicterus

Answer 30

sensory nueral hearing loss parinaud's athetosis

Question 31

what is parinauds phemonenon

Answer 31

loss of upward gaze kaya raise head to look up (+) head on body reflex = sitting balance probs

Question 32

how to encourage head control in prone and supine

Answer 32

does not really but do rotational movements if unable to pull to sit or POE activates SCM and paracervical muscles in prep to neck control

Question 33

head control in other pos

Answer 33

mod pull to sit - supp on elbow or shoulder upright supp sitting and wight shift carrying in prone crarrying upright prone in hammock or swing

Question 34

positions for trunk control in sitting

Answer 34

propped both arms forward - if wala talaga propped laterally on 1 arm - remove supp as inc control

Question 35

transitions that encourage trunk control

Answer 35

rolling from supine to prone using LE - does not improve trunk control but activates muscles sit to side lying sitting to prone - eccentric prone to 4s to kneeling kneeling to half kneeling coming to stand