Cerebral Palsy

Question 1

What is cerebral palsy?

Answer 1

Cerebral palsy (CP) is an umbrella term that encompasses a group of permanent, non-progressive abnormalities of the developing fetal or infant brain that result in disorders of movement and posture

Question 2

What are early clinical featues of cerebral palsy in infants?

Answer 2

• Unusual fidgety movements, asymmetry or paucity of movement, abnormal muscle tone (hypotonia, spasticity, dystonia)
• Delayed motor milestones (late sitting after 8 months, late walking after 18 months)
• Early hand preference before 1 year

Question 3

Which children are at increased risk of cerebral palsy and need enhanced follow-up?

Answer 3

prematurity
low birth weight
neonatal encephalopathy
perinatal brain injury

Question 4

what are the types of cerebral palsy?

most common - least common

Answer 4

1. Spastic CP (90% of cases): Hypertonia and hyperreflexia from damage to motor cortex or corticospinal tracts
2. Dyskinetic CP: Choreoathetosis due to basal ganglia or thalamic injury
3. Ataxic CP: Balance issues from cerebellar damage

Question 5

What is the Mx and first-line drug treatment for children with CP and generalised spasticity causing functional impairment, pain, or spasms

initiates by a specialist

Answer 5

Refer to child development service for a MDT paediatricians, physiotherapists, occupational therapists, speech and language therapists, and other specialists as needed

Treatment - Initiates by a specialist
1. Baclofen
2. Botulinum toxin type A injections

Question 6

What are the complications in children with cerebral palsy?

Answer 6

• Feeding and swallowing difficulties
• Drooling
• MSK Pain, joint deformities
• Epilepsy
• Sleep disturbances
• Communication & speech problems
• Mental health issues
  and other developmental or medical comorbidities