Cerebral Palsy Flashcards Preview

Neuromuscular Pathology (Midterm) > Cerebral Palsy > Flashcards

Flashcards in Cerebral Palsy Deck (24)
Loading flashcards...
1
Q

Whic is the 2nd most common neurological
impairment in children

A

CP

2
Q

2nd most common neurological nonprogressive lesion of the brain occuring prior to 2 yrs of age:

A

CP

3
Q

Incidence of CP

A

1.5 to 4 cases per 1000 live births estimated

4
Q

Causes of CP:

A
  • unknown
  • multifactorial
  • Any prenatal, perinatal or postnatal condition resulting in:
    • Cerebral anoxia
    • Cerebral hemorrhage
    • Other damage to brain
5
Q

Pathogenesis of CP:

A

No consistent or uniform pathology

  1. Hemorrhage: stroke
  2. Hypoxic-Ischemic injury/encephalopathy: decreased perfusion
  3. CNS malformation: genetics
6
Q

Classification of Cerebral Palsy

A
  1. Type of muscle tone: spastic, ataxic, dyskinetic, hypotonic
  2. Distribution of limb involvement: monoplegia, hemiplegia, diplegia, triplegia, quadriplegia (tetraplegia)
  3. Functional skills: Functional status, Need for assistive technology & wheeled mobility
7
Q

What is Periventricular leukomalacia (PVL)?

A
  • Bilateral necrosis of white matter of brain adjacent to the lateral ventricles (cystic lesions)
  • Primary hypoxic-ischemic lesion in premature infants
  • Occurs with CP
8
Q

Motor impairments in CP:

A
  • Impact changes with child maturation
  • persistence of primitive reflexes
9
Q

Percentage of mental retardation in CP cases:

A

50-70%

10
Q

Neuromuscular impariments in CP:

A
  • Altered muscle tone
  • Muscle weakness
11
Q

Common Musculoskeletal Deformities in CP:

A
  • scoliosis
  • hip
  • knee
  • ankle and foot
12
Q

Diagnosis of CP:

A
  • Observation
  • Hx
  • Neurologic Exam
  • Diagnosis studies (MRI, CT scan)
    *
13
Q

When are the moderate and severe forms of CP diagnosed?

A

At or before 2 years (6 – 18 months)

14
Q

When are ataxia and hemiplegia diagnosed in CP?

A

10-20 months

15
Q

When is the mild form of CP diagnosed?

A

Varies

16
Q

What is the medical mgmt of CP?

A
  • Pharmacological intervention
    • muscle relaxants
  • Neurosurgical intervention
  • Orthopedic surgery:
    • muscle lengthening or releases
    • muscle tendon transfers
    • bony procedures
  • Orthotics
17
Q

Medical Management Spasticity in CP:

A
  • Injection Therapy
    • Neurolytic Nerve blocks/Motor point blocks
      • Phenol
      • Botulism toxin
      • BOTOX
18
Q

Neurosurgical Interventions in CP:

A
  • Neurectomy
  • Myelotomy
  • Selective Dorsal Rhizotomy:
    • Dorsal sensory nerve roots are selectively severed
    • Usually performed at L2 – L5 levels for spastic diplegia
    • Often performed on children ages 7 to 10 yrs
    • Irreversible
19
Q

What is Selective Dorsal Rhizotomy:

A
  • Neurosurgical Interventions in CP
  • Dorsal sensory nerve roots are selectively severed
  • Usually performed at L2 – L5 levels for spastic diplegia
  • Often performed on children ages 7 to 10 yrs
  • Irreversible
20
Q

Prognosis in mild to moderate CP:

A
  • normal lifespan
  • predictors for amb based on achievements of motor milestones or by type of CP
  • usually able to amb by 8 y/o
21
Q

Common causes of death in CP population:

A

◦ Infection
◦ Aspiration
◦ Respiratory compromise
◦ Heart disease

22
Q

predictors for amb in CP based on type of CP:

A
  • Type of CP
    • Monoplegia 100%
    • Hemiplegia 100%
    • Ataxia 100%
    • Diplegia 60% -90%
    • Spastic quadriplegia 0% - 70%

*

23
Q

predictors for amb in CP based on motor function milestones:

A
  • Sit indep by age 2: Good
  • Indep crawling by age 2.5: Good
  • Primitive reflexes persist > age 2: Poor
  • Absence of postural reactions beyond age 2: Poor
24
Q

Rehabilitation Considerations in CP:

A
  • PT goals:
    • Maximize function
    • Increase variety of movements available to the child
    • Prevent secondary complications, especially orthopedic deformities
  • Tenets of motor learning and neuroplasticity apply
  • PT should be fun and interactive
  • Family-centered
  • School-aged children: include teachers in therapy program
  • Rehab needs change as child grows/ages continued need across the lifespan