Cerebral palsy and neurological conditions Flashcards
What is the main cause of spastic cerebral palsy?
Periventricular leukomalacia
What is hemiplegia?
One side of the body is affected
Delayed walking, tiptoe gait
What is diplegia?
Both legs involved with arms less affected
Excessive hip adduction, hard to put in a nappy
Scissoring of legs
Feet in equinovarus
What foot position is shown here?
Equinovarus
How do children with spastic diplegia or hemiplegia tend to walk?
On tip toes
What are the three types of cerebral palsy?
Spastic
Ataxic
Dyskinetic/ athetoid
What is athetoid cerebral palsy?
Characterised by writhing movements
Due to damage to basal ganglia
What causes ataxic cerebral palsy?
Due to cerebellar damage
Poor coordination
Ataxic gait
What is the prevalence of cerebral palsy?
1 in 400 children.
What is the aetiology of cerebral palsy?
Prenatal - cerebral malformations (polymicrogyria), congenital infections (Torch), metabolic defects
Perinatal - complications of prematurity, intrapartum trauma, hypoxic ischemic insult
Post natal - head trauma, meningitis, NAI, cardiopulmonary arrest
How is cerebral palsy diagnosed?
Clinical findings such as hypertonia, hyperreflexia (including persistent primitive reflexes), clonus, abnormal movement patterns
What are some associated co-morbidities with CP?
Learning disability
Epilepsy
Visual impairment
Squint
Hearing loss
Speech disorders
Behaviour disorders
Undernutrition and poor growth
Respiratory problems
What developmental delays might be seen in a child with cerebral palsy?
Difficulties in sitting and rolling over
Persistent primitive reflexes - Moro, grasp. asymmetric tonic neck
Hand dominance
Movements not simply delayed, although abnormal
Discuss key aspects of the management of cerebral palsy.
Physiotherapist - helping reduce contractures
Occupational therapist - trained to advise on equipment and activity
Speech therapist - feeding and language
Dietician - advise on gastrostomy feeds
MDT and child development team
