Cerebral Palsy/autism

Question 1

what does spasticity mean

Answer 1

velocity dependent increase in resistance to passive stretch

this is usually indicative of damage to the upper motor neurone pathway (pyramidal or corticospinal tracts)

Question 2

how might hemiplegic spasticity present

Answer 2

at 4-12 months: fisting of affected hand, flexed arm, pronated forearm, asymmetric use of hand.
May later develop tiptoe walking on affected side.
Affected side may be flaccid and hypotonic initially
hemianopia may be indicative of a larger brain legion

Question 3

how might quadriplegic spasticity present

Answer 3

all four limbs are affected
trunk involvement with extensor posturing (opisothonus)
often associated with seizures, microcephaly and intellectual impairment

Question 4

how might diplegic spasticity present

Answer 4

all four limbs (legs more than arms)

often associated with periventricular damage to the brain

Question 5

what is chorea

Answer 5

irregular sudden and brief non-repetitive movements

Question 6

what is athetosis

Answer 6

slow writhing movements occurring more distally such as fanning of the fingers

Question 7

what is dystonia

Answer 7

simulatneous contraction of agonist and antagonist muscles of the trunk and proximal muscles, giving a twisted appearance

Question 8

what is kernicterus

Answer 8

hyperbilirubinaemia
this affects the basal ganglia and auditory nerve if it crosses the BBB
more common in rhesus negative mothers

Question 9

what is PVL

Answer 9

cystic holes in the brain around the ventricles, associated with preterm births resulting in UMN disease

Question 10

which pathological reflexes might be present in spastic CP

Answer 10

hyperreflexia

pyramidal signs such as the babinski response