Palsy Flashcards
what is a palsy
paralysis usually accompanied weakness, loss of feeling and with involuntary tremors or movements
what is cerebral pasly
non-progressive disorder of tone and posture from an acquired pre- or post-natal insult (up to 30 days of life)
not usually apparent at birth, may be noted as early as 4 months, definitely by 2 years
what are the risk factors of CP
include permaturity, perinatal deprivation of blood or oxygen to the brain via:
PVL(periventricular leukomalacia), IVH (Intraventricular hemorrhage) or Hypoxic-ischemic encephalopathy (HIE), maternal infection, trauma, and other processes involving ischemia, inflammation, infection, genetic predisposition
what maternal infections increase the risk of CP
Zika
TORCH -
Toxoplasmosis
Other
Rubella
CMV
HSV
what are the classifications of CP
Hypotonic
Hypertonic or Spastic
Dystonic
Cerbellar ataxia
what are the types of Hypotonic CP
quadriparesis or tetrapaesis
diaparesis or diplegia
hypotonia with choreoathetosis
what are types of Hypertonic or spastic CP
quadriparesis
hemiparesis
diparesis or diplegia
what is dystonic CP
facial rictus, stimultaneous contaction of agnoist and antagonist muscles, opsithotonus
what is cerebellar ataxia CP
unsteady wide - based gate, gross motor delay, coordination and balance problems (~3%)
how is CP diagnosed
labs - look for congenital infection in mothers and kids
imaging - mri for brain changes or normal
what are differential diagnoses for CP
some neurodegenerative and neurometabolic disorders can mimic, genetic testing is helpful in differentiating
what is the prognosis of CP
spasticity tends to worsen with time vs hypotonia can improve with age
what is the intelligence level in CP patients
cognitive impairment does not always match physical deficits. can have normal intelligence with more severe hyper- or hypotonicity
what is the treatment of CP
multidisciplinary approach:
PT/OT
Bracing
Pharmacologic treatment of spasticity
what are generalized medications treatments for CP
oral antispasmodics (baclofen, tizanidine, benzodiazepeine)
what are localized treatments for CP
botulinum toxin (botox), bracing, orthopedic surgery, neurosurgery
what is a selective dorsal rhizotomy
effective in young children with spastic dispraises who can walk - involved cutting abnormal nerve in lower spinal cord to relax muscles
what is radial nerve palsy
paralysis of radial nerve due to compression of nerve against humerus
what is the common cause of radial nerve palsies
fracture of the humerus - during fracture or repair
sedated with ETOH, falling asleep with chair over arm
during sleep with a parner resting on your arm
when are radial nerves more likely to be severed and need repair
open fractures, high energy traumas, open wounds
what are the symptoms of radial nerve palsy
pain, weakness, loss of function in wrist, hand and fingers
numbness over the lateral dorsum of hand
wrist drop or finger drop
what is the cause of axillary radial nerve compression
crutches and the triceps muscle is affected and interferes with elbow extension
how is radial nerve palsy diagnosed
ultrasound can be used to distinguish between nerve ruptures, swelling around nerve, neuroma formation
what is the initial treatment for radial nerve palsy
brace or spline and PT plus NSAIDs - 90% will improve with observation alone and can take 3-6 months
