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Questions and Answers
What is cerebral palsy?
What is cerebral palsy?
Cerebral palsy describes a group of permanent disorders of the development of movement and posture, causing activity limitations that are attributed to nonprogressive disturbances that occurred in the developing fetal or infant brain.
When does cerebral palsy typically occur?
When does cerebral palsy typically occur?
Cerebral palsy can occur during pregnancy, childhood, or after birth up to about age 5.
What is the most common type of cerebral palsy?
What is the most common type of cerebral palsy?
Cerebral palsy is a progressive disorder.
Cerebral palsy is a progressive disorder.
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Cerebral palsy is a common cause of chronic childhood disability.
Cerebral palsy is a common cause of chronic childhood disability.
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What are some common risk factors for preterm infants developing cerebral palsy?
What are some common risk factors for preterm infants developing cerebral palsy?
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Which of the following is NOT a typical sign or symptom of cerebral palsy?
Which of the following is NOT a typical sign or symptom of cerebral palsy?
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What are some common treatments for cerebral palsy?
What are some common treatments for cerebral palsy?
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There is a cure for cerebral palsy.
There is a cure for cerebral palsy.
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What are some of the medical treatments used to manage cerebral palsy?
What are some of the medical treatments used to manage cerebral palsy?
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How is cerebral palsy diagnosed?
How is cerebral palsy diagnosed?
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What is the most common type of cerebral palsy, occurring in about 80% of all cases?
What is the most common type of cerebral palsy, occurring in about 80% of all cases?
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What is the common feature of spastic cerebral palsy?
What is the common feature of spastic cerebral palsy?
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Spastic children often experience hip dislocations because of the tightness of their muscles.
Spastic children often experience hip dislocations because of the tightness of their muscles.
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Children with spastic cerebral palsy often have difficulties with balance.
Children with spastic cerebral palsy often have difficulties with balance.
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What is the cause of ataxic cerebral palsy?
What is the cause of ataxic cerebral palsy?
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Children with ataxic cerebral palsy often present with hypotonia and tremors.
Children with ataxic cerebral palsy often present with hypotonia and tremors.
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Children with ataxic cerebral palsy may struggle with visual and/or auditory processing.
Children with ataxic cerebral palsy may struggle with visual and/or auditory processing.
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What is athetoid cerebral palsy?
What is athetoid cerebral palsy?
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Children with athetoid cerebral palsy may experience difficulty with fine motor skills.
Children with athetoid cerebral palsy may experience difficulty with fine motor skills.
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High levels of bilirubin in a newborn's blood can lead to brain damage in the basal ganglia known as kernicterus, which can cause dyskinetic cerebral palsy.
High levels of bilirubin in a newborn's blood can lead to brain damage in the basal ganglia known as kernicterus, which can cause dyskinetic cerebral palsy.
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Children with mixed cerebral palsy often have learning disabilities.
Children with mixed cerebral palsy often have learning disabilities.
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Hypotonia in a child with cerebral palsy is always permanent.
Hypotonia in a child with cerebral palsy is always permanent.
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Hypotonia in a child with CP can be a sign of a specific type of CP.
Hypotonia in a child with CP can be a sign of a specific type of CP.
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Study Notes
Cerebral Palsy Overview
- Cerebral palsy (CP) is a group of permanent disorders affecting movement and posture.
- The cause is non-progressive disturbances in the developing fetal or infant brain.
- CP typically develops during pregnancy, childhood, or after birth up to approximately age 5.
- It's a broad term for various "palsies" impeding movement control due to brain damage.
- Symptoms change over time, sometimes improving, sometimes worsening.
- CP is a leading cause of chronic childhood disability.
Causes of Cerebral Palsy
Prenatal Causes
- Vascular events (e.g., middle cerebral artery infarct)
- Maternal infections (e.g., rubella, cytomegalovirus, toxoplasmosis)
- Less common: metabolic disorders, maternal toxin ingestion, rare genetic syndromes
Perinatal Causes (During Labor and Delivery)
- Obstructed labor
- Antepartum hemorrhage
- Cord prolapse
- Hypoxic-ischemic encephalopathy
- Neonatal stroke (often middle cerebral artery)
- Severe hypoglycemia
- Untreated jaundice
- Severe neonatal infection
Postnatal Causes
- Metabolic encephalopathy
- Storage disorders
- Intermedullary metabolism disorders
- Metabolic disorders
- Miscellaneous disorders
- Toxicity (e.g., alcohol)
Other Causes
- Infections (e.g., meningitis, septicemia, malaria – in developing countries)
- Injuries (e.g., cerebrovascular accident, surgery for congenital malformations, near-drowning, trauma, child abuse like shaken baby syndrome)
Risk Factors
During Pregnancy
- Preeclampsia (in term newborns, but not preterm)
- Multiple pregnancies linked to:
- Preterm delivery
- Poor intrauterine growth
- Birth defects
- Intrapartum complications
During Labor
- Likely causes of perinatal asphyxia:
- Prolapsed cord
- Massive intrapartum hemorrhage
- Prolonged/traumatic delivery (cephalopelvic disproportion or abnormal presentation)
- Large baby with shoulder dystocia
- Maternal shock
Associated Events
- Prolonged second-stage labor
- Emergency Cesarean section
- Premature placental separation
- Abnormal fetal position
- Meconium-stained fluid
- Tight nuchal cord
Preterm Infants
- Patent ductus arteriosus
- Hypotension
- Blood Transfusion
- Prolonged ventilation
- Pneumothorax
- Sepsis
- Hyponatremia
- Total parenteral nutrition
- Seizures
- Parenchymal damage with ventricular dilation
Classification
Physiological Classification
- Spastic CP
- Ataxic CP
- Athetoid (dyskinetic) CP
- Mixed CP
- Hypotonic CP
Anatomical Classification
- Monoplegia (one limb affected)
- Hemiplegia (upper and lower limbs on one side affected)
- Diplegia (all limbs affected, lower more than upper)
- Quadriplegia (all four limbs affected)
Specific Types
Spastic CP
- Most common (80% of cases)
- Hypertonia and mobility impairment due to motor cortex lesion
- Clonus (muscle spasms) can occur
Ataxic CP
- Caused by cerebellum damage
- Affects balance and motor skills (writing, typing, using scissors)
- Difficulty with visual and auditory processing (common)
Athetoid (Dyskinetic) CP
- Mixed muscle tone (both hypertonia and hypotonia) with involuntary movements
- Difficulty holding steady positions (sitting, walking)
- Involuntary motions common
- Fine motor control challenges
- May include supra nuclear palsy, feeding, speech, and hearing impairments
Mixed CP
- Combination of spastic, ataxic, or athetoid features
- MRI frequently used in diagnosis
Hypotonic CP
- Hypotonia (low muscle tone) can be permanent or transient, often related to athetosis/spasticity
- Infants with generalized hypotonia may develop distal spasticity progressing proximally.
Signs and Symptoms
- Delayed milestones
- Lack/loss of head control
- Frequent epilepsy
- Saliva drooling
- Limbs deformities (muscle tightness)
- Primitive reflexes present
- Spasticity/flaccidity
- Involuntary movements
- Lack/loss of limb movements
- Lack of social response
- Hip dislocations
- Inability to sit unassisted
- Mental retardation
- Learning disabilities
- Spinal deformities
- Urinary/fecal incontinence
- Dysarthria (speech impairment)
- Feeding difficulties
Diagnosis
- Clinical evaluation: assessment of delayed development, primitive reflexes, tone abnormalities, involuntary movements
- Imaging (CT/MRI): detects brain cell degeneration (atrophy) within affected areas
Treatment
- Rehabilitation team: Neurologists, Orthopaedicians, Physiotherapists, Occupational Therapists, Speech therapists, Special educators, Parents
- Medical management: anticonvulsant drugs (e.g., dantrolene, sodium, baclofen), Botox injections, proper nutritional supplements
- Orthopaedic interventions: deformity correction, muscle length correction
- Physiotherapy: passive/active movements, active-assisted/active exercises, passive stretching, proper positioning, orthosis use, gait training, assistive devices, (e.g., Rood's approach, NDT approach, Brunnstrom's approach, sensory integration for learning difficulties)
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Description
Explore the complexities of Cerebral Palsy (CP), a group of permanent disorders affecting movement and posture. This quiz delves into the prenatal and perinatal causes that contribute to this condition, including vascular events and maternal infections. Understand the lasting impact CP has on childhood disability.
