Cerebral Palsy Overview

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Questions and Answers

What is one of the most common infectious causes of cerebral palsy?

Bacterial pneumonia

Tuberculosis

Meningitis (correct)

Viral encephalitis

Which syndrome is NOT mentioned as a genetic disorder associated with cerebral palsy?

Gillespie syndrome

Down syndrome (correct)

Joubert syndrome

Marinesco-Sjogren syndrome

What percentage of cerebral palsy cases are accounted for by genetic causes?

10%

15%

2% (correct)

Which type of cerebral palsy is characterized by muscle stiffness and tension?

Spastic Signup and view all the answers

What is a complication that can arise from maternal disorders during pregnancy contributing to cerebral palsy?

Placental infarction Signup and view all the answers

What differentiates congenital cerebral palsy from acquired cerebral palsy?

Congenital CP is due to in-utero factors while acquired CP results from early developmental factors. Signup and view all the answers

Which statement best describes the classification of motor impairments in cerebral palsy?

Cerebral palsy encompasses non-progressive yet often changing motor impairment syndromes. Signup and view all the answers

Which of the following statements is NOT a characteristic of cerebral palsy?

It is solely caused by environmental factors at birth. Signup and view all the answers

What aspect of cerebral palsy’s incidence is highlighted concerning its prevalence in developed countries?

Spastic diplegia has increased in prevalence while athetoid types have decreased. Signup and view all the answers

What are the factors explicitly excluded from the classification of cerebral palsy?

Movement disorders that are of short duration or due to progressive disease. Signup and view all the answers

What is a key characteristic of individuals with spastic cerebral palsy?

Stiffness of muscles in the involved extremities Signup and view all the answers

How does the movement speed of individuals with spastic cerebral palsy change with increased effort?

Movement becomes slower due to increased stiffness Signup and view all the answers

Which of the following terms is often used to describe individuals with acquired cerebral palsy?

Conditions based on specific diagnoses Signup and view all the answers

What is a common sequelae observed in children who have sustained brain damage before two years of age?

Similar effects to prenatal brain damage Signup and view all the answers

Which of the following is NOT characteristic of individuals with spasticity in cerebral palsy?

Increased range of movement Signup and view all the answers

What might individuals with spastic cerebral palsy develop over time as a result of their condition?

Contractures and deformities Signup and view all the answers

What differentiates acquired cerebral palsy from congenital cerebral palsy?

Acquired cerebral palsy shows more variation in causes and symptoms Signup and view all the answers

In the context of cerebral palsy, what does the term 'topographical distribution of the neuromotor dysfunction' refer to?

The distribution of muscle tone and movement abilities Signup and view all the answers

Which characteristic is true regarding the accuracy of movement in individuals with spastic cerebral palsy?

Movements are direct but slow Signup and view all the answers

Study Notes

Cerebral Palsy

Cerebral palsy (CP) is a neurodevelopmental disorder beginning in early childhood and lasting throughout life.
It is a non-progressive central nervous system (CNS) deficit.
The condition may involve one or several brain areas.
It results in definite motor and potential sensory abnormalities.
CP results from in-utero factors, events during labor and delivery, or a range of factors in early childhood development. This includes congenital CP (factors affecting the fetus during womb development) and acquired CP (factors affecting the fetus in earlier childhood development).
70-80% of CP cases are attributed to antenatal causes.

Definition

Cerebral paresis was an original description from Little in 1861.
Bax (1964) defined CP as a movement and posture disorder resulting from a lesion of the immature brain.
Mutch and colleagues (1992) introduced a more comprehensive definition of CP. They described it as a group of motor impairment syndromes resulting from brain lesions or anomalies, largely present during the initial stages of development.
CP describes a group of permanent disorders of movement and posture.
Activity limitation frequently accompanies CP and are attributed to non-progressive disturbances occurring in the developing fetal or infant brain.
Sensory, perception, cognition, communication, and behavior disturbances often accompany the motor problems.
Epilepsy and musculoskeletal issues are secondary complications frequently associated with CP.

Exclusion

Conditions excluded from the diagnosis of CP are:
- Disorders of movement/posture with short duration.
- Disorders of movement/posture due to progressive diseases.
- Disorders of movement/posture solely due to mental deficiency.

Incidence and Prevalence

550,000- 764,000 Americans have a diagnosis of CP.
9,750 new cases are reported annually (UCP, 2003).
The incidence of CP in developed countries is estimated at 2 to 2.5 cases per 1,000 live births.
Prevalence of CP has increased in industrialized regions.
Spastic diplegia is more prevalent than other types.
The incidence is slightly higher in premature infants and those who are underweight for their gestational age.
CP is slightly more common in males compared to females.

Risk Factors

Antenatal risk factors include prematurity, low birth weight, intrauterine infections, multiple gestations, and pregnancy complications.
Perinatal risk factors include birth asphyxia and complicated labor and delivery (approximately 10% of CP cases).
Postnatal risk factors include accidental harm/injury, head trauma, meningitis/encephalitis, and cardio-pulmonary arrest.
Obstetrical care, such as magnesium sulfate, antibiotics, and corticosteroids, can reduce CP risk.

Genetic Causes

Genetics account for approximately 2% of CP cases.
Examples of genetic conditions linked to CP include familial spastic paraplegia, generalized athetosis, ataxia, Joubert syndrome, Marinesco-Sjogren syndrome, Gillespie syndrome, and Behr syndrome.

Maternal Disorders

Maternal disorders affecting fetal supply can lead to CP, including bleeding during pregnancy, placental infarction, pre-eclampsia/toxemia, pre-eclampsia, small size for gestational age, diabetes in the mother, and multiple pregnancies.

Infectious Causes

Meningitis and encephalitis are common infectious causes of CP.
Other medical conditions include late-onset hydrocephalus and neoplastic intracranial lesions (tumors).

Types of Cerebral Palsy

CP is categorized into five types: spastic, dyskinetic (athetoid), ataxic, hypotonic, and mixed.
These classifications relate to the characteristics of muscle tone and movement.
Muscle tone refers to the stiffness or tension of muscles during movement.

Spastic Cerebral Palsy

Characterized by stiff muscles in the affected extremities and trunk.
Movement is slow, and speed attempts result in increased stiffness, though direction tends to be accurate.
Range of motion is reduced, with contractures and/or deformities developing over time.

Dyskinetic Cerebral Palsy

Characterized by involuntary movements and variable muscle tone.
Movement is often described as slow and writhing.
Reversal and imprecise directions are common.
Resistance to movement may be seen, especially in rigidity with increased tone in agonist and antagonist muscles.

Hypotonic Cerebral Palsy

Characterized by decreased resting muscle tension.
Individuals with hypotonia have decreased ability to generate muscular force.
Excessively flexible joints.
Often a transitional stage that can eventually progress to spasticity or athetosis.

Ataxic Cerebral Palsy

Characterized by poor balance, coordination, and difficulty controlling movement timing and sequence.
Depth perception and straight-line walking are also challenging.

Acquired Cerebral Palsy

CP acquired later in childhood, before motor brain maturity, is due to brain damage after birth.
Infections or head injuries within the first two years of childhood commonly result in acquired CP.

Classification Based on Distribution

Classification is based on the affected body part(s).
Terms like monoplegia, diplegia, hemiplegia, and quadriplegia denote the number of limbs involved.

Abnormal Oral Movement Patterns and Posture

Specific oral features associated with CP include lip retraction (tight lips in a smile posture), jaw thrust/lack of jaw grading (forceful jaw extension), tonic bite (strong and sustained biting), and tongue retraction (tongue held back in mouth, limited mobility). Nasal regurgitation may also occur.

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Description

This quiz explores the various aspects of cerebral palsy (CP), a neurodevelopmental disorder that affects motor functions and can stem from various factors during pregnancy and early childhood. Learn about its definitions, causes, and classifications, as well as its implications for those affected. Perfect for students and professionals in healthcare and related fields.