Podcast
Questions and Answers
Which of the following neurological associations is commonly linked with cerebral palsy?
Which of the following neurological associations is commonly linked with cerebral palsy?
What is the primary cause of cerebral palsy during prenatal development?
What is the primary cause of cerebral palsy during prenatal development?
Which type of cerebral palsy is characterized by spasticity primarily in the lower limbs?
Which type of cerebral palsy is characterized by spasticity primarily in the lower limbs?
What is a common clinical sign associated with spastic cerebral palsy?
What is a common clinical sign associated with spastic cerebral palsy?
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Which of the following classifications does not pertain to the topographic distribution of motor defects in cerebral palsy?
Which of the following classifications does not pertain to the topographic distribution of motor defects in cerebral palsy?
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What is the most common type of cerebral palsy associated with decreased spontaneous movements on one side and delayed walking?
What is the most common type of cerebral palsy associated with decreased spontaneous movements on one side and delayed walking?
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Which type of cerebral palsy is marked by severe motor impairment in all extremities and is highly associated with mental retardation and seizures?
Which type of cerebral palsy is marked by severe motor impairment in all extremities and is highly associated with mental retardation and seizures?
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What are common clinical features of ataxic cerebral palsy?
What are common clinical features of ataxic cerebral palsy?
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Which diagnostic tool is used to rule out brain tumors and degenerative brain disease?
Which diagnostic tool is used to rule out brain tumors and degenerative brain disease?
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In which type of cerebral palsy do patients initially present with profound hypotonia, described as 'floppy infants'?
In which type of cerebral palsy do patients initially present with profound hypotonia, described as 'floppy infants'?
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Study Notes
Cerebral Palsy (Little's Disease)
- Definition: A group of permanent movement and posture disorders causing activity limitations, resulting from non-progressive lesions in the developing fetal or infant brain. Primarily affecting motor centers (cerebral cortex, cerebellum, and basal ganglia). Often accompanied by neurological issues like mental retardation, epilepsy, hearing/vision impairments, and emotional/behavioral disturbances.
Causes
- Prenatal (80%): Factors including antenatal infections, congenital malformations, and fetal asphyxia.
- Natal (10%): Birth asphyxia and birth trauma.
- Postnatal (10%): Unknown factors.
Topographic Classification (Distribution of Motor Defect)
- Monoplegia: One limb affected.
- Hemiplegia: Upper and lower limbs on one side affected.
- Diplegia: All limbs affected, lower limbs more affected than upper limbs.
- Paraplegia: Only both lower limbs affected.
- Quadriplegia: All four limbs affected.
Clinical Types
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Spastic Cerebral Palsy: The most common type, characterized by pyramidal tract lesion (UMNL) signs like hypertonia, hyperreflexia, positive Babinski sign, and possible clonus. Often includes persistent primitive reflexes and pseudobulbar palsy. Often due to pre- or perinatal stroke.
- Spastic diplegia: Primarily affects legs (more than arms).
- Spastic hemiplegia: Due to prenatal or neonatal stroke, shows decreased movements on the affected side, and delayed walking.
- Spastic quadriplegia: Most severe form, affecting all extremities, often associated with mental retardation and seizures.
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Ataxic Cerebral Palsy: Characterized by hypotonia and hyporeflexia, cerebellar ataxia (incoordination of voluntary movements), nystagmus, and intention tremors.
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Extrapyramidal (Dyskinetic/Athetoid) Cerebral Palsy: Commonest causes include asphyxia and kernicterus. Characterized by hypotonia, then subsequently rigidity and abnormal movements (choreic, athetoid).
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Atonic Cerebral Palsy: Deep hypotonia, meaning a floppy infant, contrasting with spasticity.
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Mixed Cerebral Palsy: Combination of different types of cerebral palsy.
Diagnosis
- Clinical evaluation through thorough history and physical examination. Ruling out progressive CNS disorders, metabolic disorders, spinal cord tumors, and muscular dystrophies.
- Investigations such as CT and MRI scans to identify the cause.
Associated Conditions
- Brain malformations, spinal cord lesions, and congenital infections are possible causes. TORCH screen, genetic evaluation, metabolic screen, and assessments for hearing, visual function, and seizures are used to rule out complications.
- Other conditions that can mimic cerebral palsy may include spinal cord tumors, channelopathies, Sandifer syndrome, MECP2 duplication, congenital dopa-responsive disorders, genetic spastic paraplegia, specific metabolic disturbances (e.g. GLUT1 deficiency), and ataxia telangiectasia.
Treatment
- Multidisciplinary approach involving specialists like occupational therapists, physical therapists, speech pathologists, social workers, educators, and developmental psychologists.
- Medications include anti-spastic drugs aiming to reduce spasticity.
- Possible surgical interventions like adductor tenotomy or psoas transfer and rhizotomy for marked lower extremity spasticity. Botox injections for drooling and spastic muscles, and Levodopa for dystonia or rigidity.
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Description
Test your knowledge on cerebral palsy, also known as Little's Disease, including its definitions, causes, and classifications. This quiz covers the various types of motor defects and associated clinical indicators related to this condition. Perfect for students and professionals seeking to deepen their understanding of cerebral palsy.
