Pediatric Conditions & Cerebral Palsy

Pediatric Conditions

• Torticollis (Wryneck): A condition of SCM muscle tightness, often congenital, causing head tilting and limited range of motion. Congenital is the most common type. Acquired torticollis is spasmodic. Right torticollis affects flexion, right side-bending, and left rotation. Treatment involves stretching to extension, left side-bending, and right rotation.

• Plagiocephaly: Skull flattening due to prolonged positioning. Positional plagiocephaly is common, often due to right CMT. Right-sided plagiocephaly displays right occipitoparietal flattening and left occipital bossing with anterior right ear and frontal bossing displacement.

Cerebral Palsy

• Pathology: Nonprogressive encephalopathy, mainly due to birth trauma, or hemorrhage, hypoxia, or malformations in the CNS. Classified by body region affected (monoplegia, diplegia, hemiplegia, or quadriplegia).

• Movement Disorders: Spasticity, velocity-dependent increase in tone affecting anti-gravity muscles (due to motor cortex lesions) and abnormal postures (flexion/extension). Additional types listed as dystonia, and ataxia.

Spina Bifida

• Pathology: Neural tube defect, causing spinal cord and/or vertebral malformation, often linked to maternal folate deficiency, infections, and/or substance abuse. Types include myelomeningocele (severe with open lesions) and spina bifida occulta (closed lesions with no SC involvement.)

Arthrogryposis

• Pathology: Nonprogressive condition with multiple joint contractures and muscle weakness, appearing at birth due to multiple joint limitations.

Autism Spectrum Disorder

• Pathology: Developmental disorder appearing within the first 3 years, generally affecting social communication and interaction, and sometimes play skills. Affects more males.

Down Syndrome

• Pathology: Extra copy of chromosome 21, leading to developmental delays (especially gross motor) and other potential health issues (including hypotonia, ligament laxity, possible heart defects).

Duchenne Muscular Dystrophy (DMD)

• Pathology: X-linked recessive, affecting males— Dystrophin gene mutation results in sarcolemma permeability and muscle destruction.

• Impairments: Progressive muscle weakness, often starting in the proximal limbs and progressing distally, resulting in pseudohypertrophy, cardiomyopathy (common), and contractures.

Becker Muscular Dystrophy (BMD)

• Pathology: Slower progression of DMD, with wheelchair usage typically starting in the late 20s.

Brachial Plexus Injury

• Pathology: Brachial plexus injury during childbirth, resulting in Erb (upper arm) or Klumpke (lower arm) palsy due to traction. Results in paralysis or sensory deficits in the affected arm.