Understanding Cerebral Palsy

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Questions and Answers

What percentage of cerebral palsy cases is attributed to genetic causes?

2% (correct)

50%

10%

25%

Which of the following maternal conditions is NOT associated with an increased incidence of cerebral palsy?

Bleeding during pregnancy

Multiple pregnancies

Diabetes in the mother

Normal weight gain (correct)

Which type of cerebral palsy is characterized by a lack of muscle tone?

Dyskinetic (athetoid)

Spastic

Hypotonic (correct)

Ataxic

What is a common symptom of ataxic cerebral palsy?

Lack of coordination Signup and view all the answers

What defines acquired cerebral palsy?

It occurs due to brain damage occurring before anatomical or physiological brain maturation is complete. Signup and view all the answers

Which of the following statements accurately describes cerebral palsy?

Cerebral palsy encompasses a variety of non-progressive syndromes due to early brain lesions. Signup and view all the answers

What distinguishes congenital cerebral palsy from acquired cerebral palsy?

Congenital CP occurs from factors at the time of labor and delivery. Signup and view all the answers

According to incidence data, what is the reported range of cerebral palsy cases in developed countries?

2 to 2.5 per 1,000 live births. Signup and view all the answers

What is one of the common accompanying issues for individuals with cerebral palsy?

Communication disturbances. Signup and view all the answers

What has been noted regarding the prevalence of different types of cerebral palsy over time?

Spastic diplegia has become more prevalent while athetoid type has decreased. Signup and view all the answers

What characterizes individuals with acquired cerebral palsy in comparison to those with congenital cerebral palsy?

They tend to have a more heterogeneous group regarding etiology. Signup and view all the answers

Which of the following is not a typical characteristic of spastic cerebral palsy?

Unpredictable movement direction. Signup and view all the answers

When diagnosing individuals after brain damage during the first two years, which disorder might they be diagnosed with?

Acquired cerebral palsy. Signup and view all the answers

What is a common long-term consequence for individuals with spastic cerebral palsy?

Development of contractures and deformities. Signup and view all the answers

What term is often avoided when describing individuals with brain damage occurring after the natal period?

Cerebral palsy. Signup and view all the answers

In the context of spastic cerebral palsy, what typically happens when an individual attempts to increase movement speed?

Their stiffness increases. Signup and view all the answers

Which aspect is essential when describing the condition of individuals diagnosed with cerebral palsy?

The specific neuromotor dysfunction and muscle tone. Signup and view all the answers

Which of the following conditions could potentially result in symptoms similar to those observed in cerebral palsy?

Viral infections during pregnancy. Signup and view all the answers

Which statement accurately reflects how spastic cerebral palsy affects movement?

Movement is characterized by stiffness and slowness. Signup and view all the answers

What term might be used to describe the specific muscle tone present in individuals with cerebral palsy?

Hypertonia. Signup and view all the answers

Study Notes

Cerebral Palsy

Cerebral palsy (CP) is a neurodevelopmental condition affecting movement and posture, beginning in early childhood and lasting throughout life.
CP was originally reported by Little in 1861, initially called "cerebral paresis".
According to the American Academy for cerebral palsy and developmental medicine (1977), CP refers to a non-progressive central nervous system (CNS) deficit.
Lesions in the brain, either single or multiple, lead to motor and sometimes sensory abnormalities.
CP can be caused by factors present during pregnancy (in-utero), labor and delivery (congenital), or various factors during early development (acquired).
CP involves a group of permanent disorders that occur in early development.
CP is attributed to non-progressive disturbances in the developing fetal or infant brain, limiting activity.

Definition of CP

Bax (1964) defined CP as a movement and posture disorder stemming from a defect or lesion in the immature brain.
Mutch and colleagues (1992) redefined CP as an umbrella term for non-progressive (but often changing) motor impairment syndromes stemming from brain lesions/anomalies in the early stages of development.

Incidence and Prevalence

Approximately 550,000-764,000 Americans have a CP diagnosis.
Approximately 9,750 new cases occur annually.
The incidence of CP in developed countries is estimated at 2-2.5 per 1,000 live births.
Spastic diplegia has increased in prevalence among CP cases.
Incidence is generally slightly higher in premature neonates, largely due to anoxia).
CP is somewhat more prevalent in males

Risk Factors

70-80% of CP cases are attributed to antenatal risk factors (prematurity, low birth weight, intrauterine infections, multiple gestation, pregnancy complications)
10% of CP cases are attributed to perinatal risk factors (birth asphyxia, complicated labor and delivery)
Postnatal risk factors include non-accidental injuries, head trauma, meningitis, encephalitis, cardio-pulmonary arrest
Obstetrical care factors can reduce risks such as magnesium sulfate, antibiotics, and corticosteroids

Genetic Causes

Genetic causes of CP account for only about 2% of diagnosed cases.
Examples of rare genetic disorders linked to CP include Joubert syndrome, Marinesco-Sjogren syndrome, Gillespie syndrome, and Behr syndrome, all characterized by ataxia.

Maternal Disorders

Maternal disorders that reduce fetal blood supply, such as bleeding during pregnancy, placental infarction, toxemia/pre-eclampsia, small size for gestational age due to the mother's diabetes, and multiple pregnancies, can increase the risk of CP.
Infectious conditions like meningitis and encephalitis contribute to CP.

Other Medical Conditions

Late-onset hydrocephalus can cause CP, as well as neoplastic intracranial lesions (brain tumors) and intracranial hemorrhage from an arteriovenous malformation.

Types of Cerebral Palsy

CP can be classified into five common types (spastic, dyskinetic, ataxic, hypotonic, and mixed) based on muscle tone and movement characteristics.

Spastic Cerebral Palsy

Characterized by muscle stiffness (throughout involved extremities and trunk).
Movements are slow because of stiffness.
Movement directions are often accurate.
Range of movement tends to be reduced.
Contractures and deformities can develop.

Dyskinetic Cerebral Palsy

Characterized by involuntary movements (slow, writhing).
Movement reversal is common.
Movement direction is often imprecise.

Hypotonic Cerebral Palsy

Characterized by diminished muscle tension.
Reduced voluntary muscle strength.
Excessive joint flexibility and postural instability are common.

Ataxic Cerebral Palsy

Characterized by poor balance, coordination, and imprecise timing of movements.
Impaired postural control and disordered balance are common.

Acquired Cerebral Palsy

Individuals who experience brain damage after birth, before full neurological development, are classified as having acquired CP.
This includes those who suffered brain damage due to infections or traumatic brain injuries in early childhood.
This group of CP individuals is more varied and complex in etiology, distribution of neuromotor dysfunction, and associated conditions.
Acquired CP is not often used to describe this group.

Abnormal Oral Movements & Posture

Lip retraction: Increased muscle tone pulling lips back, tight cheeks, visible gum ridge, feeding difficulty.
Jaw thrust & jaw grading lack: Forceful downward jaw extension, arrhythmic jaw movement, or absence of jaw movement. A lack of jaw grading or proper jaw control.
Tonic Bite: Strong, rapid bite to stimuli, difficulty releasing the bite.
Tongue retraction: Tight tongue held back in the oral cavity, limited movement, trouble removing utensils, and food in the mouth.
Tongue thrust: Extrusion reflex, tongue might appear thick, difficulty transferring food to mouth.
Nasal regurgitation: Backward flow of liquid/semi-digested food through nasal passages, reflecting abnormal velopharyngeal function.

Classification based on topographical distribution

Paresis and plegia: Broad term for muscular weakness/paralysis.
Monoplegia: Affects one limb.
Diplegia/paresis: Affects symmetrical limbs.
Hemiplegia: Affects one side of the body.
Paraplegia: Affects the lower limbs.
Quadriplegia: Affects all four limbs.
Pentaplegia: Affects all five limbs (extremely rare).

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Description

This quiz explores the fundamentals of cerebral palsy (CP), a neurodevelopmental condition that affects movement and posture. It addresses its origins, definitions, causes, and the impact on individuals. Test your knowledge about CP and its implications for those affected.