Cerebral Palsy Deraya 2024 PDF

 Cerebral Palsy Basma Abdelmoez Professor Of Pediatrics, Head of Pediatric Department Minia University What is Cerebral Palsy?  Causes and Risk Factors (Different causes lead to brain damage that leads to CP can happen before birth, during birth, within a month aft...

 Cerebral Palsy Basma Abdelmoez Professor Of Pediatrics, Head of Pediatric Department Minia University What is Cerebral Palsy?  Causes and Risk Factors (Different causes lead to brain damage that leads to CP can happen before birth, during birth, within a month after birth, or during the first years of a child’s life) 1-Premature birth where brain isn’t fully developed. 2-Exposure of mother to certain viruses during pregnancy. 3-Improper development of a child’s brain durin pregnancy. 4-Lack of oxygen supply to brain during delivery. 5-A disruption of blood supply to the developing brain (fetal stroke). 6-Infant infections 7- head injury to an infant WHAT ARE THE SYMPTOMS AND SIGNS OF CP ? Symptoms of cerebral palsy involve any combination of the following: -lack of muscle control, -Diminished coordination, -Trouble speaking clearly, -Cognitive deficits, -30% with seizures and -Problems with chewing and swallowing. The symptoms of CP vary from person to person severe CP might need to use special equipment to be able to walk, or might not be able to walk at all and might need lifelong care. * Many also have related conditions such as intellectual disability; seizures; problems with vision, hearing, or speech; changes in the spine (such as scoliosis); or joint problems (such as contractures) Types of Cerebral Palsy There are five main types of CP: I-Spastic Cerebral Palsy II- Dyskinetic Cerebral Palsy (also includes athetoid, choreoathetoid, and dystonic cerebral palsies) III- Ataxic Cerebral Palsy. VI-Atonic CP V-Mixed Cerebral Palsy I- Spastic CP (most common) affects about 80% (muscles are stiff and, described by what parts of the body are affected: A-Spastic diplegia/diparesis: muscle stiffness is mainly in the legs (scissoring), with the arms less affected. B-Spastic hemiplegia/hemiparesis, affects only one side of a person’s body; usually the arm is more affected than the leg. C-Spastic Quadriplegia/quadriparesis― the most severe form of spastic CP and affects all four limbs, the trunk, and the face.  II- Dyskinetic Cerebral Palsy (also includes athetoid, choreoathetoid, and dystonic cerebral palsies) Problems controlling the movement of the hands, arms, feet, and legs, making it difficult to sit and walk. -Face and tongue are affected and the person has a hard time sucking, swallowing, and talking  III-Ataxic Cerebral Palsy Ataxic CP have problems with balance and coordination. -They might be unsteady when they walk , a hard time with quick movements or movements that need a lot of control, like writing or reach for something. IV- Hypotonic CP (in which muscles are “floppy”)  V-Mixed Cerebral Palsy The most common type of mixed CP is spastic-dyskinetic CP. Diagnosis of Cerebral Palsy  Early Signs The main sign that a child might have CP is a delay reaching motor or movement milestones (such as rolling over, sitting, standing, or walking)  1- Brain scans such as MRI which helps to get the images of brain. 2-EEG to determine if there is epilepsy. 3- Some additional tests to detect other impairments and developmental delays. 4- Investigations to know the cause Does cerebral palsy get worse with age?  Cerebral palsy is a non-progressive disorder. Still, it can cause health concerns in later life, including post-impairment syndrome in which the combination of bone deformity, muscle abnormalities, and overuse injuries can lead to worsening pain, fatigue, and disability Complications 1-Spasticity and Muscle Stiffness 2-Atrophy 3-Choking 4-Aspiration Pneumonia 5-Pressure Ulcers 6-Bladder Infections 7-Constipation  Screening and Diagnosis Diagnosing CP at an early age is important to the well-being of children and their families Treatments and Intervention Services There is no cure for CP, but treatment can improve the lives. It is important to begin a treatment program as early as possible. Respiratory Conditions  What is respiratory diseases in pediatrics? There are many respiratory diseases in children. These range from genetic conditions, surgery, infections and viruses.  *The respiratory system (the nose, throat, Trachea and lungs). Respiratory disorders may be acute or chronic, congenital problems that require lifelong treatment such as asthma or cystic fibrosis or result from infection by some virus or bacteria such as bronchiolitis.  What are the symptoms of respiratory Disorders? Coughing Runny or blocked nose Shortness of breath Altered breathing pattern Wheezing Stridor (high pitched squeaking noise made when the baby breaths)  Respiratory disorders IN Infants Infants are more susceptible to contracting respiratory infections as their lungs and airways are smaller *Respiratory conditions in infants may include: -Croup (inflammation of the vocal cords) -Whooping cough -Asthma -Bronchiolitis -Cystic fibrosis What are respiratory disorders in children? -Asthma -Cystic Fibrosis -Hyperventilation Syndrome -Neurological and development problems -Chest infections and -Pneumonia -Tetraplegia  Asthma A chronic inflammatory disorder that results in obstruction of airways. An irritant such as dust, allergens,… can trigger an inflammation response *Factors believed to influence the development of Asthma include; -Genetic factors -Auto immune respons -Environmental exposure (obesity,dust, cold air),allergies and smokes.  Bronchiectasis IT is the abnormal, permanent dilation of the airways of the lungs , bronchi, alveoli where the exchange of oxygen and carbon dioxide take place. Bronchiectasis only affects the elasticity of the smooth muscle and cellular wall of the larger upper airways WITH greater difficulty effectively clearing secretions from the lungs, which in turn leads to greater frequency of infection  -Wheezing sounds when breathing. -Coughing up excessive sputum. -Weight loss and visible wasting with long term conditions. -Nasal polyps. Less common symptoms include; *Swelling of the fingers( clubbing). *Coughing up small amounts of blood. *Cyanosis, *Pallor of the skin.  What is Cystic Fibrosis? Cystic fibrosis is a genetic defect affects all mucosal epithelial cell walls around the body. This negatively impacts the normal FUNCTION of : The sinus’, Intestines, Pancreas and Liver. What are the symptoms of Cystic Fibrosis? -Distended abdomen -Excessively dry skin -Inflammation of the nasal cavity, including polyps. -Reoccurring dry coughs -Respiratory wheezing with audible crackles. -Overuse of accessory breathing muscles hyper inflated chest. -Elevated rate of respiration (breaths per minute) -Sharp retractions of the abdominal walls with each bre -Clubbing. -Cyanosis  What is Emphysema? Emphysema is a lung condition that specifically affects the structural integrity of the respiratory tracts cell walls. It is one of the key conditions that confirm the presence of Chronic Obstructive Respiratory Disorder (COPD).  What is Respiratory Failure? Respiratory failure occurs when the exchange of gases within the lungs ceases to function effectively. -This can occur gradually over a period of days or weeks (Chronic), or rapidly over the space of minutes(Acute) depending on the underlying cause What are the symptoms of Respiratory Failure? *Difficulty breathing, with shortness of breath. *Restlessness. *Cyanosis of the he skin, particularly lips and fingernail beds. *Decreased or irregular heartbeat. *Anxiety. *Confusion or difficulty concentrating. *Excessive tiredness. *Seizures can result from extreme lack of oxygen. *Coma may occur at the end stage of respiratory failure. I-Hypoxemic respiratory failure (type I) -It is characterized by an arterial oxygen tension (PaO2) lower than 60 mm Hg with a normal or low arterial carbon dioxide tension (PaCO2). -This is the most common form of respiratory failure, and it can be associated with virtually all acute diseases of the lung, which generally involve fluid filling or collapse of alveolar units. * Some examples of type I respiratory failure are cardiogenic or noncardiogenic pulmonary edema, pneumonia, and pulmonary hemorrhage. Hypercapnic respiratory failure (type II) It is characterized by a PaCO2 higher than 50 mm Hg. Hypoxemia is common in patients with hypercapnic respiratory failure who are breathing room air. *Common etiologies include drug overdose, neuromuscular disease, chest wall abnormalities, and severe airway disorders(eg,asthma and chronic obstructive pulmonary disease [COPD]).  What is the role of chest physiotherapy in children?