CEREBRAL PALSY
Submitted To :AMANJOT KAUR MAM
(ASSOCIATE
PROFESSOR)
Submitted By :PRIYA ABROL
BSc (N) 3rd year
INTRODUCTION
● CEREBRAL :- It refers to cerebrum
which is affected area of brain.
● PALSY :- It refers to disorder of
movement.
DEFINITION
Cerebral Palsy is a chronic
non-progressive motor dysfunction
caused by damage to the motor areas of
brain.
—Blosser and Burns, 2004
INCIDENCE
● Cerebral palsy (CP) is the most common motor
disability in childhood.
● Recent population-based studies from around the
world report prevalence estimates of CP ranging from
1 to nearly 4 per 1,000 live births or per 1,000
children. The prevalence of CP is higher for children
born preterm or at low birthweight.
ETIOLOGICAL FACTORS
1. PRENATAL FACTORS
2. BIRTH FACTORS
● Genetic or
chromosomal
anomalies
● Brain anomaly
● Exposure to
teratogens
● Intrauterine infections
● Preeclampsia
● Complicated labor and
delivery
● Birth injury
● Asphyxia secondary to
cord prolapse or
strangulation
CONT….
3. PERINATAL FACTOR
4. CHILDHOOD FACTOR
● Central nervous
system infections
● Kernicterus
● Head trauma
● Meningitis
● Toxic ingestion like lead
poisoning
● Shaken baby syndrome
● Foreign body aspirations
Pathophysiology
Damage to the motor control centers of the developing brain which can occur
during pregnancy or after childbirth birth.
|
Activity limitations
|
Disturbances of sensation, depth perception and other sight based problems
And communications imapirement , Cognitive
impairement
|
Cerebral palsy
CLASSIFICATION
1.
2.
3.
4.
Spastic cerebral palsy
Ataxic cerebral palsy
Athetoid/Dyskinetic
Mixed type
1. Spastic
Cerebral palsy
● This is the most common
type of cerebral palsy
occuring in 80% of all
cases.
● These patients have
HYPERTONIA and
Neuromuscular mobility
impairment , due to upper
motor neuron lesions in
the brain as well as
corticospinal tract or
motor cortex.
Types of Spastic CP
1.
2.
3.
4.
5.
Spastic hemiplegia
Spastic diplegia
Spastic monoplegia
Spastic triplegia
Spastic quadriplegia
A.Spastic Hemiplegia
In this type one side of the
body is affected.
● Injury to left side of brain
will cause right side body
deficit and vice versa.
● Equinus.
B. Spastic Diplegia
In this type lower
extremities are affected
with little or upper body
spasticity.
● Patients have
scissors gait.
● Myopia or strabismus
C. Spastic Monoplegia
One limb is
affected
D. Spastic Triplegia
Three limbs are
affected
E. Spastic Quadriplegia
● All four limbs are affected.
● These patients are unable
to walk.
2. Ataxic
cerebral palsy
● Caused by damage to
cerebellum.
● Occurs in about 10%
cases.
● Hypotonia and
tremors may be
present.
● Wide based gait.
● Depth perception
usually affected.
Ataxic CP
3.
Athetoid/Dys
kinetic
Cerebral
palsy
● It involves mixed
muscle tone both
HYPERTONIA and
HYPOTONIA are
present along with
constant involuntary
writing motions.
● Difficulty in holding
objects.
● 10% patients may have
this.
Athetoid/Dyskinetic CP
4. Mixed type
● Symptoms of more
than one form exist in
these patients.
● Children diagnosed
with mixed type
cerebral palsy have
sustained damage to
the motor control
centers in several
parts of the brain.
CLINICAL FEATURES
● Abnormal muscle tone, reflexes or motor
development and coordinations
● Joints and bone deformities
● Scissoring and toe walking
● Irregular posture
● Pain (Tight or shortened muscle)
CLASSICAL SYMPTOMS
●
●
●
●
●
●
Spasticity
Spasms
Unsteady gait
Problems with balance
Decreased muscle mass
Delayed development
OTHER SYMPTOMS
●
●
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●
●
●
●
Seizures
Apraxia
Dysarthia
Communications disorders
Eating problems
Sensory impairments
Mental retardation
CONT…
●
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Learning disabilities
Urinary incontinence
Fecal incontinence
Behavioural disorders
Speech and language disorders
Hearing impairement
DIAGNOSTIC EVALUATIONS
● Patient's history
● Physical examination
● Neuroimaging testing
(CT SCAN , MRI , EEG)
● Blood culture
MANAGEMENT
● Treatment for cerebral palsy is a lifelong
multi-dimensional process focused on the
maintenance of associated conditions.
● Symptomatic treatment will he there.
SURGERY AND ORTHOSIS
Surgery usually involves one or combination
of following:● Selective dorsal rhizotomy is a neurosurgical
procedure to relieve muscle tightness and allow
child to move more easily.
CONT….
RHIZOTOMY
Rhizo meaning root/nerves
Tomy meaning cutting off
(Cutting of nerves of the limbs most affected by
spasms.)
CONT…
● Straightening of abnormal twists of the leg
bones i.e. femur and tibia.
● Orthotic devices such as ankle-foot orthosis
are often prescribed to minimize gait
irregularities and increase speed.
CONT…
DRUGS -Baclofen (Lioresal) is first-line oral therapy
for the treatment of spasticity in children with cerebral palsy.
- Botulinum Toxin A injections IM
(To reduce muscle hypertonous)
PHYSICAL
THERAPY
● Physiotherapy
programs are
designed to
improve gait
and voluntary
movements.
OCCUPATIONAL
THERAPY
● It enables children and
adults with cerebral
palsy to participate in
activities of daily living
that are meaningful to
them.
● It addresses sensory,
Cognitive or motor
impairments.
SPEECH
THERAPY
● It helps to control the
muscles of the month
and jaw, and helps to
improve
communication.
BIOFEEDBACK
It is an alternative
therapy in which people
with cerebral palsy learn
to control their affected
muscles.
MASSAGE
THERAPY
It is designed to help
relax tense muscles,
strengthen muscles, and
keep joints flexible.
PROGNOSIS
● Cerebral palsy is not a progressive disorder
means the brain damage does not worsen
but the symptoms can become more severe
over time.
● Person with this disorder may improve
somewhat during childhood if he/she
recieves care.
THANK YOU!!!!