Dr. Meg-angela Christi Amores

 diagnostic term used to describe a group of motor syndromes
 resulting from disorders of early brain development
 often associated with epilepsy and abnormalities of speech, vision, and intellect
 selective vulnerability of the brain's motor systems

 the most common and costly form of chronic motor disability that begins in childhood
 prevalence of 2/1000

80% of cases – antenatal factors causing abnormal brain development

<10% - had evidence of intrapartum asphyxia

High prevalence in low birth weight infants due to intracerebral hemorrhage

 congenital anomalies external to the central nervous system

Intrauterine exposure to maternal infection (e.g., chorioamnionitis, inflammation of placental membranes, umbilical cord inflammation, foulsmelling amniotic fluid, maternal sepsis, temperature greater than 38°C during labor, and urinary tract infection)


Spastic hemiplegia
 arm is often more involved than the leg
 difficulty in hand manipulation is obvious by 1 yr old

Walking delayed until 18-24 mo
 growth arrest, particularly in the hand and thumbnail

1/3 have seizure disorder

25% have cognitive abnormalities including mental retardation

MRI : Focal cerebral infarction


Spastic diplegia
 bilateral spasticity of the legs greater than in the arms
 often noted when an affected infant begins to crawl
 tends to drag the legs behind as a rudder (commando crawl)
 scissoring posture of the lower extremities

Walking is significantly delayed

Excellent prognosis for normal cognition

Minimal seizures

MRI: periventricular leukomalacia


Spastic quadriplegia

Most severe form
 marked motor impairment of all extremities
 high association with mental retardation and seizures
 speech and visual abnormalities

MRI: severe PVL and multicystic cortical encephalomalacia


Athetoid CP
 also called choreoathetoid or extrapyramidal CP
 characteristically hypotonic with poor head control and marked head lag

Feeding may be difficult, and tongue thrust and drooling

Speech is typically affected

 thorough history and physical examination should preclude a progressive disorder of the CNS

MRI scan of the brain is generally indicated to determine the location and extent of structural lesions
 tests of hearing and visual function

 team of physicians from various specialties, as well as occupational and physical therapists, speech pathologists, social workers, educators, and developmental psychologists
 no proof that physical or occupational therapy prevents development of CP
 evidence shows that therapy optimizes the development of an abnormal child

 spastic diplegia
 assistance of adaptive equipment, such as walkers, poles, and standing frames

Quadriplegia
 motorized wheelchairs, special feeding devices, modified typewriters, and customized seating arrangements


Communication skills

Bliss symbols, talking typewriters, and specially adapted computers including artificial intelligence computers

Drugs for spasticity:
 dantrolene sodium, the benzodiazepines, and baclofen