Cerebral palsy

Cerebral palsy

definition
1. abnormality of movement & posture
  1. -> activity limitation
  2. caused by non-progressive disturbances that occurred in the fetal/infant brain
    1. i.e. static underlying cause
2. brain injuries occurring up to age 2 yrs
  Anmerkungen:
  - after age 2 yrs, use 'acquired brain injury' as term to describe diagnosis
motor disorder w/
1. disturbance of
  1. cognition
  2. perception
  3. communication
  4. behaviour
2. seizure disorder
3. secondary MSK probs
clinical manifestations emerge over time
1. though lesion non-progressve
  1. motor disorder may evolve
    1. so may seem like deterioration
epidemiology
1. commonest cause of motor impairment in kids
  1. affects 2 per 1000 live births
diagnosis formulation includes
1. distribution of motor disorder
2. movement type
3. cause
4. any assoc impairment
causes
1. antenatal
  1. 80% of CP
  2. vascular occlusion
  3. cortical migration
  4. structural maldevelopment of brain
  5. genetic syndromes
  6. congenital infection
2. perinatal
  1. hypoxic-ischaemic injury
    1. during delivery
      1. 10% of CP
3. postnatal
  1. 10% of CP
  2. meningitis/encephalitis/encephalopathy
  3. head trauma
    1. accidental or not
  4. symptomatic hypoglycaemia
  5. hydrocephalus
  6. hyperbilirubinaemia
4. in preterm infants
  1. periventricular leucomalacia
    1. secondary to ischaemia
  2. severe intraventricular haemorrhage
5. MRI scan can ID
  1. but not needed to diag
Mx
1. give parents details of diag asap
2. prognosis difficult during infancy
  1. till severity & pattern of evolving signs and developmental progress becomes clearer w/ age
3. MDT approach

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