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N Cerebral Palsy
notes from lecture
Term | Definition |
---|---|
Cerebral Palsy (CP) definition | disorder of posture & mvmt seconday to damage to immature brain. (before, during, after birth) earlier, the more severe, esp 1st trimester. |
Cerebral Palsy (CP) congenital | before, during birth |
Cerebral Palsy (CP) acquired | to 3 yrs |
Cerebral Palsy (CP) spastic | damage to motor cortex &/or pathways, variety of distributions, trunk tone varies (can be low), conforms poorly to surface/position, tone changes w/position, afraid to move, takes a lot of energy to move, poor balance & post adjust |
Cerebral Palsy (CP) hypotonia | precursor to other CP types in infant (can start hypotonic baby and end up spastic), total body, jt hypermob/sublux possible, no tone changes w/posture, frog-leg, UE ER & abd, poor head control, floppy head, perched on hyper ext neck, ring sitting |
Cerebral Palsy (CP)athetoid: basal ganglia damage | mm tone fluctuates thru out body, tone changes w/position, involuntary mvmt btw one extreme of ROM to another, writhing pattern, poor balance, can't stabilize mid ranges, poor nutrition, hi energy outpt, poor speech, amb hard & wide, walker or loftstrand |
Cerebral Palsy (CP) ataxic | cerebellar damage, controls balance & coordination, low tone trunk, dysmetric (don't have good timing or control of timing), intention tremor, classic ataxic gt |
Cerebral Palsy (CP)rigid | decorticate/decerebrate |
Cerebral Palsy (CP)spastic distribution hemiplegia | most common, UE involvement > LE usually, intraventricular hemorrhage or hypoxia, can usually walk, w/UE strong hand helps wk hand |
Cerebral Palsy (CP)spastic distribution diplegia | LE's > UE's, low tone trunk, PVL (periventricular leukomalacia) brain damage-maybe injury of lack of O2 or blood flow, prematurity, crouched, gt-no dissociation |
Cerebral Palsy (CP)spastic distribution quadriplegia | UE's > LE's, mvmt dominated by flex or ext tone, UE/LE position dominated by flex or ext ton, UE/LE position dominated by position of head & trunk, low tone trunk, trouble w/head control, W sit, bunny hop instead of crawl, high guard |
Cerebral Palsy (CP)GMFCS (gross motor function classification system)1st | decrease speed balance & coordination |
Cerebral Palsy (CP)GMFCS (gross motor function classification system)2nd | limited jumping & running on uneven surfaces |
Cerebral Palsy (CP)GMFCS (gross motor function classification system)3rd | AD or WC |
Cerebral Palsy (CP)GMFCS (gross motor function classification system)4th | mostly WC |
Cerebral Palsy (CP)GMFCS (gross motor function classification system)5th | limited in all motor functions w/no Ind mob |
Cerebral Palsy (CP)some associated probs | mental or physical dev delay, persistent dev reflexes, seizures, sensory deficits (hypersensitivity, poor integration, deprivation)-spastic hem, ataxic, athetoid have normal/abv mental capacity. spastic quad, rigid have below normal. athetoid/hearing |
Cerebral Palsy (CP)associate probs cont | speech deficits, chewing, swallowing, gag reflex prob, may not be able to control behavior, contractures, hip probs, scoliosis, kyphosis, club ft, tibial torsion, mm atrophy, dental issues |
Cerebral Palsy (CP) medical management | baclofen-pump implanted in pt, wont do until @ least 3 yo & takes 6 mo to kick in, valuim, botox, dorsal rhizotomy (intense PT 1 yr post op) |
Cerebral Palsy (CP) orthopedic | tendon release (tenotomy), tendon lengthening (z plasty), tendon transfer, arthrodesis, hip sx, sx to correct spinal defromity, serial casting |