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What is the definition of Cerebral Palsy?
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When does the brain insult of CP usually occur?
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Peds 3rd
CP, Seizure Disorders, Positioning
| Question | Answer |
|---|---|
| What is the definition of Cerebral Palsy? | A non-progressive insult injury to the developing brain that affects typical development |
| When does the brain insult of CP usually occur? | before, at or shortly after birth |
| What problems associated with CP change over time? | muscular problems |
| What disorders typically occur with CP? | disorders of movement, posture & other neurological components |
| What are some causes of CP? | Congenital - prenatal infections in mom (german measles), toxins; Perinatal - low birth wt, premature birth, multiples, birth trauma (cord wrap); Post natal: acquired 1st few wks of birth, trauma, hypoxia, infection, metabolic |
| What areas are evaluated for a CP diagnosis? | (by team): Primitive reflexes, asymmetry, clonus & variable tone, involuntary movement, discrepancy in cognitive development |
| What are 5 concerns often related to CP | Cognitive delay (50%); Seizure d/o (50%); Speech problems (30%); Visual/perceptual (40%); Hearing (25%); Sensory processing - due to primary & secondary |
| Diplegia | All four limbs are impacted but LE are more impaired than UE |
| Paraplegia | No limitations in UE - just LE |
| Where in the brain do lesions occur to cause spasticity & flaccidity? | Motor cortex |
| Where in the brain do lesions occur to cause athetoid movements? | Basal ganglia |
| Where in the brain do lesions occur to cause ataxic (little drunk) movements | cerebellum |
| Treatments for high tone/spasticity | Braces, stretching, serial casting, surgery to cut contracted muscles, |
| Meds for high tone | baclofen (often via pump) |
| Surgery for spasticity | selective posterior rhizotomy - cut dorsal nerve roots in lumbar area |
| OT tx for spasticity | slow movements when positioning, handling, ROM w/emo support, functional hand skills, adaptive equip, Rood (slow rocking), ball, warmth, |
| Goals of tx with athetoid pt | stability - since movement not a problem, prevent deformity, facilitation of mobility & speech, |
| Characteristics of ataxic CP pts | staggering, poor righting, incoordination, tremors, poor fine motor, may be afraid of movement b/c falls |
| Which kind of CP often changes to another classification with age? | Flaccid/hypotonic |
| Appropriate TX for hypotonic CP | bouncing, positioning, increase tone, increase movement, ADLs, |
| Precautions for hypotonic CP | choking |
| Definition of a Seizure | A sudden, temporary, involuntary change of consciousness, behavior, motor activity, sensation or automatic functioning |
| What are the two main types of seizures? | Generalized seizures (40%) that involve entire cerebral cortex; Partial seizures (60%) that are usually localized or on one side of the brain |
| What are the four generalized seizure types? | 1) tonic-clonic (Grand mal); 2) Myoclinic; 3) Absence (petit mal); Atonic (akinetic) |
| What is a mixed seizure disorder? | when a person experiences both generalized and partial seizures |
| What are the two kinds of partial seizures? | simple & complex |
| What is a complex partial seizure? | Usually originates in temporal lobe, may show automatic reactions (lip smacking, chewing, buttoning/unbuttoning clothes), similar to absence seizures, may be confused or report sensory experiences |
| What is a simple partial seizure? | Usually involve motor cortex, clonic reactions in face or extremities; sensory hallucinations, nighttime awakenings w/twitching to face & hands |
| What is a myoclonic seizure? | Mild form of generalized seizure in which a single muscle or muscle group has a series of contractions |
| What is an akinetic seizure? | A mild generalized seizure in which patient goes limp - |
| What is it called when a child has an extended seizure of 30 min or longer? | status epilepticus - requires medical management to maintain body functions and hydration |
| What is an absence seizure? | A type of generalized seizure in which there is a momentary loss of awareness & motor activity except for blinking /eye-rolling, No aura or postictal period, usually in children up to age 10. May be mistaken for daydreaming |
| What is a tonic-clonic seizure? | A type of generalized seizure (grand mal). Aura & postictal period of 1-2 hrs., brain storm of neuronal firing followed by loss of consciousness, rigidity (tonic) & rhythmic clonic contractions of extremities, incontinence common. |
| If a child is having a seizure should you restrict them & lay them on their back? | don't restrict but move items around them. lay on SIDE, stay until over, time seizure, remain calm |
| Roll of OT with seizures | Educate child & parents, help child be advocate, use head gear, restrict spinning, avoid high climbing, oral hygiene for medications, go with a buddy, reinforce development |
| Positioning / techniques for child with low tone | Stomach positioning, carry in forward facing position or football hold to get them to hold head up, bounce in seated posture, fast movements, swinging, bolster seating, quick depression on shoulders |
| Positioning/techniques for child with high tone | hands to midline, use body to help control child's body position, side lying, rocking, leave in side position as prep for feeding, rocking on ball, slight forward head for feeding, hands on lap tray,gently shake arm before dressing |
Created by:
sherryama
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