Peds Lec 4: Cerebral Palsy

What is cerebral palsy?

neurologic condition causing motor and sensory disorders

what causes cerebral palsy?

caused by a permanent, chronic, non-progressive defect, injury or lesion in single or multiple locations int he immature brain

T/F: Someone with CP will have the same impairments throughout their lifetime

F: impairments will change throughout the lifespan

cerebral palsy etiology: 70-80% have onset _____

prenatal

teratogens

environmental hazards

is CP a chromosomal abnormality?

no, but multiple issues chunked together may impact CP

pre-eclampsia

high blood pressure during pregnancy

CP etiology- less than 10% occurs from ____ and ____

labor, delivery

meconium aspiration

ingesting first intestinal shed

CP etiology - 5-10% of causes occur _____

postnatal

monoplegia

one limb affected (rare with CP)

Diplegia

LE’s mainly affected, UEs less involved

Hemiplegia

one side of the body affected, UE and LE

tetraplegia

aka quadriplegia: all 4 extremities affected and the trunk

spastic CP is caused by injuryy to what parts of the brain?

motor cortex and white matter

dyskinetic CP is caused by injury to what aspect of the brain?

basal ganglia

ataxic CP is caused by damage to what part of the brain?

cerebellum

CP hypotonicity is caused by injury to what area of the brain?

global

what is athetoid?

slow, continuous involuntary rhything movements

What is the gold standard classification system for CP?

Gross Motor Function Classification System

The GMFCS categorizes CP by defining their ability in what skill?

mobility

the basic GMFCS covers what ages?

6-12

Describe GMFCS Level 1

• Can walk indoors and outdoors, climb stairs without using their hands for support

• Can run and Jump

• Has decreased speed, balance, and coordination

Describe GMFCS Level 2

• can walk indoors and outdoors, can climb stairs using a rail

• experiences difficulty with uneven surfaces, inclines, or while in crowds

• can minimally run or jump

Describe GMFCS Level 3

• walk with assistive mobility devices indoors and outdoors on level surfaces

• may be able to climb stairs using a railing

  • may propel a manual wheelchair, may require assistance for long distances or uneven surfaces

Describe GMFCS Level 4

• walking ability is severely limited, even with assistive devices

• uses a wheelchair most of the time and may propel their own power wheelchair

  • may participate in standing transfers

Describe GMFCS Level 5

• has physical impairments that restrict voluntary movement control and the ability to maintain head and neck position against gravity

• experiences impairment in all areas of motor function

• can’t sit or stand independently, even with adaptive equipment

• can’t independently walk, though may be able to use powered mobility devices

the goal is not to “normalize“ function, it is to “_______“ function

maximize

CP with diplegia and hemiplegia have a _____ prognosis

good

what is the prognosis for an individual with tetraplegia (quadriplegia)?

individual will have increased medical complications, or risks such as respiratory and other infections