CP (Cerebral Palsy) neuromuscular disorder

quadriplegia

(all limbs)

diplegia

(both legs or both arms) mild UE involvement significant impairment of fun. LE

hemiplegia

(entire right/left side)

visual problems

***acuity, movements, muscles impaired vision blindness limitations in eye movements & eye tracking squinting strabismus (lazy eye) eye muscle weakness eye incoordination

Treatments for CP (5 'categories') think about the brain, muscle tone

- Orthopedic: surgery, bracing (splinting?) - Anti-spasticity medication: oral, injectable - Neuro-surgical: brain, spinal cord, peripheral nerves - rehab: OT, PT, SLP - psychological & respite services --- tone-reducing/inhibitive casts - increase ROM

acquired CP happens before what age?

2 years old

Reflexes persistent in CP

Babinski flexor withdrawal extensor thrust ATNR STNR TLP/TLS

Bleeding in the brain, severe jaundice, fetal asphyxia, anoxia during/after birth, brain trauma, prenatal materal infection, brain infections --> these are...

Causes of CP

POSSIBLE Co-existing conditions with CP think of the 4 areas of functioning difficulty

Cognitive impairment, below avg intelligence speech & lang difficulties (receptive & expressive - central processing impairment) sensory deficits/processing issues seizures (partial epilepsy, more common in spastic type) feeding problems psychosocial challenges - hearing & visual disorders

is CP progressive or non progressive?

NON progressive, movement disorder

Causes of CP

PREMATURITY, LWB --> spastic diplegia lack of oxygen (prenatal, during, after birth) --> athetoid jaundice --> athetoid brain trauma infections bleeding in utero developmental brain abnorm

most widely used neurosurgical procedure

SPR (selective posterior rhizotomy) improves motor control, UE functioning, sitting balance

feeding problems

abnormal oral movements, tone, sensation hyper/hypo sensitive to touch around/in mouth sucking, chewing, swallowing difficult to initiate/control

ataxic (intentional tremor, affects coordination) (which part of brain affected?)

cerebellar damage

most effective motor intervention

constraint-induced intervention

Athetosis is...(tone)

fluctuation of tone: with spasticity, with tonic spasms

auditory problems

hearing problems (acuity) auditory-perceptual problems agnosia (inability process sensory info)

types of limb involvement in CP

hemiplegia (entire right/left side) diplegia (both legs or both arms) quadriplegia (all limbs)

CP results from...

injuries to/abnormalities to brain occur BEFORE, DURING, or up to 1 year after birth (baby gets f***** up from prenatal -- 1 year old)

CP is essentially...

lack of accuracy in movement strategies/problems with control of movement strategies

spasticity (which part of brain affected?)

lesion in motor cortex

fluctuating muscle tone (which part of brain affected?)

lesions in basil ganglia

high or low incidence of CP?

low (2.4/1000 = .0024)

difficulties with....what types of functioning? 4 types (the main ones really)

motor, sensory, cognitive, & psychosocial functioning NEUROLOGIC, MOTOR, POSTURAL DEFICITS

what is a contracture?

permanent shortening of a muscle or joint due to prolonged hypertonic spasticity muscles or tendons that have remained too tight for too long, thus becoming shorter

concerns, what we want to prevent

prevent development of contractures & deformities, limiting of function (because of abnormal movement patterns, muscle tone, sensory function + gravity + growth)

How to differentiate CP from other conditions? 2 main components

quality of tone limb involvement

'symptoms' of CP

retention of primitive reflexes & automatic reactions variable tone hyper-responsive tendon reflexes asymmetry in use of extremities clonus (muscle spasms?) poor sucking/tongue control involuntary movements MOTOR DELAYS

in CP quality of tone can be...

spastic (cortical motor areas) athetoid (hyper & hypo, basil ganglia damage) ataxic (intentional tremor, affects coordination) flaccid mixed

most common from of CP?

spastic diplegia & quadriplegia

Muscle tone

tension/resistance to movement enables to keep body in position/posture changes in ___ enables movement