CEREBRAL PALSY is an umbrella term encompassing a group of non progressive, non contageous (non communicable) motor condition that causes physical disabilities in human development it occurs due to damage to the brain at or around birth. Clinical picture changes as the nervous system develops and child grows.
In cerebral palsy cerebrum is the affected area in the brain.
Causes of cerebral palsy
preterm babies are much more likely to be brain damaged both at delivery by trauma , and after because of their immature respiratory and cardiovascular systems making them more likely to develop hypoxia and low blood pressure.
Immaturity of the liver makes haemmorhage more likely to occur and be severe.
It is a condition caused by insufficient intake of oxygen to the brain.
Severe asphyxia is still an important cause of cerebral palsy even in mature infants, and may be caused by accidents at birth, knotted umblical cord, cord around the neck or prolapsed cord.
Multiple deliveries may be associated with delay and asphyxia of the second or third infant, especially with malpresentation.
Birth trauma occurs in following ways
high level of unconjugated bilirubin in the blood damages the basal ganglia causing athetoid cerebral plasy and high tone deafness.
low blood sugar for long period can cause severe brain damage and epilepsy.
The cerebellum seems vulnurable causing ataxia, and there are often visual problems.
Intauterine virus infections
Rubella virus infections
cytomegalovirus infections are two viruses can cause severe brain damage and associated deafness and visual problems including cataracts.
Early meningitis may cause sever brain damage.
occlusion of internal carotid or middle cerebral artery may occur before or after birth and cause hemiplegia.
Classification of Distribution
one side of the body affected- Hemiplegia
all four limbs affected (upper more than lower)- Quadriplegia
all four limbs affected (one side more then the other)- Bilateral Hemiplegia
legs more affected, but arms less so-Diplegia
One limb only affected- Monoplegia
Types of cerebral palsy(CP)
Spastic Cerebral palsy
It is a disorder of tone where there is an increase in initial resistance to stretch which may be lessen abruptly.
It is the damage in the upper motor neuron in the cortex or along the pathways which terminate in the spinal cord.
Spastic muscles are contineusly contracting and there is weakness in the antagonostic muscles leading to abnormal positioning of the joints on which they act.
Deformities of joints develop which may become fixed contactures with time.
Dystonic Cerebral palsy
It is a movement disorder in which involuntary muscle contractions occur which may be sustained or intermittent causing repititive and twisting movements, abnormal postures or both.
In Dystonic CP there is hypertonia involuntary postures or movement or both.
Choreo athetoid Cerebral palsy
Choreic movements are rapid involuntary jerks present at rest which are increased by voluntary movements.
Athetoid Cerebral palsy
It is the damage to the brain as in other types of CP
Area of brain affected- Basal Ganglia or its pathways.
It is charaterized by the occurance of slow movements with muscle rigidity and persistant abnormal postures that relax after second or minutes.
Ataxic Cerebral palsy
It occurs due to damage to the cerebellum or its pathways.
Common associated problems
unclear speech or other speech disorder may occur.
Infrequent seizures are there and medications should be considered carefully.
Most of the cases have multiple neurological defecits.
Squint, cataracts, perceptual and refractive errors may be present.
Partial or complete loss of hearing
Aphasia, Dysarthria and misarticulation may be present.
May have generalized or focal tonic seizures
Causes of cerebral palsy physiotherapy
Medical disease or infections to the mother during pregnancy like
PHYSICAL EXPECTATIONS FROM CHILD
Physical and movement development
Physical and movement development
physical and movement development
child is able to