Cerebral PalsyCerebral Palsy

Thomas B. King, M. Ed.

Hospital Education Program

VCU Health Systems

What is Cerebral Palsy?What is Cerebral Palsy?

One of many types of neurological disorders

Appears in infancy or early childhoodPermanently affects body movement and

muscle coordinationGenerally does not worsen over time

General CharacteristicsGeneral Characteristics

Faulty development or damage to motor areas in the brain

The results are of a number of potential chronic neurological disorders

Usually associated with events that occur before or during birth, but may be acquired during the first few months or years of life

CausesCauses

Head traumaInfection

Types of CPTypes of CP

Spastic CPAthetoid CPAtaxic CPMixed CP

Spastic CPSpastic CP

Person is stiff, with permanently contracted muscles. Spasticity

accounts for about 50% to 75% of all CP

Terms associated with Spastic Terms associated with Spastic CPCP

Spastic hemiplegia – muscles on one side of the body are affected

Spastic triplegia – affects muscles of three limbs

Spastic diplegia – affects either both arms or both legs

Spastic quadraplegia – all extremities are affected and there are many complications

Athetoid CPAthetoid CP

Slow, uncontrolled, writhing movements (AKA dysknetic CP). Accounts for about 10% to 20% of

cases.

Athetoid CPAthetoid CP

Choreoathetoid CPDyskinetic CP

Athetoid CPAthetoid CP

Poor coordinationSlurred speechDroolingMay be adversely affected by emotions.

Symptoms will exacerbate when the child is upset

Ataxic CPAtaxic CP

Poor coordination, and balance difficulties. May also have problems with depth perception. Accounts for

5% to 10% of cases

Ataxic CPAtaxic CP

Loss of equilibriumPoor muscle coordination or unsteady gaitPerson appears intoxicatedIt is caused by damage to the cerebellum

Mixed CPMixed CP

Two or more types present. This accounts for around 10% of CP.

Mixed CPMixed CP

Not a separate type, but just a combination of the other types already mentioned

The most common type of mixed CP is spastic CP with athetoid CP

IncidenceIncidence

About 1,000,000 people in the US have CPThe increase in the survivability of

premature and difficult births actually contribute to a rise in the incidence of CP and other neurological disorders

AcquiredAcquired

About 10% to 20% of children acquire CP after birth

These are typically within the first few months to years of life

Acquired CP is the result of infection (such as meningitis) or..

Trauma (such as shaken baby syndrome)

CongenitalCongenital

Occur at birth or are present at birthCan be undetected for months after birthComplications from birth accidents or birth

trauma account for about 3% to 13% of congenital CP

Other considerations for Other considerations for causescauses

Infections during pregnancy such as German measles or cytomegalovirus or toxoplasmosis

Hyperbillirubinemia (untreated jaundice)AsphyxiaBrain hemorrhage

Comorbid conditionsComorbid conditions

EpilepsyDevelopmental delaysMental retardationLearning disabilities

TreatmentTreatment

Medications (especially for Athetoid CP)– Trihexyphenidyl– Benztropine– Procyclidine hydrocholoride

TreatmentTreatment

Medications to treat comorbidity such as epilepsy (AED’s)

Surgery such as heal chord releaseSpecial education services

– MR placement– LD placement– Speech and language– OT and PT