Cerebral Palsy

U.S. Statistics:

(According to the Centers for Disease Control and Prevention (CDC))

• About 764,000 children and adults in the U.S. manifest one or more of

the symptoms of cerebral palsy.

• Each year about 10,000 babies born in the United States will develop

cerebral palsy.

• 1,200 - 1,500 preschool age children are also recognized to have cerebral

palsy each year.

• The prevalence was significantly higher in boys than in girls overall

(male/female ratio, 1.4:1)

ClassificationTopographic Etiological FunctionalPhysiological

1- Pyramidal

a- Spastic

2- Extra-Pyramidal

I- Dyskinesia

a- Chorea b- Athetosis

c- Corea-athetosis

d- Dystonia f- Rigidity

g- Tremor

II - Ataxic

1- Monoplegia

2- Paraplegia

3- Diplegia

4- Hemiplegia

5- double hemiplegia

6- Triplegia

7- Quadriplegia

1- Prenatal

2- Perinatal

3- Postnatal

1- Class I

2- Class II

3- Class III

4- Class IV

5- Class V

Chorea

Athetosis

Tremor Rhythmic, oscillation of a body part in a fixed plane

DystoniaInvoluntary muscle contractions that result in slow repetitive movements, cramps, or

abnormal posture.

HOW IS CP CLINICALLY DIAGNOSED?

- Diagnostic criteria for Cerebral palsy (POSTER criteria)

P - Posturing/abnormal movements.) chorea, athetosis , tremor or

dystonia)

O - Oropharyngeal problems (e.g., tongue thrusts, swallowing abnormalities)

S - Strabismus

T - Tone (hyper- or hypotonia)

E - Evolutional mal-development (primitive reflexes persist or protective

equilibrium reflexes fail to develop)

R - Reflexes (increased deep tendon reflexes/persistent Babinski's reflex)

Abnormalities in four of these six categories point to CP

Primitive reflexes

Moro reflex

Rooting reflex

Tonic neck reflex

Palmar grasp reflex

Plantar reflex (Babinski sign)

Parachute reflex

Tonic labyrinthine reflex

Gross motor developmental milestones

Clinical Signs of Cerebral Palsy in Babies and Young Children:1- The head lags when the baby is picked up2- When picked up, his or her legs stiffen and cross3- The baby is irritable, has difficulty sleeping, and is difficult to handle4- Poor visual attention5- Excessive docility (the body doesn’t appropriately tense or stiffen)6- Difficulty feeding7- Frequent vomiting8- Inability to roll over9- Stiffness10- Floppiness11- Shaky arms and legs12- The baby reaches out with one hand only while keeping the other one in a fist, or the baby keeps both hands in fists continuously14- Inability to bring the hands together15- Inability to push up into the hands when lying face-down16- Difficulty bringing the hands to his or her mouth17- Lopsided crawling reflex (the baby pushes off with one hand and leg while dragging the opposite hand and leg)18- Inability to sit without supports19- Inability to stand while holding onto support

Treatments:

Treatment depends on severity Long-term treatment includes physical and

other therapies, drugs, and sometimes surgery.

Therapies

- Occupational therapy: Improves daily living and work skills of patients.

- Physical therapy: Restores muscle strength and function through

exercise.

Stretching: Stretching exercises can improve flexibility and improve

physical function.

Medications Muscle relaxant: Reduces muscle tension and helps relieve

muscle pain and discomfort

Specialists

- Pediatric neurologist: Treats nervous system disorders in children.

- Speech therapist: Specializes in voice rehabilitation.

- Neurodevelopmental disabilities pediatrician: Specializes in nervous system

developmental disorders.

- Orthopedic surgeon: Performs surgery for conditions affecting bones and muscles.

- Physical medicine and rehabilitation: Restores function and quality of life to

those with physical disabilities.

- Neurologist: Treats nervous system disorders.

- Pediatrician: Provides medical care for infants, children, and teenagers.

- Primary care provider (PCP): Prevents, diagnoses, and treats diseases.