Monday, September 17, 2018

PT Pathologies: Cerebral Palsy

Cerebral Palsy (CP) is a group of non-progressive movement disorders that result from brain damage.  This diagnosis is seen in 2-4 children out of 1,000 births and is the most common cause of permanent disability iin children cross the US.  The cause of CP is often multifactorial or sometimes even unknown.  This disease can occur as prenatal, which has an 80 percent occurrence, and postnatal, which has a 20 percent occurrence among children with CP.  Malnutrition during pregnancy, infection and diabetes are prenatal contributing risk factors, while cardio-vascular accidents, head trauma and neonatal infection contribute the to the disease after the child is born.

If CP is suspected through clinical findings, such as motor delays, poor balance and seizures, and electrocephalograph (EEG) may be performed.  Also urine tests may be administered to investigate the metabolic cause.  The clinical presentation of a child who has CP would lack motor skills, have poor balance, and depending on the severity of the child's condition, they may be affected intellectually and have a learning disability.

Since CP is a non-progressive disorder, the individual will never see a decrease in mobility or motor function because of the disease.  Based on severity, each patient is ranked either mild, moderate or severe.  However, a patient can potentially improve with the help of physical therapy to improve motor skills and work on improving their balance.  Also, adaptive equipment is probably necessary in most cases, such as a wheelchair or crutches.  Physical therapy would benefit the patient by maximizing the patients level of current function, and help the patient learn to ambulate if physically possible, which usually occurs by age 8.

Cerebral Palsy Primary Motor Patterns (mixed motor patterns exist)

  • Spastic- indicating a lesion in the motor cortex of the cerebrum: upper motor neuron damage
  • Athetoid - indicating a lesion involving the basal ganglia
Distribution of involvement:
  • Monoplegia - one extremity
  • Diplegia - Bilateral lower extremity involvement, however, upper extremities may be affected
  • Hemiplegia - unilateral involvement of the upper and lower extremities
  • Quadriplegia - involvement of entire body

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