cerebral palsy by sharada prasad singh
TRANSCRIPT
Cerebral Palsy
UNDER SUPERVISION OF SHEELU KACHHAP
PRESENTED BYSHARADA PRASAD SINGHB.Ed.-SPECIAL (H.I.)BANARAS HINDU UNIVERSITY
William John Little(1810-1894)
* Formerly known as "Cerebral Paralysis,“
* First identified by English surgeon William Little in 1860. (Little’s disease)* Believed that asphyxia during birth is chief cause
Historical Background
• In 1897, Sigmund Freud, suggested that difficult birth was not the cause but only a symptom of other effects on fetal development.
• National Institute of Neurological Disorders & Stroke (NINDS) in 1980s suggested that only a small number of cases of CP are caused by lack of oxygen during birth
Definition• Cerebral“- Latin Cerebrum;
Affected part of brain
• “Palsy " -Gr. Para- beyond, lysis – loosening
Lack of muscle control
Cerebral Palsy-a condition caused by injury to the parts of the brain that control our ability to use our muscles and bodiesCerebral palsy (CP) is a group of permanent movement disorders that appear in early childhood.
Prenatal (70%)Peri-natal (5-10%)Post natal
In about 70 % of cases, CP results from events occurring before birth that can disrupt normal development of the brain.Commonly thought to be due to birth asphyxia; now known to be due to existing prenatal brain abnormalities.
Premature delivery is the single most important determinant of CP.In 24% of cases, no cause is found.
Causes of CP
• Maternal infections E.g. rubella, herpes simplex • Inflammation of placenta (chorion amnionitis)• Rh incompatibility • Diabetes during pregnancy • Genetic causes • Exposure to radiations • Maternal jaundice• Teratogens
Prenatal
• Prematurity- immature respiratory & cardiac function
• Asphyxia• Maconeum aspiration • Birth trauma • Disproportion • Breech delivery • Rapid delivery • Low birth weight• Coagulopathy
Peri- natal
• Brain damage secondary to cerebral hemorrhage, trauma, infection or anoxia
• Motor vehicle accidents • Shaken baby syndrome • Drowning • Lead exposure • Meningitis • Encephalitis
Post natal
• A) Classification by number of limbs involved:– 1) Quadriplegia- all 4 limbs– 2) Diplegia- all 4 limbs, legs more severely affected
than arms– 3) Hemiplegia- one side of the body; arm is usually
more involved than the leg– 4) Triplegia- three limbs are involved, usually both
arms and a leg– 5) Monoplegia- only one limb is affected, usually
an arm
Types of Cerebral Palsy
Monoplegia Diplegia
Hemiplegia
Quadriplegia
Total Body
Types of Cerebral
Palsy
• B) Classification by movement disorder:– 1) Spastic CP- too much muscle tone or tightness.
Movements are stiff, especially in the legs, arms, and/or back.
– 2) Athetoid CP (dyskinetic CP)- affect movements of the entire body. Involves slow, uncontrolled body movements and low muscle tone; hard for person to sit straight and walk.
– 3) Ataxic CP- least common. Disturbed sense of balance and depth perception. Poor muscle tone, a staggering walk and unsteady hands. Results from damage of the cerebellum.
– 4) Combined classifications- both movement and number of limbs involved are combined.
Types of CP (cont.)
Signs and Symptoms
• OF CEREBRAL PALSY
a.
b.
c.
d.e.
f.
g.h.
ASSOCIATED PROBLEMSOF CEREBRAL PALSY
• Hearing and visual problems
• Sensory integration problems
• Failure-to-thrive, Feeding problems
• Behavioral/emotional difficulties,
• Communication disorders
• Bladder and bowel control problems, digestive problems
(gastroesophageal reflux)• Skeletal deformities,
dental problems• Mental retardation and
learning disabilities in some
• Seizures/ epilepsy
TreatmentOF CEREBRAL PALSY
No
-No treatment to cure cerebral palsy. -Brain damage cannot be corrected.
Crucial for children with CP:
Early Identification; Multidisciplinary Care; and Support
“The earlier we start, the more improvement can be made”
-Health worker
• I. Nonphysical Therapy
A. General management - Proper nutrition and personal care
B. Pharmacologic Botox, Intrathecal, Baclofen
- control muscle spasms and seizures, Glycopyrrolate -control drooling
Pamidronate -may help with osteoporosis.
C. Surgery-To loosen joints,
-Relieve muscle tightness, - Straightening of different twists or unusual
curvatures of leg muscles - Improve the ability to sit, stand, and walk.
Selective posterior rhizotomy In some cases nerves need to be severed to decrease muscle
tension of inappropriate contractions.
D. Physical Aids • Orthotics, braces and splints• Positioning devices• Walkers, special scooters, wheelchairs
E. Special Education
F.Rehabilitation Services- Speech and occupational therapies
G. Family Services -Professional support
H. Other Treatment
- Therapeutic electrical stimulation,- Acupuncture,- Hyperbaric therapy - Massage Therapy might help
'The ultimate long-term goal is realistic independence. To get there we have to have some short-term goals.
Those being a working communication system, education to his potential, computer skills and, above all, friends'.
- Parent of boy with CP
• II. Physical Therapy
A.Sitting- Vertical head control
and control of head and trunk.
B. Standing and walking- Establish an equal
distribution of weight on each foot, train to use steps or inclines
“A disabled child has the right to enjoy a full and decent life, in conditions which ensure dignity, promote self-reliance and facilitate the child’s active participation in the community.”
-UN Convention on the Rights of the Child. 1989.
Summary
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