Cerebral palsy means ‘brain paralysis’. It is a disability that affects movement and body position. It occurs from brain damage that happened before the baby was born, at birth, or as a baby. The whole brain is not damaged, only parts of it, mainly parts that control movements. Once damaged, the parts of the brain do not recover, nor do they get worse.
Prevalence

  • 2-4/1000; new babies each year
  • During past 3 decade considerable advances made in obstetric & neonatal care, but unfortunately there has been virtually no change in incident of CP

Causes of Cerebral palsy

  • Prenatal (70%): Infection, anoxia, toxic drugs intake, Rh disease, congenital malformation of brain
  • Natal (5-10%): hypoxia, traumatic delivery, hypoxic ischemic encephalopathy, asphyxia
  • Post-natal: Trauma, infection, toxicity.
Classification
Physiologic classification

  • Athetold
  • Ataxic
  • Rigid Spastic
  • Atonic
  • Mixed
Topographic classification

  • Monoplegic
  • Paraplegic
  • Hemiplegic
  • Triplegic
  • Quadraplegic
  • Diplegic
Early Signs of Cerebral Palsy

1. Birth History: Premature birth, Seizures, Low apgars, Intracranial haemorrhage.
2. Delayed Milestones
3. Abnormal Motor Performance: Handedness; Reptilian crawl; Toe waking.
4. Altered Tone (hypotonic/ hypertonic/rigidity)
5. Persistence of primitive reflexes.
6. Abnormal posturing
7. Abnormal walking pattern

The ultimate and long term goal of treatment of CP gaining independence in activities of daily living, school or work and social life. Provide community and social support.

The short term goals of treatment of CP: Education of parents and care givers, Positioning and handling, Normalization of tone, Prevention of deformity and contracture, Training for problems related with sensory integration, Providing assistive adaptive devices and training for proper use, Gait training and hand function.

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