DEFINITION

● A group of disorders arising from a

malfunction of motor centers and
neural pathways of the brain.
DEFINITION

● It is a non – progressive
neuromuscular disorder of the
varying degrees resulting from
damage or a defect in the part of the
brain that controls motor function.
DEFINITION

Cerebral palsy is any non

progressive CNS based disorder of
strength , muscle control, posture
or movement due to a brain injury
occurring during early brain growth.
CAUSES

✓ Hypoxia / Anoxia
✓ Bleeding in the brain
✓ Brain infections (encephalitis, meningitis,
herpes simplex infections)
✓ Infections in the mother during
pregnancy (rubella, toxemia)
TYPES

1. Spastic
2. Dyskinetic
3. Mixed
1) Spastic (Pyramidal)
✓ This is the most common type of CP,
accounting for about 70-80% of cases.
✓ Increased muscle tone.
✓ The muscles are stiff (spastic).
✓ Movements are jerky or awkward.
✓ This type is classified as per the part of
the body is affected: diplegia,
hemiplegia, or quadriplegia.
2) Dyskinetic (Extrapyramidal):

ATHETOID ATAXIC
2) Dyskinetic (Extrapyramidal):

➢ ATHETOID: The person has

uncontrolled movements that are slow
and writhing.
• The movements can affect any part of
the body, including the face, mouth,
and tongue.
• About 10-20% of cerebral palsy cases
are of this type.
2) Dyskinetic (Extrapyramidal):

➢ ATAXIC: This type affects balance

and coordination.
• Depth perception is usually affected.
•
If the person can walk, the gait is
probably unsteady.
2) Dyskinetic (Extrapyramidal):

➢ ATAXIC:
• He or she has difficulty with
movements that are quick or require
a great deal of control, such as
writing.
•
About 5-10% of cases of cerebral
palsy are of this type
3) Mixed
This is a mixture of different types of
cerebral palsy.
A common combination is spastic and
athetoid.
SIGNS AND SYMPTOMS

● The signs of cerebral palsy are usually

not noticeable in early infancy but
become more obvious as the child’s
nervous system matures. Early signs
include the following:
SIGNS AND SYMPTOMS

 Delayed milestones such as controlling

head, rolling over, reaching with one
hand, sitting without support, crawling, or
walking.
 Persistence of “infantile” or “primitive”
reflexes, which normally disappear 3-6
months after birth.
SIGNS AND SYMPTOMS

 Developinghandedness before age 18

months: This indicates weakness or
abnormal muscle tone on one side,
which may be an early sign of CP
DIAGNOSIS

Lab Studies: Various blood and urine

tests may be ordered if your child’s
health care provider suspects that the
child’s difficulties are due to chemical,
hormonal, or metabolic problems.
Ultrasound Of The Brain: Ultrasound is
often used on newborns who cannot
tolerate more rigorous tests such as CT
scans or MRI.
DIAGNOSIS

CT Scan Of The Brain: It identifies

malformations, hemorrhage, and certain
other abnormalities in infants more clearly
than ultrasound.
MRI Of The Brain: Children who are
unable to remain still for at least 45
minutes may require a sedative to
undergo this test.
DIAGNOSIS

MRI Of The Spinal Cord: This may be

necessary in children with spasticity of
the legs and worsening of bowel and
bladder function.
Electroencephalography (EEG):
Important in the diagnosis of seizure
disorders.
DIAGNOSIS

Electromyography (EMG) and nerve

conduction studies (NCS): May be
helpful in distinguishing CP from other
muscle or nerve disorders.
TREATMENT

There is no cure for cerebral palsy.

With early and ongoing treatment,
however, the disabilities associated
with cerebral palsy can be reduced.
MEDICAL TREATMENT

Goal Of Treatment
To help the individual with cerebral palsy
reach his or her greatest potential
physically, mentally, and socially.
REHABILITATION

● A comprehensive rehabilitation program

may include
1) Physical Therapy
2) Use Of Special Equipment
3) Spasticity Treatment
1) PHYSICAL THERAPY

● The goal is to maximize function and

minimize disabling contractures. It
involves:
▪ Stretching
▪ Physical exercises, and
1) PHYSICAL THERAPY

▪Other activities that develop

- Muscle strength
- Flexibility
- Control
2) SPECIAL EQUIPMENT

Special equipment that may be

helpful to people with CP includes:
- Walkers
- Positioning Devices
- Customized Wheelchairs
- Scooters
- Tricycles
SPASTICITY TREATMENT

➢ Spasticitymay be treated by injections

into the muscles or by medications.
➢ Reduction of spasticity can improve:
- Range of motion
- Reduce deformity
- Improve response to occupational and
physical therapy
- Delay the need for surgery
OCCUPATIONAL THERAPY

Helps the individual learn physical skills he or

she needs to function and become as
independent as possible in everyday life.
Examples are feeding, grooming, and
dressing.
OTHER THERAPIES
● Speech/language
therapy: This
therapy helps
the child
overcome
communication
problems.
OTHER THERAPIES

● Vision problems: An ophthalmologist is

consulted for children who have
strabismus and visual problems
MEDICAL THERAPY

This encompasses treatment for all

medical problems whether related to CP
or not.
➢ Seizures
➢ Feeding And Digestive Problems
➢ Breathing Problems
EDUCATIONAL SERVICES

● Many children with cerebral palsy, even

those of average or above-average
intelligence, are challenged in “cognitive”
processes such as thinking, learning,
and memory. They can benefit from the
services of a specialist in learning
disabilities
NURSING MANAGEMENT

Functioning as a member of health team.

Providing counseling and education for
parents.
Encouraging health maintenance.
Providing nutritional needs.
Encouraging rest and relaxation.
NURSING MANAGEMENT

● Preventing infection and injury

● Promoting a positive self image
● Encouraging self help
● Toilet training
● Assisting with physical therapy
● Assisting with speech therapy
NURSING MANAGEMENT

❄ Preventing child abuse

❄ Counseling for educational
and vocational training.
NURSING DIAGNOSIS

● Impaired physical mobility

● Self care deficit
● Potential for injury
● Impaired verbal communication
● Body image disturbances
● Altered family process.
FOLLOW – UP

● The overall goal for ongoing care of

individuals with CP is to help them reach
their full physical, mental, and emotional
potential. Generally, this includes living
as much as possible in the mainstream
of their society and culture
COMPLICATIONS

● Osteoporosis
● Bowel obstruction
● Hip dislocation and arthritis in the hip
joint
● Injuries from falls
● Joint contractures
● Pneumonia caused by choking
COMPLICATIONS

● Poor nutrition
● Reduced communication skills
(sometimes)
● Reduced intellect (sometimes)
● Scoliosis
● Seizures (in about half of patients)
● Social stigma
SUPPORT GROUPS