Cerebral palsy (Definition, Classification, Symptoms)

3. (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)

8. Classification
Topographic 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

13. Chorea

14. Athetosis

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

16. DystoniaInvoluntary muscle contractions that result in slow repetitive movements, cramps, or
abnormal posture.

18. - 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)

19. Primitive reflexes
Moro reflex

20. Rooting reflex

21. Tonic neck reflex

22. Palmar grasp reflex

23. Plantar reflex (Babinski sign)

24. Parachute reflex

25. Tonic labyrinthine reflex

26. Gross motor developmental milestones

27. Clinical Signs of Cerebral Palsy in Babies and Young Children:
1- The head lags when the baby is picked up
2- When picked up, his or her legs stiffen and cross
3- The baby is irritable, has difficulty sleeping, and is difficult to handle
4- Poor visual attention
5- Excessive docility )the body doesn’t appropriately tense or stiffen)
6- Difficulty feeding
7- Frequent vomiting
8- Inability to roll over
9- Stiffness
10- Floppiness
11- Shaky arms and legs
12- The baby reaches out with one hand only while keeping the other one in a fist, or the baby keeps both
hands in fists continuously
14- Inability to bring the hands together
15- Inability to push up into the hands when lying face-down
16- Difficulty bringing the hands to his or her mouth
17- Lopsided crawling reflex (the baby pushes off with one hand and leg while dragging the opposite
hand and leg)
18- Inability to sit without supports
19- Inability to stand while holding onto support

28. 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

29. 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.