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Cerebral palsy and its types

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Cerebral palsy and its types

  1. 1. CEREBRAL PALSY AND ITS TYPES. BY Vinishaa BPO-II Year NIEPMD, Chennai
  2. 2. INTRODUCTION TO CEREBRAL PALSY Cerebral palsy is a non progressive, neuro – muscular disorder of the brain which may be prenatal, natal or postnatal in origin. It is a group of permanent disorders of the muscle tone, movement, posture and balance which may be associated with seizures ,intellectual disability, communication disorder and hearing & visual impairment. It is a upper motor neuron lesion –Lesion at brain cortical and sub cortical region.
  3. 3. CAUSES Prenatal Causes: (From conception until setting in of labor pains) -Maternal viral infections such as TORCH infections(Toxoplasmosis, Rubella, cytomegalo virus or herpes simplex). - Consanguineous marriage - Drugs during pregnancy - Metabolic disorders in mother - Kernicterus ( high level of bilirubin in a baby’s blood) - Poor prenatal care - Early or late primi mothers
  4. 4. Natal Causes:(During labor) - Birth injury (Cord around the neck, placenta previa) - Complications at birth - Breech delivery - Anoxia Post Natal Causes:(Acquired after birth) - Infections of central nervous system (TB,meningitis,encephalitis) - Hydrocephalic baby - Head injury - Cerebro - vascular accidents - Jaundice
  5. 5. CLASSIFICATION OF CEREBRAL PALSY Physiological - Spastic - Ataxic - Athetoid or dyskinetic - Mixed - Flaccid Topographic - Hemiplegia - Paraplegia - Monoplegia - Diplegia - Quadriplegia Etiologic - Pre Natal - Natal - Post Natal
  6. 6. 1.PHYSIOLOGICAL CLASSIFICATION - It focuses on neuro – muscular symptoms of the disorder(According to tone of muscle)
  7. 7. SPASTIC CEREBRAL PALSY - It occur due to injury in motor cortex. - 70 to 80 % are of spastic type. - Hypertonic condition( Increased resistance to any movement) - Spasticity is the exclusive impairment present (velocity dependent). - Change in postures may occur with emotional outbreaks, which increase muscle tension. - Spasticity does not mean paralysis, there may be some voluntary movements.
  8. 8. -As compared to other types of cerebral palsy, spastic CP is more easily manageable by the person affected , and medical treatment can be pursued throughout life. -Spasticity can lead to onset of muscle – stress symptoms like arthritis and tendinitis. -Managed with occupational therapy and physiotherapy. -If spasticity is too much for the person to handle, other remedies like antispasmodic medications and neurosurgery known as rhizotomy.
  9. 9. ATHETOID CEREBRAL PALSY - It occur due to injury in basal ganglia of mid brain. -10 to 15% cases are of athetoid type. - Athetoid cerebral palsy or dyskinetic cerebral palsy is mixed muscle – both hypertonia and hypotonia mixed with involuntary motions. - Abnormal amount of involuntary and uncontrolled motion of limbs, heads and eyes(writhing and rotary patterns) & dysarthria.
  10. 10. -These movements often increase during periods of emotional stress and disappear during sleep. -Generally does not get any contractures or deformities as both the muscle groups are equally strong. -Non fitted with any orthosis as there are chances of some injury due to involuntary movements.
  11. 11. ATAXIC CEREBRAL PALSY -It occur due to injury in cerebellum. -5 to 10% of cases are ataxic types. -Disturbance of balance and coordination are the main characteristics. -some may have hypotonia and tremors. -The child reaches out to objects but, unable to achieve it because of over shooting or under reaching.
  12. 12. - Stability of the head on the trunk and the body on the pelvis is poor. - Child appearing clumsy in nature. - Nystagmus may be present. - Mental ,visual and perceptual problems are too often present. - Wide based gait. - Tendency to fall and stumble. - Instability to walk in straight line.
  13. 13. MIXED CEREBRAL PALSY - Mixed cerebral palsy is symptoms of athetoid, ataxic and spastic CP ,appearing each to varying degrees. - Mixed CP is the most difficult to treat as it is extremely heterogeneous and unpredictable in its symptoms and development over the lifespan.
  14. 14. FLACCID CEREBRAL PALSY - Present with flaccid weakness - Loose and floppy limbs, with reduced muscle tone. - Relatively rare - Child develops deformities like kyphosis and genu recurvatum easier than other types.
  15. 15. 2.TOPOGRAPHICAL CLASSIFICATION - Classification of cerebral palsy based on the parts of body affected. It includes 6 types:
  16. 16. 1.MONOPLEGIA Only one limb is affected usually an arm.
  17. 17. 2.QUADRIPLEGIA All four limbs are affected.
  18. 18. 3.TRIPLEGIA Involvement of three limbs. Usually both the arms and one leg are affected.
  19. 19. 4.HEMIPLEGIA One side of the body is affected .The arm is usually more involved than the leg. Circumduction of the leg.
  20. 20. 5.PARAPLEGIA Involvement of both the legs.
  21. 21. 6.DIPLEGIA Involvement of four limbs with the legs more affected than the arms. Spastic diplegia gaits (true equinus, jump, apparent equinus and crouch) Spasticity of hip adductors lead to scissoring gait.
  22. 22. DOUBLE HEMIPLEGIA Same as diplegia, but with arms affected more than legs.
  23. 23. 3.ETIOLOGICAL CLASSIFICATION Based on the time of the occurrence of brain damage to the young child. - Prenatal - Natal - Postnatal
  24. 24. THANK YOU!

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