Cerebral palsy for medical students in descriptive way.

2.  Cerebral Palsy is defined as a non progressive
neuromotor disorder of cerebral origin.
 It is a disorder that affects muscle tone,
movement, and motor skills (the ability to
move in a coordinated and purposeful way).
 1-2 per 100 live birth.

4. Factors may be due to prenatal period or
post natal period.
 Perinatal Hypoxia
 Birth Trauma
 Intrauterine or acquired infections -Infections
like cytomegalo viruses, viral encephalitis,
toxoplasmosis, bacterial meningitis, chicken
pox

5.  Abnormal placenta, umbilical cord around the
neck, neonatal breathing disorders, jaundice,
and intracranial hemorrhage due to birth
trauma can also cause Cerebral Palsy.
 Prematurity
 Mild birth asphyxia

6.  A variety of pathological reasons such as
cerebral atrophy, microcephaly, degeneration
of the basal ganglia, cerebellar lesions may
be involved.

8. Is divided according to topographic
distribution, neurological findings and
etiology:

10. • Spastic cerebral Palsy : This is the commonest.
In this type spasticity (muscle tightness) is the
exclusive or almost-exclusive impairment
present.
• A person with spastic CP develops tight
muscles in some parts of the body that are
unable to relax. Affected joints become stiff
and hard to move.
•
• Usually, a person has problems controlling
movements, poor coordination and balance,
and difficulty talking and eating.

11. • Early diagnostic feature of neural damage includes
• Abnormally persistent neonatal reflexes
• Feeding difficulties.
 On vertical suspension the neonate goes into
scissoring due to adductor spasm with an extensor
posture and doesn’t flex his knees or thigh.

13.  Despite pyramidal involvement these patients are
atonic or hypotonic.
 Tendon reflexes are normal or brisk.
 Babinski sign positive (upper motor neuron lesion
constituting damage to the corticospinal tract(The
corticospinal tract conducts impulses from the brain
to the spinal cord that make possible the execution
of precise voluntary movements.)
 Delayed CNS maturation.

15.  The atonic child is weak, floppy, and lacks
normal muscle tone. Symptoms of this type
of CP include:
 poor balance
 poor depth perception
 an unsteady walk
 poor coordination

16.  The extrapyramidal system is a neural network
that is part of the motor system that causes
involuntary reflexes and movement, and
modulation of movement (i.e. coordination).
 Extrapyramidal (nonspastic) CP is caused by
damage to nerve cells outside of the pyramidal
tracts in the basal ganglia or the cerebellum
 The clinical manifestation include dyskinesia
such as athetosis (slow, writhing movements),
dystonia, tremors and rigidity.

17.  Arms, leg and trunk may be involved
 Mental retardation and hearing deficits may
be present.
 Early diagnostic indicator is inability to reach
for and grasp a dangling ring by the age of
six months.

18.  There is hypotonia and hyporeflexia.
 Ataxia (lack of muscle coordination) and
intention tremors (cerebellar tremor, is a
dyskinetic disorder characterized by a broad,
coarse, and low frequency tremor) appear by
the age of 2years.

19.  Mixed cerebral palsy is symptoms of athetoid,
ataxic and spastic CP appearing
simultaneously, each to varying degrees, and
both with and without certain symptoms of
each.