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Diet and disease-CEREBRAL PALSY
- 2. PRESENTATION BY: SYLVIA E. SELASSIE, RD, LD CEREBRAL PALSY
- 3. Brief history Cerebral palsy overview Types of cerebral palsy Assessment and diagnosis Treatment regimen Definition of terms References CONTENT
- 4. In 1860s, referred to as ‘cerebral Paralysis’ or ‘Little’s Disease’ After a first medical descriptions by an English surgeon- William John Little(1810-1894) BRIEF HISTORY
- 5. “Cerebral”- Latin Cerebrum Affected part of the brain “Palsy”- Para-beyond -lysis- loosening Lack of muscle control CEREBRAL PALSY
- 6. A motor function disorder Due to permanent, non-progressive brain lesion Present at birth or shortly thereafter(Mosby, 2006) Non-curable, life-long condition Damage doesn’t worsen May be congenital or acquired CEREBRAL PALSY
- 7. A heterogeneous group of movement disorders An umbrella term Not a single diagnosis
- 8. Balance Posture Movements CEREBRAL PALSY EFFECTS
- 9. An insult or injury to the brain Fixed, static lesion(s) In single or multiple areas of the motor centers of the brain Early in CNS development ETIOLOGY
- 10. Development Malformations The brain fails to develop correctly Neurological damage Can occur before, during or after delivery Rh incompatibility, illness, severe lack of oxygen ETIOLOGY
- 11. Severe deprivation of oxygen or blood flow to the brain hypoxic-ischemic encephalopathy or intrapartal asphyxia MAJOR NOTED CAUSE
- 12. Prematurity Blood-type incompatibility Placental insufficiency; Maternal infection that includes German measles other viral diseases Neonatal jaundice Anoxia at birth Bacterial infections of the mother, fetus, or infant that affect the central nervous system Causative agents
- 13. ACCORDING TO NEUROLOGIC DEFICITS Based on: extent of brain damage and area of the brain damage Each type involves the way a person moves TYPES OF CEREBRAL PALSY
- 14. 1. Pyramidal -originates from the motor areas of the cerebral cortex 2. Extrapyramidal - basal ganglia and cerebellum 3. Mixed MAIN TYPES
- 15. MAIN TYPES: PYRAMIDAL : 1. Spastic CP Extrapyramidal: 2. Athethoid CP 3. Ataxic CP Mixed : 4. Spastic & Athethoid CP ACCORDING TO TYPE OF MOVEMENTS
- 16. -Plegia/paresis-paralyzed or weak Paraplegia Diplegia Hemiplegia Quadriplegia Monoplegia- one limb(extremely rare) Triplegia- three limbs(extremely rare) ACCORDING TO AFFECTED LIMBS:
- 17. MILD- 20% of cases MODERATE- 50%; require self help for assisting their impaired ambulation capacity SEVERE- 30%; total incapacitation and bedridden ACCORDING TO DEGREE OF SEVERITY
- 18. Hypotonia Hypertonia Dystonia ACCORDING TO MUSCLE TONE ABNORMALITIES
- 19. SYMPTOMS
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- 21.
- 22. Poor ability to concentrate Unusual tenseness Irritability BEHAVIOURAL SYMPTOMS
- 24. Physical evaluation MRI, CT Scan Laboratory and radiologic work up Assessment tools: growth curve monitoring, MUAC, height and length, Peabody Development Motor Skills DIAGNOSIS
- 25.
- 26. Interview A. history taking: involves all predisposition factors such as Risk factors Psychosocial factors Family adaptation B. child’s health history: often admitted to hospitals for corrective surgeries and other complications. Subjective
- 27. Respiratory status Motor function Presence of fever Feeding and weight loss Any changes in physical state Medical regimen
- 29. Crucial for children with Cerebral palsy Early identification, multidisciplinary care and support Nonphysical: proper nutrition and personal care Treatment
- 30. Botox, Intrathecal, Baclofen Controls muscle spasms and seizures Glycopyrrolate- controls drooling Pamidronate- may help with osteoporosis Pharmacologic treatment
- 31. To loosen joints Relieve muscle tightness Straightening of different twists or unusual curvatures of leg muscles Improve the ability to sit, stand and walk. Surgery
- 32. Note
- 33. Physical aids: orthosis, braces and splints; positioning devices; walkers, special scooters, wheelchairs Special Education Rehabilitation services- speech and occupational therapies Family services- professional
- 34. Spastic CP: Increased muscle tone, persistent infant reflexes, increased deep tendon reflexes in one of three patterns: hemiplegia (arm and leg on one side of the body), diplegia (involving the lower extremities), and quadriplegia (all four extremities and may include the trunk, head, and neck) Dyskinetic CP: Abnormalities in muscle tone that affect the entire body; includes athetoid CP, which includes uncontrolled and continuous involuntary movements Definition of terms
- 35. Mixed CP: A condition in which both athetosis and spasticity are present Ataxic CP: Abnormalities of voluntary movement and balance such as unsteady gait Athetoid dyskinetic CP: Normal intelligence but difficulty walking, sitting, speaking clearly Pyramidal: one of the carpal bone Athetosis: series of involuntary writhing movements of the limbs
- 36. Krause chapter 45 Ida Sherri L. Cerebral palsy Capone G, et al: Down syndrome. In Ekvall SW, Ekvall VK, editors: Pediatric nutrition in chronic disease and developmental disorders, New York, 2005, Oxford University Press Stevenson RD: Use of segmental measures to estimate stature in children with cerebral palsy, Arch Paediatr Adolesc Med 149:658,2005. References
Notas del editor
- Cerebral Palsy Cerebral palsy results from damage to the structures of the cerebral cortex, cerebellum, and spinal cord. It is characterized by atypical muscle tone and poor coordination among muscle groups which results in postural abnormalities and structural deformities.
- Unknown in many instances
- A moderate disability child has normal life expectancy and most can lead a relatively independent life