Cerebral Palsy

non-progressive brain lesions
involving motor or Postural abnormalities

"A group of disorers of the development of movement and posture causing activity limitations that are attributed to non-progressive disturbances that occured in the developing fetal or infant brain. The motor disorders of cerebral palsy are often accompanied by disturbances of sensation, cognition, communication, perception and/or behavior and/or a seizure disorder" (Bax,2005)

onset: fetal or neonatal period upto 3 years
restricted to brain only
Associated: 30-50% MR, 15-60% Epilepsy


Brain lesions due to
Prenatal, Perinatal, Postnatal insults
Risks - preterm birth, multiple gestation, intrauterine growth restriction, male sex, low Apgar scores, intrauterine infections, maternal thyroid abnormalities, prenatal strokes, birth asphyxia, maternal methyl mercury exposure, and maternal iodine deficiency


Spastic most common (80%)
due to cortical/pyramidal lesions
Spastic hemiplegia
Spastic diplegia (lower more affected)
Spastic quadriplegia
Dyskinetic CP
(athetoid CP, choreoathetoid CP, and dystonic CP) abnormal movements; hypertonicity often is associated
Mixed CP
Hypotonic CP - hypotonia with hyperreflexia, persistent primitive reflexes; rare


Prenatal - drug exposure, toxins/infections, DM, tauma, radiation, prenatal care, fetal movements
Perinatal - Gestational age, presentation & delivery type, birth weight, APGAR
Neonatal - ICH, feeding difficulties, apnea, bradycardia, infection, hyperbilirubinemia
Developmental - gorss, fine, language, social
Gross - head control (2 months), Roll (4 months), Sit (6 months), walk (1 year)


observe for abnormal neck & truncal tone
asymmetric posture, gait, coordination
increased reflexes
persistence of primitive reflexes
Athetosis, Chorea, Dystonia


GIT/Nutritional - FTT, Obseity, GER, Constipation, Dental Caries
Resp - Increased risk of aspirational pneumonia, Chronic lung disease, bronchilitis/asthma
Skin - Decubitus ulcer
Orthopedic - Contractures, hip dislocation, scoliosis
Neurologic - Epilepsy, Hearing loss, MR

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