Cerebral Palsy

Infantile cerebral palsy Prepared by: Legnica Herrera Degree in Physiotherapy UdelaR 2009 Panama
INTRODUCTION When this occurs specifically in the brain may appear motor, mental, behavioral, auditory, optical or language, rising to form a group of syndromes that cause psychomotor developmental delay including cerebral palsy . Cerebral palsy is the leading cause of disability in childhood The child who suffers from this disorder show motor effects that prevent a normal development. Multiple factors produce the largest per cent occurs in the time of birth that can happen for various reasons a hypoxia of the brain, injuring the same area. This injury causes various disabilities such as disorders of posture and movement that may be with or without seizures, mental retardation, visual problems, hearing and language.
What is infantile cerebral paralysis (ICP)? Cerebral palsy is a term used to describe a group of motor disabilities caused by damage in the child’s brain that can occur in the prenatal period, perinatal or postnatal.
DEFINING PCI More accurate and more widely accepted is that of a “disorder postural tone and movement, a persistent (but not invariable), secondary to an assault on a non-progressive brain immature” Under the concept of PCI are different types of diseases with different causes, with variable prognosis depending on the degree of impact and extent of the lesion in the brain. The brain injury is and therefore does not cover other causes of motor disorder (spinal cord injury, peripheral nervous system).
How many people suffer from this disorder? Despite progress in preventing and treating certain causes of cerebral palsy The number of affected children and adults has not changed, or perhaps risen slightly over the past 30 years. This is partly because more critically premature and weak babies are surviving on the improvements in intensive care. Unfortunately, many of these babies suffer from problems in the development of the nervous system or suffer neurological damage. Research to improve care for these children is in progress and studies on technology to alleviate disturbances of breathing and testing of drugs to prevent bleeding of the brain before or soon after birth.
CAUSES OF infantile cerebral palsy. The causes are classified according to the stage where damage has occurred on this the brain is forming, growing and developing. Cases are classified as prenatal, perinatal or postnatal.
1. ANTE-NATAL CAUSES 1 – Prenatal Anoxia. (round the neck, or placental pathology cord). 2 – prenatal cerebral hemorrhage. 3 – prenatal infection. (toxoplasmosis, rubella, etc.).. 4 – Rh Factor (mother-fetus incompatibility). 5 – Exposure to radiation. 6 – Ingestion of toxic drugs or during pregnancy. 7 – maternal malnutrition (anemia). 8 – Threatened abortion. 9 – Taking drugs contraindicated by the physician. 10 – Mother years too young.
2. CAUSES PERINATAL 1 – Prematurity. 2 – Low birth weight. 3 – perinatal hypoxia. 4 – direct physical trauma during childbirth. 5 – Misuse and application of instruments (forceps). 6 – Placenta previa or landslide. 7 – prolonged and / or difficult. 8 – breech presentation with head restraint. 9 – Asphyxiation by andalusia circular neck (anoxia). 10-Cyanosis at birth. 11-Bronco aspiration.
3. POSTNATAL CAUSES 1 – head injury. 2 – Infections (meningitis, meningoencephalitis, etc.).. 3 – Poisoning (lead, arsenic). 4 – Vascular Accidents. 5 – Epilepsia. 6 – high fevers with convulsions. 7 – electric shock accidents. 8 – by anoxia encephalopathy.
TYPES Classification infantile cerebral palsy clinic: a cerebral palsy-spastic cerebral palsy disquinética b-or c-distónica atáxica Cerebral palsy Cerebral palsy d-mixed
A-When spastic cerebral palsy affecting the motor cortex or subcortical intracerebral routes, mainly via the pyramid (the most frequent clinical form of cerebral palsy). Its main feature is the hypertonia, spasticity, which can be as much rigidity. It is recognized by a continuous resistance to a plastic or passive throughout the movement.
Cerebral Palsy DISQUINÉTICA B-O DISTÓNICA When extrapyramidal system involvement (base of the nuclei and their connections: caudate, putamen, and pale subtalámico). It is characterized by disturbance of muscle tone fluctuations and abrupt changes with the same appearance and persistence of involuntary movements manifested very archaic reflexes. The movements are of different types: chorea, atetosis, tremor, balismo, and dystonia.
C-ATÁXICA Cerebral Palsy There are three distinct clinical forms have in common the existence of a cerebellar involvement with hypotonia, incoordination of movement and balance disorders in different degrees. Depending on the predominance of one or the other symptoms and signs with no association or involvement with other levels of the nervous system, are classified as spastic diplegia, and ataxia syndrome simple imbalance.
D-Cerebral Palsy MIXTA There are various combinations extrapyramidal motor disorders and various types of disturbances of tone and combinations spastic hemiplegia or diplegia, especially ATET. The mixed forms are very common.
TOPOGRAPHIC CLASSIFICATION ACCORDING TO THE EXTENSION OF BRAIN DAMAGE. The suffix plejia means absence of movement, when there is some kind of mobility use the suffix paresis (cuadriparesias, tetraparesis, hemiparesis and monoparesias).
a-quadriplegia: the four members are affected. tetraplegia-b: Effect including global trunk and four limbs, with a predominance of involvement in the upper limbs. c-Triplejía: Effect of the lower extremities and an upper d-diplegia: Effect of the four extremities with predominance in lower extremities. e-Hemiplegia: one side is taken of the body (limbs), and within this the most affected is the upper limb. f-Double hemiplegia: When there is involvement of all four extremities but much more evident in a limbs, behaving as a functionally hemiparesis. g-Paraplegia: Very rare, it affects only the lower limbs . h-Monoplejía: It affects only one member (arm or leg), such cases are rare.
WHAT DISORDERS ARE RELATIONSHIP with cerebral palsy? Mental Retardation: Two thirds of all patients. Is the most common Children with spastic quadriplegia. Learning problems eye abnormalities (strabismus, amblyopia, nystagmus, refractive errors ) Deficit of auditory communication disorders seizures: one third of the total patients; observed more frequently in children with spastic Hemiplegia of Deficiency Power Problems Development gastroesophageal reflux emotional and behavioral problems (especially with attention deficit hyperactivity, depression).
Treatment principle in the rehabilitation process should take into account certain factors to meet the objectives. We found the basic principles of rehabilitation 1 – Prevention of sensory deprivation. 2 – To promote active participation. 3 – Repeat with and without variation. 4 – Achieve an understanding of the utility. 5 – Fully motivation. 6 – “Force ” the process. 7 – Further development of the law cervicofacial cephalo-caudal. 8 – Keep in mind that integration precedes the subcortical cortical integration. 9 – to handle the facilitation-inhibition. 10-Be patient care and provide a sensitive and affectionate.

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