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Cerebral Palsy - A Help Guide. Authors Nadire Berker and Selim Yalin 2003

Cerebral Palsy - A Help Guide. Authors Nadire Berker and Selim Yalin 2003

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CEREBRAL PALSY
CEREBRAL PALSY

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Published by: prasad616 on Mar 26, 2010
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Global-HELP Publication
CONTENTSPreface.....................................................................2Global-HELP ..........................................................2Contributors ...........................................................3Foreword .................................................................4
Introduction
General concepts .....................................................5Classification.........................................................10Associated problems .............................................12Physical examination & making the diagnosis .....15Gait ........................................................................26Prognosis & goals of management .......................32
Management
Principles...............................................................36Rehabilitation & physiotherapy ............................38Bracing ..................................................................47Mobility aids & assistive devices .........................52Orthopaedic surgery ..............................................58Anesthesia & chronic pain management ...............67
Spasticity
Pathophysiology ....................................................71Essentials of treatment ..........................................74Oral medications ...................................................76Botulinum toxin & neuromuscular blocks ............77Intrathecal baclofen ..............................................86Selective dorsal rhizotomy ....................................88
Types of CP
Hemiplegia ............................................................89Diplegia .................................................................97Quadriplegia ........................................................103Dyskinesia ...........................................................110Special situationsThe neglected child .......................................112The adult ......................................................115Management with limited resources .............118
Appendix
For families ........................................................119Resources ............................................................129
The HELP Guide to
Cerebral Palsy
Authors
Nadire BERKER Selim YALÇIN 
Consultants
Leon ROOT Lynn STAHELI 
Contributors
ntigone PAPAVASSILIOU Dhiren GANJWALAaren KOLOYAN Zeyn
 
 p ETI 
For more information about Global-HELP and other publications,visit our web site at global-help.org
Global-HELP Publication
Other Global-HELP PublicationsEnglish:
 
What Parents Should Know Bibliography of Orthopaedic Problemsin Developing CountriesPonseti: Clubfoot Management  Authors Guide to Producing HELP Publications
Turkish (by Drs. Berker & Yalçın):
 
Cerebral Palsy Spina BifidaParent’s Guide to Cerebral Palsy Parent’s Guide to Spina BifidaHip UltrasonographHuman Gait 
Publications in Development:
 
Management of PoliomyelitisManagement of TuberculosisPediatric OrthopedicsOsteomyelitisOrthotics
HealthEducationLow-costPublications
Global-HELP (GHO) is a not-for-profit, non-politi-cal, humanitarian organization that creates low-costpublications to improve the quality of health care intransitional and developing countries.Global-HELP’s objective is to create and distrib-ute publications using desktop computer technol-ogy, digital imaging, and electronic media. This newtechnology makes possible the production of low-cost books, brochures, pamphlets, and CDs that areaffordable to health care providers in countries withlimited resources.Cerebral palsy is one of the devastating disorders in medicine.This relatively common problem occurs in babies, lasts for alifetime and creates disability ranging from mild to severe. Thelesion cannot be cured but the consequences can be minimizedwith proper treatment.The past decades have witnessed a great deal of change andimprovement in the management of CP. Procedures have beenmodified to be more effective and at the same time minimizethe impact of therapy, bracing and surgery on the child’s life.However, this changing and increasing knowledge did notreach many parts of the world.This book aims to provide concise, up-to-date information onthe basic aspects and new approaches to treatment of muscu-loskeletal problems of children with CP. We hope that it will beuseful in the correction of problems that cause lifelong disabilityfor millions of children worldwide.
   T   h  e   H   E   L   P   G  u   i   d  e   t  o
   C  e  r  e   b  r  a   l   P  a   l  s  y
   B   E   R   K   E   R  -   Y   A   L   Ç   I   N
 
Contents ..................................................................1Preface.....................................................................2Global-HELP ..........................................................2Contributors ...........................................................3Foreword .................................................................4
Introduction
General concepts .....................................................5Classification.........................................................10Associated problems .............................................12Physical examination & making the diagnosis .....15Gait ........................................................................26Prognosis & goals of management .......................32
Management
Principles...............................................................36Rehabilitation & physiotherapy ............................38Bracing ..................................................................47Mobility aids & assistive devices .........................52Orthopaedic surgery ..............................................58Anesthesia & chronic pain management...............67
Spasticity
Pathophysiology ....................................................71Essentials of treatment ..........................................74Oral medications ...................................................76Botulinum toxin & neuromuscular blocks ............77Intrathecal baclofen ..............................................86Selective dorsal rhizotomy ....................................88
Types of CP
Hemiplegia ............................................................89Diplegia .................................................................97Quadriplegia ........................................................103Dyskinesia ...........................................................110Special situationsThe neglected child .......................................112The adult ......................................................115Management with limited resources .............118
Appendix
For families ........................................................119Resources ............................................................129
Authors
Nadire BERKER Selim YALÇIN 
Consultants
Leon ROOT Lynn STAHELI 
Contributors
 Antigone PAPAVASSILIODhiren GANJWALAGaren KOLOYAN Zeynep ETI 
The HELP Guide to
The HELP Guide to Cerebral Palsy
1
1
 
2The Story of the EMCPDM
The authors of this book were among thegroup of dedicated American Academyof Cerebral Palsy and DevelopmentalMedicine (AACPDM) memberswho felt the necessity to improve thequality of health care services urgentlyneeded by children with neuromuscular diseases in the Middle East. After longdiscussions on what to do, they plannedto start meetings to provide a regional platform for educating physicians and therapists. Drs. Berker and Yalçın shouldered the responsibility of the first meetingin Istanbul, performing the secretarial work, graphic design,and fund raising by themselves. With seed money donated bythe AACPDM, they organized a large meeting at which recentscientific advances in the area of childhood neuromuscular disability and CP were the main topics.The first Eastern Mediterranean Cerebral Palsy andDevelopmental Medicine meeting was held in 2002 in Istanbul.More than 300 participants from 18 countries were in attendance.For the 3-day congress in the most modern convention center in Turkey, registration fees were kept to a minimum of $100and free accommodation was provided to participants fromcountries with economical problems.
Preface
Drs. Nadire Berker and Selim Yalçın have created an excellent publication, providing an overview of the diagnosis andmanagement of cerebral palsy (CP). This publication isauthoritative, comprehensive, extensively illustrated, colorfuland engaging. The need for this publication is enormous, as CPis common throughout the world and no affordable managementguide has been available to date.The authors are highly qualified to produce this publication.Dr. Nadire Berker is professor of rehabilitation medicine atthe Marmara School of Medicine in Istanbul, Turkey. She hasextensive experience in managing the full spectrum of CP fromchildhood to adult life. Dr. Berker continues a family traditionin rehabilitation medicine that was started in the 1920s by her grandfather who established the specialty in Turkey, and wascontinued by her mother who headed the department for manyyears. Dr. Selim Yalcin is associate professor of orthopedicsat the same university. Dr. Yalcin is an accomplished clinicianwho specializes in pediatric orthopedics. He has broad clinicalexperience, and is a prolific author and producer.The authors have produced numerous books and videoson cerebral palsy, spina bifida, gait analysis, clubfoot, the useof ultrasonography in orthopedic management, and historicalaspects of medicine.They practice medicine in Istanbul, a city positioned at thecrossroads of the world. The economy of Turkey is midwayin the economic spectrum of nations of the world. Thisgeography and economic environment provides the authorswith an ideal vantage point from which to make managementrecommendations that are both practical and relevant for mostsocieties of the world.The authors recommend a balanced approach to management.This approach balances the medical, social, psychological andeducational needs of the child and family. The humanitarian,whole-child approach is evident throughout the publication.Global-HELP Organization is pleased to support
The HELP Guide to Cerebral Palsy
. Printed copies are available for thosein developing countries for only the cost of postage and indeveloped countries for a smallcharge. Please visit our website at www.global-help.org for details. The book is availablethrough our web site in pdf format; for non-commercialuse, it may be downloadedwithout charge.
 Lynn Staheli, MDSeattle, USA 2004
Preface
This is a Global-HELP publication. Visit our web site at global-help.orgThe faculty included renowned physicians and physio-therapists from the United States, Europe and the Middle East,most of whom volunteered to participate and donated their time and efforts. The success of the first meeting led to thenext in 2004 in Greece, which also was very successful. The2006 meeting will be held in Warsaw, Poland with the aim of covering Eastern Europe.The EMCPDM (www.turkortopedi.net/emcpdm.htm) became a wonderful opportunity for the physicians andtherapists of the region to get together, share knowledge andexperience, and discuss the latest developments. The group islooking forward to future meetings with proud anticipation.
EASTERN MEDITERRANEANCEREBRAL PALSY &DEVELOPMENTAL MEDICINECONGRESS

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