CEREBRAL

PALSY
 A group of
nonprogressive
disorders of upper motor
neuron impairment that
result in motor
dysfunction
 Cause is unknown
 Associated with a variety of contributory fx
brain anoxia → brain cell dysfunction
SGA
short pregnancy interval
delivery
kernicterus (athetoid)
infections
head injury
severe dehydration
 Pyramidal or Spastic

 Extrapyramidal
• Ataxic
• Dyskinetic or Athetoid
• Mixed
 hypertonic muscles
 abnormal clonus
 deep tendon reflexes
 abnormal reflexes
 neonatal reflexes present
 no “parachute reflex”
 “scissors gait”
 plantar flexion
 Abnormal involuntary movements
 Limp and flaccid
 Slow, writhing motions
 Poor tongue and swallowing movements
 Stress = irregular and jerking motions CHOROID
 Disordered muscle tone
 Awkward, wide-based gait
 Unable to perform finger-to-nose test
 Unable to do repetitive movements

Mixed
 Child shows symptoms of both spasticity and
athetoid movements
 Can be manifested at the same time
 History
 Physical exam
 Delayed motor deveopment
 Abnormal HC, posture,
reflexes
 Abnormal muscle tone and performance
 Neurologic assessment
 Cranial Xray / sonogram
 Negative CT scan
 Instruct parents
 Promote functions not affected
 Prevent further loss of function
 Self-care
 Communication
 Ambulation
 Education
 Safety
 Nutrition
 Self-esteem
 SEIZURE
DISORDERS
 CONVULSIONS
- involuntary contraction of muscle caused by
abnormal electrical brain discharges
- 50% unexplainable
neonates: 75% known cause
 Trauma and anoxia
 Metabolic disorders
 Neonatal infection
 Kernicterus
Cont..
Infants and toddlers: 50% identifiable cause
- Infantile spasms
- Burns itself out by age 2; developmental lag remains
- high doses of anticonvulsant medication
Children ↑ 3 y/o: idiopathic
- residual damage from a focal or diffuse brain injury
- consider brain tumor
 Partial (Focal) Seizures
 Simple partial – with motor/sensory signs
 Complex partial (psychomotor)
 Generalized Seizures
 Tonic-clonic
 Absence
 Atonic
 Myoclonic
 Infantile
 Seizures associated with high fever (38.9-40
degrees Celsius)
 Preschool/ b/w 5mo-5yrs (3mos-7yrs)
 Tonic-clonic
 Familial
 Subsides once temperature goes down
 highly preventable – TSB, ↑ fluids
 acetaminophen
 phenobarbital
 Remain calm
 Keep environment safe
 Prevent aspiration
 Ensure adequate supply of medication
 Status epilepticus - Oxygen