Palsi Serebral

Dr. Isyanto, SpA

COMPLICATIONS OF NEURODEVELOPMENTAL DISORDERS

Cognitive Dysfunction
Motor
Dysfunction

Seizures
Behavior
Dysfunction

Definisi
Suatu

keadaan kerusakan jaringan otak

menetap dan tidak progresif meskipun
gambaran klinisnya dapat berubah
selama hidup
Terjadi pada usia dini
Insidens 2-5 % kelahiran hidup & 2/1000
usia sekolah

Etiologi
1. Pranatal (70%)
Infeksi intrauterin
Anoksia intra uterin
Radiasi sinar X
keracunan

2. Perinatal (5-10%)
Hipoksia
Perdarahan otak
Prematuritas
Ikterus
Meningitis purulenta

3. Pasca natal
Trauma kapitis
Meningitis
ensefalitis

Cerebral Palsy: klasifikasi

fisiologi
Topograpi
Etiologi

Cerebral Palsy: Physiologi

Athetoid
Ataxic
Rigid-Spastic
Atonic
Mixed

Cerebral Palsy: Topographic

Monoplegic
Paraplegic
Hemiplegic
Triplegic
Quadraplegic
Diplegic

Cerebral Palsy: Etiologi

Prenatal

(70%)
Infection, anoxia, toxic, vascular, Rh
disease, genetic, congenital
malformation of brain
Natal (5-10%)
Anoxia, traumatic delivery, metabolic
Post natal
Trauma, infection, toxic

Cerebral palsy

Spastic Diplegia

Cerebral palsy

Spastic
Hemiplegi

Cerebral palsy

Spastic
Quadriplegia

Manifestasi Klinis
Spastisitas
Tonus

otot berubah
Koreo-atetosis
Ataksia
Gangguan pendengaran
Gangguan bicara
Gangguan mata

Diagnosis Banding
Proses

degeneratif
Higroma subdural
Arterio-vena malformation
Kerusakan medula spinalis
Tumor intra kranial

Pemeriksaan khusus
Pemeriksaan

mata & pendengaran

Pungsi lumbal
Pemeriksaan EEG
Pemeriksaan pencitraan kepala
Penilaian psikologis
Pemeriksaan metabolik

Cerebral Palsy: komplikasi

Spasticity
Weakness
Increase reflexes
Clonus
Seizures
Articulation &
Swallowing difficulty

Visual compromise
Deformation
Hip dislocation
Kyphoscoliosis
Constipation
Urinary tract infection

Cerebral Palsy: Management

Neurologic
OT

and Physiatric

and PT
Speech
Adaptive equipment
Surgical
Rhizotomy, Baclofen pumps, Botoxin