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Palsy
CEREBRAL
PALSY
is a group of nonprogressive
disorders of upper motor
neuron impairment that result
in motor dysfunction. Affected
children also may have
speech,ocular difficulties,
seizures, cognitive challenges
or hyperactivity.
1. PYRAMIDAL
OR SPASTIC
TYPE
2. EXTRAMIRAMIDAL
a. Dyskinetic or
Athetoid Type
-worm-like
-involuntary and uncoordinated motions without conscious
control, normal reflexes when in a relaxed state, upper
extremities often more involved
-lesion is in the basal ganglia
a. Ataxic type
a. Rigidity
Risk factors:
1Ante-natal
a. Congenital defects resulting from an arrested
development of the cerebrum and cyamidal tract
b. Maternal infections, disease (influenza, German
measles)
c. Excessive radiation
d. Nutritional deficiencies on the mother( Iron,
Calcium, Phosphorus)
e. Incompatibility
f. Thalidomide drugs during pregnancy
2. Natal
a. nerve cell injury ff
cerebral hemorrhage due
to trauma at
birth( forceps, breech
presentation)
b. anoxia of hyporix ff
winding of the umbilical
cord around the babys
neck
3. PostNatal
a.
oncephalitis
b. meningitis
c. brain
tumors
oxygen supply
anoxia
Cell destruction
Brain cell
dysfunction
Nervous System
Decreased intelligence or
learning disabilities are
common, but intelligence
can be normal
Speech problems (dysarthria)
Hearing or vision problems
Seizures
Pain, especially in adults
Diagnostic test
Brain scans
Brain-imaging technologies can reveal
areas of damage or abnormal
development in the brain. These tests
may include the following:
Magnetic resonance imaging
(MRI).An MRI uses radio waves and a
magnetic field to produce detailed 3-D
or cross-sectional images of your
child's brain. An MRI can often identify
any lesions or abnormalities in your
child's brain.
Electroencephalogram (EEG)
If your child has had seizures, your doctor
may order an electroencephalogram (EEG)
to determine if he or she has epilepsy.
Laboratory tests
Your child's blood may need to be checked
to rule out other conditions, such as bloodclotting disorders that can cause strokes,
which may mimic cerebral palsy signs and
symptoms. Laboratory tests may also
screen for genetic or metabolic problems.
MEDICAL
MANAGEMENT
Muscle relaxant (Diazepam)
Anticonvulsant
seizures(Phenytoin)
Behaviour disturbance and
hyperkinesias (Amphetamines)
Spasticity-( Intrathecal
Baclofen therapy)
Additional tests
If your child is diagnosed with
cerebral palsy, you'll likely be
referred to specialists for
assessments of other conditions
that are often associated with the
disorder. These tests may identify:
Vision impairment
Hearing impairment
Speech delays or impairments
Intellectual disabilities
Other developmental delays
Movement disorders
SURGICAL
MANAGEMENT
SURGICAL MANAGEMENT
To correct existing deformities
Atoffel operation- cutting the
nerves causing spasm
Osteotomy
Release of contracture
Arthrodesis
Lenghtening of Achilles Tendon
Nursing diagnosis
and Interventions
a. Risk for injury r/t spasms,
uncontrolled movements and seizures
1) avoid children from harmful objects, for
example can be dropped.
2) watch the children during activity.
3) give the kids a break when tired.
4) usesafety equipmentwhen necessary.
5) when a seizure;installa safety device in
the mouth so that the tongue is not bitten.
6) do suction.
7) the provision of anti-seizure in the event
of a seizure.