Cerebral palsy-clinical presentation

v.djabatey
Mind Map by v.djabatey, updated more than 1 year ago
v.djabatey
Created by v.djabatey about 6 years ago
68
1

Description

paeds-community paeds and psychiatry Mind Map on Cerebral palsy-clinical presentation, created by v.djabatey on 01/10/2014.

Resource summary

Cerebral palsy-clinical presentation
1 during neonatal period
1.1 babies IDed if at risk
2 early features
2.1 infancy
2.1.1 abnormal limb &/or trunk posture & tone
2.1.2 delayed developmental milestones
2.1.3 +/-slowing of head growth
2.2 feeding difficulties w/
2.2.1 oromotor incoordination
2.2.2 slow feeding
2.2.3 gagging
2.2.4 vomiting
2.3 abnormal gait once walking achieved
2.4 asymmetric hand function before 12 months old
3 persistence of primitive reflexes (pathological)
3.1 normal role of primitive reflexes
3.1.1 aid appearance of normal patterns of movement
3.1.2 to disappear for motor development to progress
4 diagnosis
4.1 by clinical exam w/ attn to
4.1.1 posture & pattern of tone in limbs & trunk
4.1.2 hand function
4.1.3 gait
5 3 main clinical subtypes
5.1 spastic
5.1.1 damage to upper motor neurone pathway
5.1.1.1 pyramidal/corticospinal tract
5.1.2 persistently increased limb tone (spasticity)
5.1.2.1 velocity dependent spastic tone
5.1.2.1.1 the faster muscle stretched, the greater resistance it'll have
5.1.2.1.1.1 -> dynamic catch
5.1.2.1.1.1.1 characteristic of spasticity
5.1.2.2 clasp knife
5.1.2.2.1 increased limb tone suddenly gives way under Pa
5.1.3 brisk deep tendon reflexes
5.1.4 extensor plantor responses (upgoing)
5.1.5 unilat or bilat limb involvement
5.1.6 early presentation
5.1.6.1 even as neonate
5.1.7 3 main types
5.1.7.1 hemiplegia
5.1.7.1.1 unilat arm & leg involvement
5.1.7.1.1.1 arm > leg affected
5.1.7.1.2 face spared
5.1.7.1.3 present @ 4-12 months old
5.1.7.1.3.1 fisting of affected hand
5.1.7.1.3.2 a flexed arm
5.1.7.1.3.3 asymmetric reaching/hand funcn
5.1.7.1.3.4 subseq tiptoe walk
5.1.7.1.3.4.1 toe-heel gait on affected side
5.1.7.1.4 initially affected limbs flaccid & hypotonic
5.1.7.1.4.1 increased tone then emerges as dominant sign
5.1.7.1.5 past med hx
5.1.7.1.5.1 normal
5.1.7.1.5.1.1 unremarkable birth hx
5.1.7.1.5.2 neontal stroke
5.1.7.1.5.2.1 can be the cause
5.1.7.1.6 hemianopia
5.1.7.1.6.1 ipsilat side as affected limbs
5.1.7.1.6.2 due to larger brain lesions (strokes)
5.1.7.2 quadriplegia
5.1.7.2.1 all 4 limbs affected
5.1.7.2.1.1 often severely
5.1.7.2.2 truncal involvement
5.1.7.2.2.1 tendency to opisothonus (extensor posturing)
5.1.7.2.2.2 poor head control
5.1.7.2.2.3 low central tone
5.1.7.2.3 more severe CP
5.1.7.2.4 assoc
5.1.7.2.4.1 microcephaly
5.1.7.2.4.2 seizures
5.1.7.2.4.3 moderate/severe intellectual impairment
5.1.7.2.5 hx of perinatal hypoxic-ischaemic encephalopathy
5.1.7.3 diplegia
5.1.7.3.1 all 4 limbs
5.1.7.3.1.1 legs>arms affected
5.1.7.3.1.1.1 relatively normal hand funcn
5.1.7.3.1.1.1.1 arm motor difficulties most visible on using hands
5.1.7.3.2 abnormal walking
5.1.7.3.3 assoc
5.1.7.3.3.1 preterm birth
5.1.7.3.3.1.1 periventricular brain damage
5.2 dyskinetic
5.2.1 movements
5.2.1.1 involuntary
5.2.1.2 uncontrolled
5.2.1.3 stereotyped (sometimes)
5.2.1.4 more evident w/ active movement or stress
5.2.2 variable muscle tone
5.2.3 primitive motor reflex patterns predominate
5.2.4 description
5.2.4.1 chorea
5.2.4.1.1 irreg, sudden & brief non-repetitive movements
5.2.4.2 athetosis
5.2.4.2.1 slow writhing movements occurring distally
5.2.4.2.1.1 e.g. fanning of fingers
5.2.4.3 dystonia
5.2.4.3.1 simultaneous contracn of agonist & antag truncal & prox mm
5.2.4.3.1.1 twisting appearance
5.2.5 relatively unimpaired intellect
5.2.6 presentation
5.2.6.1 infancy
5.2.6.1.1 floppiness
5.2.6.1.2 poor trunk control
5.2.6.1.3 delayed motor development
5.2.6.1.4 abnormal movements can show only toward end of 1st year of life
5.2.7 pathology
5.2.7.1 damage/dysfunction
5.2.7.1.1 basal ganglia
5.2.7.1.2 extrapyramidal pathways
5.2.8 cause
5.2.8.1 kernicterus (hyperbilirubinaemia)
5.2.8.1.1 commonest cause in past
5.2.8.1.2 due to Rh disease of newborn
5.2.8.2 hypoxic-ischaemic encephalopathy @ term
5.2.8.2.1 current commonest cause
5.3 ataxic (hypotonic)
5.3.1 cause
5.3.1.1 genetically determined
5.3.1.2 acquired brain injury to cerebellum or its connections
5.3.1.2.1 signs ipsilat to lesion
5.3.1.2.1.1 but rel symmetrical
5.3.2 early trunk & limb hypotonia
5.3.3 poor balance
5.3.4 delayed motor developments
5.3.5 features appearing later
5.3.5.1 incoordinate movements
5.3.5.2 intention tremor
5.3.5.3 ataxic gait
6 description of functional ability
6.1 Gross Motor Function Classification
6.1.1 Level I
6.1.1.1 walks w/o limitations
6.1.2 Level II
6.1.2.1 walks w/ limitations
6.1.3 Level III
6.1.3.1 walks using a handheld mobility device
6.1.4 Level IV
6.1.4.1 self-mobility w/ limitations; may use self-powered mobility
6.1.5 Level V
6.1.5.1 transported in a manual wheelchair
Show full summary Hide full summary

Similar

Cerebral palsy
v.djabatey
Abnormal motor development
v.djabatey
Developmental delay
v.djabatey
Learning difficulties
v.djabatey
Question Words - GCSE German
lucykatewarman1227
Developmental Psychology - Freud, Little Hans (1909)
Robyn Chamberlain
Sociology Key Words
kazoakley
An Inspector calls - Gerald Croft
Rattan Bhorjee
GCSE AQA Physics - Unit 2
James Jolliffe
GCSE AQA Chemistry - Unit 2
James Jolliffe
GCSE History – Social Impact of the Nazi State in 1945
Ben C