- Branch : Pediatrics .. - Title : Cerebral Palsy ..

1. SAWA'EDTEAM @RaedRayani
1
Cerebral Palsy ( CP )
# Outlines :
- DefinitionOf CerebralPalsy .
- Association .
- Etiology .
- ClinicalPresentation .
- Treatment .

2. SAWA'EDTEAM @RaedRayani
2
#Definition :
- Disorder Of Movement &Posture Due ToNon-Progressive Lesion In DevelopingBrain (UpTo 5 YearsOf Age ) .
# Note:
- The Lesion Is Not-Progressive ,But Clinical Manifestation Progress Over Time
( That Means As Age Increase , Developmental Skills Are Not Developed ) .
#Cerebral PalsyAssociated With :
- Learning Difficulties ( 50% ) .
- Epilepsy ( 35% ) .
- Squint ( 25% ) .
- Hearing Impairment ( 20% ) .
- Speech & Language Disorders .
- Behavior And Feeding Disorders .
- Hip Subluxation .
#Etiology :
- Ante-Natal Causes (80% ) .
- Intra-Partum Asphyxia ( 10% ) .
- Post-Natal Causes ( 10% ).
#Note:
- Reduce O2 Can Occurs Intrapartum And Intrauterine .

3. SAWA'EDTEAM @RaedRayani
3
#Clinical Presentation :
A- Physiological :
 Athetoid.
 Ataxia .
 Rigid-Spastic .
 Atonic .
 Mixed .
B- Topographic :
 Monoplegic .
 Paraplegic .
 Hemiplegic .
 Quadriplegic.
 Diplegic .

4. SAWA'EDTEAM @RaedRayani
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- Age Child < 3 Years Old .
- Hand Preference At Early Age .
- Characterized By Delay Walking , Circumductive Gait & Walking On Tiptoes (Due To Tone ) .
- MRI Is The Best Investigation .
- Lower Limbs Affected > Upper Limbs .
- Discovered When Child Begin To Crawl .
- Present With UMNL .
- Intellectual Development Is Good .
- Characterized By Diplegic Gait & Scissoring Posture .
- MRI Is The Best Investigation .
Spastic Hemiplegia
Spastic Diplegia

5. SAWA'EDTEAM @RaedRayani
5
- Most Severe Form .
- Child Is Mentally Retarded .
- Present With UMNL .
- Present With Seizures .
- Aspiration Pneumonia Is Common .
- Have Speech And Visual Abnormalities .
- Less Common Than Spastic .
- Initially Present With Hypotonia ,Then Change To Hypertonia & Rigidity .
- Have Speech And Feeding Problems .
- No UMNL .
- Intellectual Development Is Good .
- Could Be Due To Kernicterus Or Birth Asphyxia .
- Associated With Hypothalamus & Basal Ganglia Lesions .
- MRI Show Bilateral Lesion In Globus Pallidus .
- No Seizures .
- To Diagnose ThisType YouHaveTo Rule Out Progressive Disorders .
Spastic Quadriplegia
Athetoid CP

6. SAWA'EDTEAM @RaedRayani
6
#Treatment :
- Multidisciplinary Team Management .
- Call Specialists .
- Family Education .
- Rhizotomy Cutting Of Sensory Supply To Spastic Reflex.
- Drugs :
 Botulonium Toxins .
 Intrathecal Baclofen .
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