CEREBRAL PALSY
Defined as any nonprogressive central motor deficit dating to
perinatal period
Etiology: #'s 1 & 2 most common
- Neonatal anoxia; often complicated by intraventricular or
subependymal hemorrhage
- Brain trauma (esp. for spastic hemiplegia)
- Cong. brain malfomation/cerebrovascular occlusion
- Kernicterus (causes choreoathetosis?)
- Chorioamnionitis (ass'd with OR of 3.81 after
adjustment for confounding factors in a case-control study; JAMA 290:2677,
2003--abst)
Px: check pos'n, voluntary movement, ROM of limbs
Classification (according to type of motor deficit)
- Spastic--most common; hyperreflexic, persistent neonatal
reflexes (inc. Babinski), "scissoring" of legs,
lordosis, ankle clonus, contractures of heel cord, leg
adductors, hip internal rotators
- Quadriplegia--us. also have pseudobulbar palsy and MR
- Diplegia--us. lower ext., sometimes upper; the form
most associated with low birthweight
- Paraplegia--only LE
- Hemiplegia--1 side; unilateral sensory deficit
- Extrapyramidal--hypotonic/dystonic; choreoathetoid
movements
- Atonic--us. MR, too; can become spastic
- Mixed