CEREBRAL PALSY


Defined as any nonprogressive central motor deficit dating to perinatal period

Etiology: #'s 1 & 2 most common

  1. Neonatal anoxia; often complicated by intraventricular or subependymal hemorrhage
  2. Brain trauma (esp. for spastic hemiplegia)
  3. Cong. brain malfomation/cerebrovascular occlusion
  4. Kernicterus (causes choreoathetosis?)
  5. 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)

  1. Spastic--most common; hyperreflexic, persistent neonatal reflexes (inc. Babinski), "scissoring" of legs, lordosis, ankle clonus, contractures of heel cord, leg adductors, hip internal rotators
  1. Quadriplegia--us. also have pseudobulbar palsy and MR
  2. Diplegia--us. lower ext., sometimes upper; the form most associated with low birthweight
  3. Paraplegia--only LE
  4. Hemiplegia--1 side; unilateral sensory deficit
  1. Extrapyramidal--hypotonic/dystonic; choreoathetoid movements
  2. Atonic--us. MR, too; can become spastic
  3. Mixed