Cerebral palsy(CP) Paediatric

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Definition:

  Cerebral Palsy is a disorder that affects muscle tone, movement and motor skills (the ability to move in a coordinated and purposeful way)



Types of Cerebral Palsy:

  • Spastic Cerebral Palsy - causes stiffness and movement difficulties.
  • Athetoid Cerebral Palsy- leads to involuntary and uncontrolled movements
  • Ataxic Cerebral Palsy- disturbed sense of balance and depth perception
Causes:

Exact cause is unknown, but believed that Cerebral Palsy can be caused by 
  1. Problems occuring during🤰 pregnancy such as Infections, Maternal health problems, Genetic disorder, Something that interfered with normal 🧠 brain development
  2. Premature👶 babies - higher risk of cerebral palsy than babies 👶carried full term
  3. Bacterial meningitis
  4. Lead 🤮poisoning
  5. Trauma
  6. Birth asphyxia



Bacterial Meningitis 




Birth Asphyxia


Signs and symptoms:
  • Extreme irritability and crying
  • Feeding 🤱difficulties
  • Stiffness and rigid arms or legs
  • Delayed developmental milestones
  • Abnormal posturing
  • Persistence of primitive infantile reflexes after 6 months
  • Seizures





Diagnosis:
  1. Medical history and physical examination
  2. CT and MRI brain - to look for the cause of cerebral Palsy 
  3. Blood test for chromosomal studies

Blood Test

CT SCAN




Management:
  • No cure for Cerebral Palsy
  • But variety of resources and therapies can provide help and improves the quality of life for kids with Cerebral palsy
  • A multidisciplinary team approach is needed to meet the requirements of the child
  • Seizure medication - if the child has seizures
  • Medication for spasticity - Dantrolene sodium, diazepam, baclofen and botulinum toxin is injected to tight muscles to relax them.
  • Surgery for spasticity - done in severe form of muscle spasticity.eg : Tendon release procedures
  • Physical therapy - Helps in achieving balance and improved gait
  • Occupational therapy - Assists child with the skils needed for day - to - day life. Eg : eating, writing
  • Speech therapy - Helps to improve the quality and the quantity of speech production.
Nurse's Interventions:
  • The goal of management is early recognition and intervention to maximize the child's abilities.
  • Therapeutic management includes physical therapy, occupational therapy, speech therapy, education and recreation.
  • Assess the child's developmental level and intelligence.
  • Encourage early intervention and participation in school programs 
  • Encourage communication and interaction with the child on his or her developmental level rather than chronological age level 
  • Prepare for using mobilizing devices to help prevent or reduce deformities
  • Provide a safe environment for the child
  • Position the child upright after the meals
  • Administer medication as prescribed, to decrease spasticity.
  • Prepare for surgical intervention if needed.

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